Abstract
ABSTRACTOBJECTIVE To assess the coverage of the fluoridation of the public water supply in Brazilian municipalities at the first decade of the 21st century, according to population size and municipal human development index (MHDI).METHODS We have used data produced by national information agencies and the United Nations Development Programme. Population size was separated into < 10,000, 10,000–50,000, and > 50,000 inhabitants. The MHDI was classified into < 0.600, 0.600–0.699, 0.700–0.799, and > 0.799. Absolute and relative inequalities between categories were evaluated using indicators of effect and total impact.RESULTS We have obtained information for 5,558 municipalities. The coverage rate of water fluoridation increased from 67.7% to 76.3%. Approximately 884 (15.9%) municipalities and 29,600,000 inhabitants started being benefited by the measure. We have observed a significant expansion in municipalities with < 10,000 inhabitants (increase of 21.0 percentage points) and low or very low MHDI (17.7 percentage points).CONCLUSIONS Population coverage of the public policy has increased 8.6%, and we can also see significant reductions in absolute and relative inequality according to population size and MHDI. Regarding municipal coverage rate, there was also a reduction in inequality in all comparisons except for absolute inequality between the categories of MHDI. The public policy has operated as a factor of health protection in the context of the ongoing social protection policies in the country.
Highlights
Environmental conditions, notably the sanitation conditions, are a particular dimension of the development
The coverage rate of water fluoridation increased from 67.7% to 76.3%
We have observed a significant expansion in municipalities with < 10,000 inhabitants and low or very low municipal human development index (MHDI) (17.7 percentage points)
Summary
Environmental conditions, notably the sanitation conditions, are a particular dimension of the development. The Human Development Index (HDI), a composite indicator used to scale the degree of human development, assigns weight to the dimensions of education, per capita income, and life expectancy. The impact of sanitation conditions on human development is captured only indirectly, insofar as such conditions may increase or reduce the risk of premature mortality by waterborne diseases and, the values of life expectancy. References to the importance of sanitation for development and references to water are recurrent, recognized as one of the most significant determinants of health levels. Of special interest to public health, impacts the health of individuals and populations, both because it is essential to life, operating as a factor in health protection, and because it is a vehicle for a variety of microorganisms and, constitutes an important health risk factor[5]. Systematic review studies have confirmed the effectiveness of preventive intervention[6,16]
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