Vulnerability of female dentists to workplace violence – Nature

Report on Workplace Violence Against Female Dentists and Alignment with Sustainable Development Goals (SDGs)

Executive Summary

A cross-sectional study of 165 female dentists in São Paulo, Brazil, reveals that workplace violence is a significant occupational hazard, directly impeding progress on several Sustainable Development Goals (SDGs). Approximately 62.4% of respondents have experienced violence, primarily verbal and psychological abuse. This issue critically intersects with SDG 3 (Good Health and Well-being), SDG 5 (Gender Equality), SDG 8 (Decent Work and Economic Growth), and SDG 16 (Peace, Justice, and Strong Institutions). Key predictors of violence—intimidation and stalking—highlight systemic failures in ensuring safe work environments. The findings underscore the urgent need for protective strategies, institutional support, and accessible mental health resources to safeguard female healthcare professionals and advance the global development agenda.

Introduction: A Public Health and Sustainable Development Issue

Violence against women in the workplace, particularly in healthcare, is a persistent public health crisis that undermines fundamental principles of sustainable development. This report analyzes the vulnerability of female dentists to workplace violence, framing the issue within the context of the SDGs. The prevalence of such violence directly contravenes:

• SDG 3 (Good Health and Well-being): By inflicting physical and psychological trauma on essential healthcare workers.
• SDG 5 (Gender Equality): As it constitutes a form of gender-based violence that limits women’s full and effective participation in the workforce.
• SDG 8 (Decent Work and Economic Growth): By creating unsafe and insecure working conditions that hinder productivity and professional stability.

The study investigates the conditions contributing to this vulnerability and proposes strategies aligned with SDG targets to foster a safer, more equitable work environment in the dental profession.

Methodology Overview

This observational, cross-sectional study was conducted with a sample of 165 female dentists in São Paulo, Brazil. Data was collected via a structured, anonymous digital questionnaire focusing on demographic, professional, and exposure-related variables. Logistic regression models were used to analyze the data and identify significant predictors of violence, with a focus on generating evidence to inform policies that support the SDGs.

Key Findings and SDG Implications

The study’s results reveal an alarming rate of violence and identify critical risk factors, each with direct implications for the SDGs.

1. High Prevalence of Violence: 62.4% of respondents reported experiencing some form of violence. This finding highlights a failure to protect female workers, undermining SDG 8 (Target 8.8), which calls for protecting labor rights and promoting safe and secure working environments for all workers, especially women.
2. Mental Health Impact: Of the 28% of victims who sought help, 46.8% required psychological treatment. This underscores the severe mental health toll of workplace violence, directly impacting SDG 3 (Target 3.4) on promoting mental health and well-being. Less experienced professionals were significantly more likely to require psychological support, indicating a particular vulnerability among new entrants to the workforce.
3. Predictors of Violence:
   • Feeling intimidated increased the likelihood of violence by 16-fold.
   • A history of being stalked by patients or their companions increased the likelihood of violence by 3-fold.

   These predictors point to a pattern of harassment and aggression that must be addressed to achieve SDG 5 (Target 5.2), which aims to eliminate all forms of violence against all women and girls in the public and private spheres.

4. Work Environment Risks: Higher rates of violence were noted among dentists in public healthcare services. This suggests systemic vulnerabilities in public institutions, signaling a need for stronger institutional frameworks as advocated by SDG 16 (Peace, Justice, and Strong Institutions).

Discussion: Addressing Violence Through an SDG Framework

The strong correlation between stalking, intimidation, and subsequent violence demands a proactive, systemic response. Stalking, a criminal offense in Brazil and other nations, was reported by 50.3% of the dentists, with 75% of those stalked later experiencing violence. This connection establishes stalking as a critical red flag and an early form of psychological violence that contravenes the principles of SDG 16, which seeks to significantly reduce all forms of violence.

The feeling of intimidation, which increased the risk of violence sixteenfold, represents a direct assault on a professional’s sense of security and well-being, compromising the goal of decent work (SDG 8). These experiences are not isolated incidents but symptoms of a work environment that fails to protect its predominantly female workforce, thereby hindering progress toward SDG 5.

Recommendations for Achieving SDG Targets

To mitigate workplace violence against female dentists and align with the SDGs, the following strategies are recommended:

1. Strengthen Institutional Protection (SDG 16): Establish clear, accessible reporting channels through professional bodies like the Federal Council of Dentistry. Public security agencies and dental organizations must advocate for safer work environments, particularly in public health settings.
2. Leverage Technology for Safety (SDG 5 & SDG 8): Promote the use of digital tools for safety, such as monitoring apps (e.g., FollowItApp™) and the (video) recording of clinical consultations where legally permissible. Such measures can act as a deterrent and provide evidence, contributing to the elimination of violence against women and ensuring safer workplaces.
3. Prioritize Mental Health Support (SDG 3): Integrate regular psychological support into the work schedules of female dentists, especially for those in high-volume public services and those early in their careers. Making mental health resources accessible and destigmatized is crucial for the well-being of the healthcare workforce.

Conclusion

Workplace violence against female dentists is a severe barrier to achieving good health and well-being (SDG 3), gender equality (SDG 5), decent work (SDG 8), and peaceful societies with strong institutions (SDG 16). The findings confirm that stalking and intimidation are powerful predictors of violence, necessitating urgent preventive and protective measures. By implementing technology-driven safety solutions, strengthening institutional support, and providing robust mental health resources, stakeholders can create a safer work environment for female dentists and make tangible progress toward the Sustainable Development Goals.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

The article on workplace violence against female dentists in São Paulo, Brazil, addresses and connects to several Sustainable Development Goals (SDGs). The analysis reveals relevance to the following goals:

• SDG 3: Good Health and Well-being

  The article explicitly frames workplace violence as a “significant public health issue.” It details the consequences on the mental health of female dentists, noting that “mental health trauma” is a primary consequence, which can “impair their performance.” The study finds that a significant portion of victims required “psychological treatment,” directly linking the issue to the promotion of mental health and well-being as outlined in SDG 3.

• SDG 5: Gender Equality

  This goal is central to the article, which focuses specifically on the “vulnerability of female dentists.” It highlights that violence disproportionately affects “female healthcare professionals” and notes the high proportion of women in the dentistry field in Brazil (72% including assistants and technicians). The study investigates forms of violence against women—psychological, verbal, and stalking—in a public sphere (the workplace), which directly aligns with the objective of eliminating violence against women.

• SDG 8: Decent Work and Economic Growth

  The article’s core subject is violence experienced “during occupational activities,” which is a fundamental issue of workplace safety. It discusses how violence leads to “workplace absenteeism, leading to financial and social issues.” The call to “promote a healthier work environment for women in Dentistry” and implement “preventive and protective strategies” to create “safer work environments” directly corresponds with the aims of SDG 8 to protect labor rights and ensure safe working conditions for all workers.

• SDG 16: Peace, Justice and Strong Institutions

  The article discusses acts of violence, “intimidation,” and “stalking,” which are criminal offenses. It references “Federal Law No. 14,132” in Brazil, which criminalizes stalking, thereby touching upon the role of legal frameworks and justice. The call for “public security agencies and dentistry-related organizations to advocate for female professionals” and establish a “hotline with the Federal Council of Dentistry” points to the need for strong, responsive, and accountable institutions to protect citizens from violence and ensure access to justice.

2. What specific targets under those SDGs can be identified based on the article’s content?

Based on the article’s content, the following specific SDG targets can be identified:

1. SDG 3: Good Health and Well-being

   • Target 3.4: “By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.” The article’s focus on “mental health trauma” and the need for “psychological treatment” among victims of workplace violence directly relates to the promotion of mental health and well-being.
   • Target 3.d: “Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks.” Workplace violence is identified as a “public health issue” and a health risk. The study’s aim to identify predictive factors like intimidation and stalking serves as a form of early warning and risk assessment.

2. SDG 5: Gender Equality

   • Target 5.2: “Eliminate all forms of violence against all women and girls in the public and private spheres, including trafficking and sexual and other types of exploitation.” The study’s entire premise is to assess and address “workplace violence” (a public sphere) against “female dentists,” including “psychological, physical, or sexual violence.”

3. SDG 8: Decent Work and Economic Growth

   • Target 8.8: “Protect labour rights and promote safe and secure working environments for all workers…” The article directly addresses this by investigating violence in an occupational setting and advocating for “safer work environments” and “protective strategies” for female dentists.

4. SDG 16: Peace, Justice and Strong Institutions

   • Target 16.1: “Significantly reduce all forms of violence and related death rates everywhere.” The article quantifies the prevalence of various forms of non-fatal violence (psychological, verbal, stalking, intimidation) and aims to propose strategies to reduce it.
   • Target 16.3: “Promote the rule of law at the national and international levels and ensure equal access to justice for all.” The mention of Brazil’s anti-stalking law and the discussion of victims’ low rates of seeking help (only 28% sought help) highlight issues related to the rule of law and access to justice and support systems.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

Yes, the article provides several quantitative and qualitative indicators that can be used to measure progress towards the identified targets.

1. Indicators for SDG 3 (Good Health and Well-being)

   • Proportion of workers requiring mental health support due to workplace violence: The finding that “among those who did [seek help], almost half (46.8%) required psychological treatment” serves as a direct indicator of the mental health burden (relevant to Target 3.4).
   • Proportion of workers seeking help after a violent incident: The article states that “nearly 72% of the overall sample did not seek help,” while “28% sought help.” Tracking this percentage over time can measure the effectiveness of support systems (relevant to Target 3.4).

2. Indicators for SDG 5 (Gender Equality)

   • Prevalence of workplace violence against women in a specific profession: The study reports that “approximately 55%” or “62.4%” of female dentists experienced some form of violence. This is a direct indicator for Target 5.2.
   • Prevalence of specific forms of violence/harassment: The article notes that “verbal and psychological abuse being the most common” and provides a “stalking prevalence of 50.3% among female dentists.” These are specific sub-indicators for Target 5.2.

3. Indicators for SDG 8 (Decent Work and Economic Growth)

   • Frequency rate of non-fatal occupational violence: The figure that “62.4% of respondents reported experiencing some form of violence” is an indicator of non-fatal occupational safety incidents (relevant to Target 8.8).
   • Prevalence of feelings of insecurity at work: The finding that intimidation created an “intimidating environment for most dentists (n = 95, 75.8%)” is a qualitative indicator for the lack of a “safe and secure working environment” (relevant to Target 8.8).

4. Indicators for SDG 16 (Peace, Justice and Strong Institutions)

   • Proportion of the population subjected to violence: The statistic that “62.4%” of the surveyed female dentists experienced violence serves as an indicator for Target 16.1 within a specific demographic.
   • Effectiveness of legal frameworks: The article notes a 34.5% increase in stalking cases in Brazil “even after the implementation of the law,” which can be used as an indicator to assess the practical impact of institutional and legal measures (relevant to Target 16.3).

4. Table of SDGs, Targets, and Indicators

Source: nature.com