Epidemiology and Health

Original Articles

Deprived areas and community water fluoridation in Brazil: a multilevel approach for refocusing public policy: Franklin Barbosa da Silva, José Leopoldo Ferreira Antunes, Paulo Frazão; Epidemiol Health. 2021;43:e2021031. Published online May 1, 2021; DOI: https://doi.org/10.4178/epih.e2021031

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Abstract Summary PDF: Abstract
OBJECTIVES
The aim of this study was to determine whether geographic location, socioeconomic status, infant mortality, and mortality from diarrheal disease in health regions are associated with the provision of community water fluoridation (CWF) in Brazilian municipalities.
METHODS
A multilevel ecological study was conducted based on data from the National Survey of Basic Sanitation and Human Development Atlas. A multilevel analysis was carried out considering Brazilian municipalities as the first level and health regions as the second level, comprising sanitation, demographic, socioeconomic, and health characteristics.
RESULTS
The observation units comprised 5,565 municipalities clustered in 438 health regions in Brazil. The lack of CWF provision was positively associated with the following municipal characteristics: a below-median proportion of inhabitants covered by the sewage network, medium to very low human development index, below-median per capita gross domestic product, and an above-median percentage of expenditures on sanitation. In relation to the health regions, the likelihood of a lack of CWF provision was greater in the municipalities belonging to the health regions located in the Northern and Northeastern areas of Brazil and in those where child mortality due to acute diarrheal disease and the proportion of people with low income were higher when adjusted by municipal indicators.
CONCLUSIONS
Information on the characteristics associated with CWF provision constitutes important input for refocusing public policy to reduce inequalities among Brazilian municipalities and health regions. These findings may help policy-makers to understand the challenges facing CWF expansion in low-, middle-, and high-income countries.; Summary

Key Message
Just as the challenges for CWF's expansion in Brazil's most vulnerable areas require firm leadership for refocusing public policy, expansion in low- and middle-income countries demands a continued global collaborative effort.

Epidemiologic Transition of Communicable Diseases in Korea: Academia's Contributions to the National Communicable Disease Prevention and Control Programs.: Joung Soon Kim, Hae Kwan Cheong; Korean J Epidemiol. 2006;28(1):4-21.

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Abstract PDF: Abstract
This paper describes the transition of communicable diseases in Korea since 1970s. Some of Korean's general living background and health indicators are introduced, followed by trends in the changes during the last several decades in socioeconomic, demographic, and living environmental status, which are closely associated with the transition of communicable diseases. The current incidence of classified, notifiable disease, the incidence by year, and the transition of communicable diseases are presented. Governmental responses to prevent and control communicable diseases, including both emerging and re-emerging infectious diseases, which have become recognized as having public health importance are described. Finally, the role played by academia during the last several decades in the successful control of communicable diseases is analyzed.; Summary

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