Water fluoridation in Brazilian cities at the first decade of the 21st century

Abstract

OBJECTIVE: To assess the coverage of the fluoridation of the public water supply in Brazilianmunicipalities at the first decade of the 21st century, according to population size and municipalhuman development index (MHDI).METHODS: We have used data produced by national information agencies and the UnitedNations 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 indicatorsof effect and total impact.RESULTS: We have obtained information for 5,558 municipalities. The coverage rate of waterfluoridation increased from 67.7% to 76.3%. Approximately 884 (15.9%) municipalities and29,600,000 inhabitants started being benefited by the measure. We have observed a significantexpansion in municipalities with < 10,000 inhabitants (increase of 21.0 percentage points) andlow or very low MHDI (17.7 percentage points).CONCLUSIONS: Population coverage of the public policy has increased 8.6%, and we canalso see significant reductions in absolute and relative inequality according to population sizeand MHDI. Regarding municipal coverage rate, there was also a reduction in inequality in allcomparisons except for absolute inequality between the categories of MHDI. The public policyhas operated as a factor of health protection in the context of the ongoing social protectionpolicies in the country.