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Abstract: Objective: Advances in geospatial technologies have recognized the role of geographic distance as a barrier to healthcare accessibility. Frequent transportation is supposed to buffer issues with distance, while infrequent services impede the uptake of care. The role of public transportation on the accessibility of health care—including oral health care—is not well elucidated in the context of megacities, such as the municipality of São Paulo, Brazil. This study aimed to compare the supply of public transportation to primary dental clinics and the population between advantaged and disadvantaged areas in São Paulo city. Methods: A total of 4101 primary dental clinics in São Paulo city were identified and geocoded. Geographic coordinates were also retrieved for the 19 242 bus stops, 56 commuter rail stations and 64 rapid transit stations. Clinic locations and transport points were integrated with the city's 19 128 constituent census tracts—each containing sociodemographic data on the 11 252 204 residents—using Geographic Information Systems (GIS). Results: Almost all clinics were located within 0.5 km of public transportation. Half of all clinics were within 0.5 km of high‐frequency transport points, and three‐quarters were within 1 km. Likewise, 99% of the population resided within 0.5 km of any public transportation. However, only 22% were within 0.5 km of high‐frequency options, and half were within 1 km. Those within 0.5 km of high‐frequency points had higher average monthly household incomes and lower illiteracy rates, with lower proportions of children and ethnic minorities, and higher proportions of older people. Conclusion: Clinics and populations in sociodemographically disadvantaged tracts have poorer public transportation links in São Paulo city. [ABSTRACT FROM AUTHOR]

Objective: To calculate and map the health inequalities in the city of São Paulo using the Urban Health Index (UHI) methodology., Methods: Seven indicators were selected from the Brazilian census: (1) proportion of households with access to sewage systems, (2) proportion of households served by regular waste collection, (3) proportion of households with two or more toilets, (4) proportion of households receiving tap water, (5) average income per household, (6) percentage of white people, and (7) literacy rate. Based on the UHI methodology, all health indicators were standardized and aggregated into a single metric at the census tract level. The UHI scores were ranked and plotted. The disparity ratio and the graph slope were calculated. The correlation between indicators was tested. Results were geocoded to produce a map of health risks., Results: The distribution of index values showed a linear middle section and deviations at each end. The disparity ratio found was 2.95, while the slope was 0.30. All indicators were significantly correlated. The map displayed a typical pattern of health inequality between the downtown and the periphery. The tracts located in the city's downtown had higher UHI values than those on the outskirts., Conclusions: The results of this study presented a visual distribution of health disparities in the city of São Paulo, proving to be a valuable method for identifying areas that require public health attention.

Objectives: Brazil is one of the largest countries in the world, in terms of geography and population. Most Brazilians reside in the south and south-eastern regions, with notable numbers in the regions' megacities, such as São Paulo city. Healthcare provision in such a complex environment is difficult. Thus, a clear understanding of the distribution - or rather, the maldistribution - of these services is fundamental for optimising the allocation of human and financial resources to areas of greatest privation. The present study aimed to determine the distribution of primary dental clinics in São Paulo city., Methods: A total of 4,101 primary dental clinics in São Paulo city were identified and geocoded. Clinic locations were integrated with the city's 19,128 constituent census tracts - each containing sociodemographic data for the 11,252,204 residents - using Geographic Information Systems (GIS)., Results: Approximately two-thirds (64.8%) of the population resided within 0.5 km of a primary dental clinic, and a further 23.9% were within 1 km. Populations more than 1 km out were typically characterised as sociodemographically disadvantaged. Primary dental clinics were also more sparsely distributed in the city's peripheral census tracts than central census tracts., Conclusion: Primary dental clinics are maldistributed in São Paulo city, with disadvantaged populations having less spatial access than their advantaged counterparts., (© 2017 FDI World Dental Federation.)