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Racial inequalities in dental service utilisation: exploring individual and contextual determinants among a sample of middle-aged Brazilian adults

Mendes Constante, Helena; (2019) Racial inequalities in dental service utilisation: exploring individual and contextual determinants among a sample of middle-aged Brazilian adults. Doctoral thesis (Ph.D), UCL (University College London). Green open access

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Abstract

Dental service helps to alleviate and prevent pain and suffering and promote oral health. International evidence has shown that some racial/ethnic minority groups are less likely to use dental services compared to Whites. In Brazil, where individuals are classified according to their colour/race, researchers also observed colour/race inequalities in dental service, but evidence concerning this issue is scarce. Therefore, this thesis investigated the differences between Pardos (mixed) and Blacks compared to Whites in dental service utilisation in a national sample of 35 to 44-year-old Brazilian adults taking into consideration the role of individual-level and contextual-level characteristics. The final overall sample was 6,157 individuals nested in the 27 Brazilian State Capitals. Dependent variables were time since last dental visit, reason for the last dental visit, and type of service used. The main exploratory variable was self-reported colour/race (White, Pardo, or Black). Individual-level and contextual-level characteristics were considered covariates. The results showed that for the time since last dental visit, the individual-level characteristics fully explained the differences between groups. The same occurred for differences between Blacks and Whites for visits due to pain or extraction, and due to treatment. However, Pardos were 1.24 and 1.21 times more likely, respectively, to visit the dentist due to pain or extraction, and due to treatment compared to Whites even after the adjustment for individual and contextual-level covariates. Additionally, Pardos and Blacks were 1.24 and 1.69 times more likely, respectively, to visit the public dental service compared to Whites after the adjustment for all covariates. To conclude, colour/race differences in dental service utilisation were evident for middle-aged adults in Brazil. Individual-level characteristics, especially level of education and income, were more relevant to reduce differences compared to contextual-level characteristics, but these reductions were not sufficient to fully explain the inequalities observed for some of the investigated outcomes.

Type: Thesis (Doctoral)
Qualification: Ph.D
Title: Racial inequalities in dental service utilisation: exploring individual and contextual determinants among a sample of middle-aged Brazilian adults
Event: UCL (University College London)
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Copyright © The Author 2019. Original content in this thesis is licensed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) Licence (https://creativecommons.org/licenses/by/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > UCL SLASH
UCL > Provost and Vice Provost Offices > UCL SLASH > Faculty of S&HS
URI: https://discovery.ucl.ac.uk/id/eprint/10068257
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