Association between socioeconomic context and getting preventive screenings among Brazilian women aged 50 years and older

Abstract

ABSTRACT Objective: To evaluate the association between contextual socioeconomic conditions and indicators of health service use among women aged 50 years or older, according to source of care (Brazilian Unified Health System-SUS vs. private health insurance). Methods: A cross-sectional study was conducted using baseline data from the Brazilian Longitudinal Study of Aging (2015-2016), a nationally representative survey of the population aged 50 years and older. The following indicators of health service use were analyzed: mammogram, Pap smear, measurements of cholesterol, blood glucose, and blood pressure. Contextual socioeconomic condition was assessed using the Brazilian Deprivation Index (Índice Brasileiro de Privação - IBP). Crude and adjusted multilevel logistic models were fitted after significant between-census-tract variability was confirmed. Results: The sample included 5,314 women, 54.2% of whom were aged 60 years or older. A socioeconomic gradient was observed in blood glucose and cholesterol testing, with lower odds of undergoing these tests among women living in areas of greater deprivation. This pattern was observed among both SUS users and private health insurance beneficiaries (blood glucose: OR 0.82, 95%CI 0.69-0.96 and OR 0.91, 95%CI 0.87-0.96; cholesterol: OR 0.71, 95%CI 0.59-0.87 and OR 0.89, 95%CI 0.85-0.95, respectively). Conclusion: The findings highlight socioeconomic inequities in cholesterol and blood glucose testing among women aged 50 years or older, particularly among SUS users living in areas with higher levels of deprivation. These results reinforce the need for public policies aimed at reducing socioeconomic inequities in healthcare utilization among women.