Socioeconomic Inequality |
Refers to the way and intensity with which socioeconomic inequalities influence access to health services. Income concentration and poverty are key factors for understanding the dynamics of health inequalities in this dimension1818 Viacava F, Oliveira RAD, Carvalho CC, Laguardia J, Bellido JG. SUS: supply, access to and use of health services over the last 30 years. Cien Saude Colet 2018; 23(6):1751-1762.,2424 Comissão Econômica para a América Latina e o Caribe (CEPAL). Panorama Social da América Latina e do Caribe [Internet]. 2022. [acessado 2023 fev 7]. Disponível em: https://repositorio.cepal.org/bitstream/handle/11362/48609/S2200949_pt.pdf?sequence=5&isAllowed=y https://repositorio.cepal.org/bitstream/...
,2626 Monteiro CA, Benicio MHD, Conde WL, Konno SC, Lima ALL, Barros AJD, Victora CG. Desigualdades socioeconômicas na baixa estatura infantil: a experiência brasileira, 1974-2007. Estud Av 2013; 27(78):35-49.. |
Cross-sectional to other dimensions of inequalities. Associations between socioeconomic inequality and difficulty in accessing PHC, oral health, and women’s health services stand out - notably more deficient among vulnerable populations. Several articles address restricted access to healthcare for immigrants, Black, riverine, and Indigenous populations. |
Main access barriers identified: socioeconomic, geographic, services’ availability, and cultural. Main conditioning factors: income and schooling, showing the relationship between lower education and worse socioeconomic status. |
Geospatial Inequality |
It concerns the way and frequency in which geospatial inequalities influence access to health services. Aspects such as inequalities in the distribution of health services in the territory stand out2727 De Pietri D, Dietrich P, Mayo P, Carcagno A, De Titto E. Indicadores de accesibilidad geográfica a los centros de atención primaria para la gestión de inequidades. Rev Panam Salud Publica 2013; 34(6):452-460.,2828 Aguilera SL, França BH, Moysés ST, Moysés SJ. Intermunicipal inequities in access and use of secondary health services in the metropolitan area of Curitiba. Rev Bras Epidemiol 2014; 17(3):654-667.. |
Strong association between geospatial and socioeconomic inequalities and moderate association with ethnic/racial and gender inequality. The inequalities in access to health between urban and remote/rural areas and the travel time to access health units stand out. Some articles focus on specific health actions and services, such as specialized care. |
Main access barriers identified: geographic, socioeconomic, and services’ availability. Main conditioning factors: Transportation and housing, with significant expression of income and schooling. |
Gender Inequality |
Related to the way and intensity with which gender inequalities influence access to health services1919 Comissão Econômica Para a América Latina (CEPAL). Panorama Social da América Latina [Internet]. 2018. [acessado 2022 jan 14]. Disponível em: https://repositorio.cepal.org/bitstream/handle/11362/44412/1/S1801085_pt.pdf https://repositorio.cepal.org/bitstream/...
,2929 Aqui estão os nomes organizados de acordo com a norma Vancouver e separados por vírgulas:. |
Strong association between gender and socioeconomic inequalities in most of the articles reviewed. Significant association between this dimension and ethnic/racial and geospatial inequalities. The inequalities in access between men and women, among women living in urban and rural areas, and the barriers faced by immigrant, Indigenous, and women deprived of liberty stand out. |
Main access barriers identified: socioeconomic cultural, services’ availability, and geographic. Main conditioning factors: income and schooling. |
Ethnic/racial Inequality |
It expresses how race/ethnicity issues influence access to health services3030 Martínez HLH, Artmann E, Nascimento M. Desvendando barreiras de gênero no acesso de adolescentes à informação sobre saúde sexual e reprodutiva na Venezuela. Cad Saude Publica 2020; 36(4):e00193918.. |
Strong association between ethnic/racial and socioeconomic inequalities. Moderate association with geospatial and gender inequality. Studies that address access difficulties for original and racialized populations in Latin America and immigrants stand out. Some articles focus on how communication problems and cultural issues prevent access to health services. |
Main access barriers identified: socioeconomic de services’ availability, and cultural. Highlighting the cultural barrier, rarely mentioned in other dimensions. Main conditioning factors: income and schooling. |
Inequalities in People with Disabilities |
Gathers studies that address the inequalities faced by people with disabilities in accessing health services3333 Lages RB, Oliveira GP, Simeão Filho VM, Nogueira FM, Teles JBM, Vieira SC. Desigualdades associadas à não realização de mamografia na zona urbana de Teresina-Piauí-Brasil, 2010-2011. Rev Bras Epidemiol 2012; 15(4):737-747.
34 World Health Organization (WHO). Global report on health equity for persons with disabilities [Internet]. 2022. [cited 2023 fev 5]. Available from: https://apps.who.int/iris/handle/10665/364834 https://apps.who.int/iris/handle/10665/3...
-3535 Banco Mundial. Inclusão das pessoas com deficiência na américa latina e no Caribe: um caminho para o desenvolvimento sustentável [Internet]. 2021. [acessado 2023 fev 26. Disponível em: https://documents1.worldbank.org/curated/en/099140012012113013/pdf/P1753830ce0fdc022096580be345ee9f027.pdf https://documents1.worldbank.org/curated...
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Strong association with socioeconomic inequalities and moderate association with geospatial and gender inequalities. Articles focusing on the difficulties in accessing mental health care, oral health, cervical-uterine cancer prevention and child care stand out for people with disabilities. |
Main access barriers identified: socioeconomic, services’ availability, architectural, acceptability and cultural barriers. Main conditioning factors: income and schooling, highlighting the importance of improving accessibility in schools. |