The Role of Public Oral Health Services and Socioeconomic Factors in Oral Cancer Mortality in Brazil

Abstract

Objective

To assess the relationship between socioeconomic factors and the provision of oral health services in Primary Healthcare with mortality due to oral cancer in Brazil.

Methods

This ecological study was conducted across 1105 Brazilian municipalities, encompassing 11,412 oral health teams (OHTs). The outcome variable was the oral cancer mortality rate, standardized by age and sex. Socioeconomic factors and variables related to the oral health services provided by municipal OHTs were considered explanatory variables. We employed multilevel Poisson regression models with random effects at the municipal level to assess the association between oral cancer mortality rates and explanatory variables.

Results

At the municipal level, oral cancer mortality was negatively associated with higher human and social development and greater income inequality but positively linked to higher rates of population aging and greater coverage of primary and oral healthcare services. At the OHT level, mortality reduction was observed among those who received specialized support and had greater availability of consultations. Active case-finding for cancerous lesions and care monitoring were also linked to lower mortality. Conversely, the identification of high-risk vulnerable patients by these teams was associated with higher mortality.

Conclusion

This study suggests that oral cancer mortality in Brazilian municipalities is influenced by socioeconomic factors and the availability of oral health services.