Association between perceived discrimination in health services and oral health-related quality of life in older adults

Objective: To verify the association between perceived discrimination in health services and oral health-related quality of life (OHRQoL) in Brazilian older adults. Methods: In this cross-sectional study, it was analyzed the baseline data from the "Longitudinal Study of the Health of Elderly Brazilians" (ELSI-Brazil), which included a representative sample of individuals aged = 60 years. The dependent variable was the impact on OHRQoL, assessed using the Oral Impacts on Daily Performances (OIDP) questionnaire. The association between perceived discrimination and OHRQoL was verified using Poisson regression models adjusted for socioeconomic and demographic factors. Owing to the complexity of the sample, the sample weight was considered in all analyses. Results: Data from 5432 individuals were analyzed. In both the crude [rate ratio (RR): 1.92, 95% confidence interval (CI): 1.70-2.16] and adjusted analyses (RR: 1.85, 95% CI: 1.62-2.11), the mean impact on OHRQoL was higher in individuals who experienced discrimination in health services than in those who did not. Conclusion: The findings suggest that perceived discrimination in health services has a negative impact on OHRQoL in older adults. To combat intrinsic social behaviors, such as discrimination, it is essential to eliminate health inequities and to promote social justice. Clinical significance: Participation in health-related behaviors is paramount for promoting health and preventing oral diseases. However, discrimination may erode an individual's protective resources and increase vulnerability to disease onset. Therefore, perceived discrimination may potentially decrease participation in healthy behaviors, leading to worse oral health outcomes.