Abstract
Objective: To explore factors associated with social discrimination against users of health services regarding dental aesthetic conditions. Methods: Based on a Brazilian National Survey, multivariate Poisson regressions with robust variance were used to explore the association of outcome discrimination related to different motivations in health services and exposure to sociodemographic and dental variables. Effect modification by complete prosthesis wearing was assessed. Results: Among the 60,200 people interviewed, 11.5% reported being discriminated against in health services. For women, a higher prevalence of discrimination was found among those in the age group of 30–44 years. For both sexes, discrimination was associated with black and brown skin color. Regarding dental characteristics, the higher the tooth loss was, the higher the prevalence of discrimination; however, complete prosthesis wearing presented as a protective factor. Social discrimination was the major motivation for reported discrimination and presented higher prevalence in edentulous individuals who did not wear prosthesis. Conclusion: Dental loss may lead to self-reported discrimination in health care services. The prevalence of discrimination increases when tooth loss increases, and the major reason associated is social discrimination.
Highlights
Worldwide, people face multiple forms of discrimination and prejudice, and the discrimination users of public healthcare services have been facing recently represents an important concern [1, 2]
The research question of the present study is the following: Are patients’ dental aesthetic conditions, such as lack of teeth and use of a prosthesis, possibly associated with social discrimination in healthcare services? This research question was enriched by another question: Do patient characteristics, such as sex, social vulnerability and age, motivate discrimination in a health services? To investigate these issues, the present study aims to analyze social discrimination in terms of the motivation perceived by users of health services in Brazil regarding dental aesthetic conditions
All sociodemographic variables and dental characteristics are significantly associated with discrimination in health services (p < 0.001) (Table 1)
Summary
People face multiple forms of discrimination and prejudice, and the discrimination users of public healthcare services have been facing recently represents an important concern [1, 2]. This phenomenon can be understood as exposure to a social experience that leads a person to sense a discriminatory effect and face stressor conditions [1]. Social discrimination may be a trigger point for judgment through stereotyping, leading to individualization, prejudice and segregation [1] These factors are important concerns to be analyzed, for individuals who are already vulnerable, such as dependent older persons and those who need healthcare [2,3,4].
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