Family Health Strategy, private health care, and inequalities in access to mammography in Brazil

• Authors: Alves LS, Arcêncio RA, Arcoverde MAM, Berra TZ, Campoy L, Júnior JFM, Lapão LV, Palha PF, Popolin MP, Ramos ACV
• Publication Year: 2018
• Journal: Revista Panamericana de Salud Publica
• Link: https://scielosp.org/article/rpsp/2018.v42/e166/

Objective

To evaluate the association between access to mammography and coverage by private health insurance or by the public healthcare system through the Family Health Strategy (FHS).

Method

An ecological study was performed with data obtained from the Unified Health System Data Processing Department (DATASUS). Time trends were analyzed using the Prais-Winsten method, having the Brazilian federal units as units of analysis. Multiple linear regression was used to investigate the relationship between the dependent variable – women aged 50 to 69 years who never had a mammogram – and the independent variables (coverage by the FHS or private health care and socioeconomic aspects).

Results

Acre was the only Brazilian state for which an increasing growth trend in private health care was not observed. Roraima, Tocantins, Maranhão, Piauí, Rio Grande do Norte, and Paraíba showed a stable trend for FHS coverage, whereas all other federal units had increasing coverage. A significant association was observed between never having had a mammogram at 50 to 69 years of age and the variables mean per capita income and FHS and private health care coverage (R² = 0.77; P < 0.001).

Conclusion

Unequal access to mammography is a reality in Brazil. Both private health care and the FHS have contributed to improve health care accessibility for Brazilian women.