Family vulnerability to support the organization of demand for public dental health service

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Abstract The objective of this study is to analyze vulnerability/family risk instruments with socio-demographic and dental care factors, and to approach spatially the instrument. This was a cross-sectional study carried out in 2017 that included 114 families from Ubirajara, Sao Paulo, Brazil. The dependent variable was vulnerability/family risk instruments proposed by Coelho and Savassi, classified as “no risk” and “presence of risk”. The independent factors were selected based on theoretical model of access concept proposed by Andersen and organized into three hierarchical blocks: predisposing factors, facilitators and perceived needs. We conducted a bivariate analysis and estimated hierarchical logistic regression model, which was adjusted and evaluated using the Akaike's information criterion (AICC), remaining in the final model a p ≤ 0.05. The Kernel density estimation was used for spatial analysis of concentration of families. In bivariate analysis, vulnerability/family risk was associated with less years of formal education (OR = 2,42; 1.13-5.19), household with more than 4 individuals (OR = 3.25; 1.47-7.20), lower family income (OR = 2.53; 1.04-6.13), dissatisfaction with oral health (OR = 3.18; 1.45-6.98), shame to smile and to speak (OR = 4.08; 1.52-10.94) and inability to sleep (OR = 2.90; 1.10-7.60). Household with more than 4 individuals (OR = 3.46; 4.66-8.16), individuals who were unsatisfied with oral health (OR = 2.38; 1.00-5.67), and who had shame to smile and to speak (OR = 3.03; 1.01-9.13) had more chance of “familial risk”. Spatial analysis enabled to observe great concentration area “familial risk”, which indicated that this area has priority for development of actions. The association of the analyzed instrument, by including socio-demographic and dental care factors, in addition to help to observe and determine the most vulnerable areas, also helped us to conclude that such instrument may be adopted by oral health care teams in order to promote high equity access Key messages Help to observe and determine the most vulnerable areas. The instrument may be adopted by oral health care teams in order to promote high equity access.