IMPLEMENTATION OF ORAL HEALTH TEAMS IN BRAZIL (2002–2020): ASSOCIATION WITH SOCIOECONOMIC INDICATORS

Abstract

The aim of this study was to analyze the implementation of Oral Health Teams (eSB), types I and II, in Brazilian states, in relation to the Human Development Index (HDI), the Gini coefficient, and population size, from 2002 to 2020. This is an ecological, retrospective, and longitudinal study using secondary data, collected from de Humam Development Atlas in Brazil, IBGE and e-Gestor AB database. A descriptive spatial analysis was conducted, and to investigate the association with socioeconomic indicators, linear mixed-effects models with random effects were fitted. Analyses were performed using R software, with the lme4 and lmerTest packages, adopting a 5% significance level. Type I teams showed significant growth over the study period, while type II expanded more modestly. Only the association between type I teams and HDI was statistically significant (β = 6.44; p = 0.0359), indicating that a one-unit increase in HDI is associated with a 6.44-unit increase in the coverage rate of type I teams, controlling for state and year-level variation. The South and Southeast regions predominantly showed combinations of high HDI with medium or high coverage of type I eSB, suggesting a positive association between human development levels and service availability. In the Northeast, although most states had low HDI, some such as Maranhão and Piauí showed high eSB coverage, suggesting the presence of compensatory policies. In the North, low HDI combined with low or medium eSB coverage was predominant, reflecting greater challenges in terms of development and access to oral health services. The study reinforces the expansion of oral health services under the National Oral Health Policy and highlights the need to promote equity in service provision, especially in vulnerable contexts.