Factors associated with the use of health services by elderly men in Brazil: a cross-sectional study.

BACKGROUND: Studies have shown that older men use health services less frequently than women do. However, there has been little scientific research on this subject, making it necessary to investigate the influence of various factors on the profile of health service use by this population. This study aims to analyze both the profile of health service utilization by elderly Brazilian men and associated factors. METHOD: A population-based cross-sectional study with a secondary database from the National Health Survey (2013) were used. A total of 10,536 male individuals aged 60 years or over were included. The dependent variable was composed of the research questions related to the Use of Health Services, grouped and categorized through the Latent Class Analysis. The independent variables were the factors of predisposition, capacity and health need, organized according to a theoretical model. The association measures were performed by the Rao-Scott test and those of effect by simple and multiple models of multinomial logistic regression. The level of significance was 5%. RESULTS: The use of health services was marked by the predominance of sporadic medical appointments in the year previous to the study. It was observed that elderly men from the North, Northeast and Midwest regions, those who were illiterate, those without private health insurance, those who had been diagnosed as having a disease, those with functional difficulties and those with a perception of their health status as very poor had been reluctant to use health services of medium and high complexity in the previous 2 weeks, or accept hospitalization. In the previous year, they had consulted their doctor only sporadically. CONCLUSION: It was noted that unfavorable social issues affected the profile of health service utilization and that the health care of the elderly Brazilian man is centered on the disease and on curative and rehabilitative attention. In this context, intra- and inter-sectorial policies and actions should encourage early contact of the elderly male population with the health services, especially Primary Care services.

Can evidence drive health equity in the COVID-19 pandemic and beyond?

Using scoping review methods, we systematically searched multiple online databases for publications in the first year of the pandemic that proposed pragmatic population or health system-level solutions to health inequities. We found 77 publications with proposed solutions to pandemic-related health inequities. Most were commentaries, letters, or editorials from the USA, offering untested solutions, and no robust evidence on effectiveness. Some of the proposed solutions could unintentionally exacerbate health inequities. We call on health policymakers to co-create, co-design, and co-produce equity-focussed, evidence-based interventions with communities, focussing on those most at risk to protect the population as a whole. Epidemiologists collaborating with people from other relevant disciplines may provide methodological expertise for these processes. As epidemiologists, we must interrogate our own methods to avoid propagating any unscientific biases we may hold. Epidemiology must be used to address, and never exacerbate, health inequities-in the pandemic and beyond.

Association of traumatic dental injuries with individual-, sociodemographic- and school-related factors among schoolchildren in midwest Brazil.

The objective of this study was to assess the association of untreated traumatic dental injuries (TDI) with individual-, sociodemographic- and school-related factors among 12-year-old schoolchildren in Midwest Brazil. This cross-sectional study was carried out in 2010 in the city of Goiania, Brazil. A random sample of 2075 schoolchildren was examined and interviewed. Untreated TDI in the permanent incisors was assessed using the methodology of the Brazilian National Oral Health Survey. Rao-Scott test and multinomial logistic regression were used to analyze the associations between independent variables and three categories of TDI, using a hierarchical method. Independent variables were children's sex, self rated color/race and size of incisal overjet, their mother's level of schooling, and the schools' type and geographic location. The prevalence of trauma was 17.3% (CI 95% = 15.2-19.4); enamel fractures were the most common TDI (13.1%). In the adjusted model, a higher chance of having two or more teeth with TDI was found among boys, those whose mothers had lowest level of schooling, and those attending schools located in health districts with lower socioeconomic indicators. It was concluded that the prevalence of TDI was low and that it was associated with individual factors as well as the school environments.