Socioeconomic position and subjective oral health: findings for the adult population in England, Wales and Northern Ireland
Identifieur interne : 000394 ( Main/Exploration ); précédent : 000393; suivant : 000395Socioeconomic position and subjective oral health: findings for the adult population in England, Wales and Northern Ireland
Auteurs : Carol C. Guarnizo-Herre O [Royaume-Uni] ; Richard G. Watt [Royaume-Uni] ; Elizabeth Fuller [Royaume-Uni] ; Jimmy G. Steele [Royaume-Uni] ; Jing Shen [Royaume-Uni] ; Stephen Morris [Royaume-Uni] ; John Wildman [Royaume-Uni] ; Georgios Tsakos [Royaume-Uni]Source :
- BMC Public Health [ 1471-2458 ] ; 2014.
Abstract
The objective of this study was to assess socioeconomic inequalities in subjective measures of oral health in a national sample of adults in England, Wales and Northern Ireland.
We analysed data from the 2009 Adult Dental Health Survey for 8,765 adults aged 21 years and over. We examined inequalities in three oral health measures: self-rated oral health, Oral Health Impact Profile (OHIP-14), and Oral Impacts on Daily Performance (OIDP). Educational attainment, occupational social class and household income were included as socioeconomic position (SEP) indicators. Multivariable logistic regression models were fitted and from the regression coefficients, predictive margins and conditional marginal effects were estimated to compare predicted probabilities of the outcome across different SEP levels. We also assessed the effect of missing data on our results by re-estimating the regression models after imputing missing data.
There were significant differences in predicted probabilities of the outcomes by SEP level among dentate, but not among edentate, participants. For example, persons with no qualifications showed a higher predicted probability of reporting bad oral health (9.1 percentage points higher, 95% CI: 6.54, 11.68) compared to those with a degree or equivalent. Similarly, predicted probabilities of bad oral health and oral impacts were significantly higher for participants in lower income quintiles compared to those in the highest income level (p < 0.001). Marginal effects for all outcomes were weaker for occupational social class compared to education or income. Educational and income-related inequalities were larger among young people and non-significant among 65+ year-olds. Using imputed data confirmed the aforementioned results.
There were clear socio-economic inequalities in subjective oral health among adults in England, Wales and Northern Ireland with stronger gradients for those at younger ages.
The online version of this article (doi:10.1186/1471-2458-14-827) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1186/1471-2458-14-827
PubMed: 25107286
PubMed Central: 4137102
Affiliations:
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Guarnizo-Herre O</name><affiliation wicri:level="4"><nlm:aff id="Aff22">Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, WC1E 7HB London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, WC1E 7HB London</wicri:regionArea><orgName type="university">University College de Londres</orgName><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Watt, Richard G" sort="Watt, Richard G" uniqKey="Watt R" first="Richard G" last="Watt">Richard G. 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Guarnizo-Herre O</name><affiliation wicri:level="4"><nlm:aff id="Aff22">Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, WC1E 7HB London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, WC1E 7HB London</wicri:regionArea><orgName type="university">University College de Londres</orgName><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Watt, Richard G" sort="Watt, Richard G" uniqKey="Watt R" first="Richard G" last="Watt">Richard G. Watt</name><affiliation wicri:level="4"><nlm:aff id="Aff22">Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, WC1E 7HB London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, WC1E 7HB London</wicri:regionArea><orgName type="university">University College de Londres</orgName><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Fuller, Elizabeth" sort="Fuller, Elizabeth" uniqKey="Fuller E" first="Elizabeth" last="Fuller">Elizabeth Fuller</name><affiliation wicri:level="1"><nlm:aff id="Aff23">National Centre for Social Research NatCen, 35 Northampton Square, EC1V 0AX London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>National Centre for Social Research NatCen, 35 Northampton Square, EC1V 0AX London</wicri:regionArea><wicri:noRegion>EC1V 0AX London</wicri:noRegion></affiliation></author><author><name sortKey="Steele, Jimmy G" sort="Steele, Jimmy G" uniqKey="Steele J" first="Jimmy G" last="Steele">Jimmy G. Steele</name><affiliation wicri:level="1"><nlm:aff id="Aff24">School of Dental Sciences, Newcastle University, Framlington Place, Tyne and Wear, NE2 4BW Newcastle Upon Tyne, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>School of Dental Sciences, Newcastle University, Framlington Place, Tyne and Wear, NE2 4BW Newcastle Upon Tyne</wicri:regionArea><wicri:noRegion>NE2 4BW Newcastle Upon Tyne</wicri:noRegion></affiliation></author><author><name sortKey="Shen, Jing" sort="Shen, Jing" uniqKey="Shen J" first="Jing" last="Shen">Jing Shen</name><affiliation wicri:level="1"><nlm:aff id="Aff25">Institute of Health and Society, Newcastle University, Baddiley-Clark Building, Tyne and Wear, NE2 4AX Newcastle Upon Tyne, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Institute of Health and Society, Newcastle University, Baddiley-Clark Building, Tyne and Wear, NE2 4AX Newcastle Upon Tyne</wicri:regionArea><wicri:noRegion>NE2 4AX Newcastle Upon Tyne</wicri:noRegion></affiliation></author><author><name sortKey="Morris, Stephen" sort="Morris, Stephen" uniqKey="Morris S" first="Stephen" last="Morris">Stephen Morris</name><affiliation wicri:level="4"><nlm:aff id="Aff26">Department of Applied Health Research, University College London, 1-19 Torrington Place, WC1E 7HB London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Applied Health Research, University College London, 1-19 Torrington Place, WC1E 7HB London</wicri:regionArea><orgName type="university">University College de Londres</orgName><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Wildman, John" sort="Wildman, John" uniqKey="Wildman J" first="John" last="Wildman">John Wildman</name><affiliation wicri:level="1"><nlm:aff id="Aff27">Business School, Newcastle University, 5 Barrack Rd, Tyne and Wear, NE1 4SE Newcastle Upon Tyne, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Business School, Newcastle University, 5 Barrack Rd, Tyne and Wear, NE1 4SE Newcastle Upon Tyne</wicri:regionArea><wicri:noRegion>NE1 4SE Newcastle Upon Tyne</wicri:noRegion></affiliation></author><author><name sortKey="Tsakos, Georgios" sort="Tsakos, Georgios" uniqKey="Tsakos G" first="Georgios" last="Tsakos">Georgios Tsakos</name><affiliation wicri:level="4"><nlm:aff id="Aff22">Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, WC1E 7HB London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, WC1E 7HB London</wicri:regionArea><orgName type="university">University College de Londres</orgName><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author></analytic><series><title level="j">BMC Public Health</title><idno type="eISSN">1471-2458</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>The objective of this study was to assess socioeconomic inequalities in subjective measures of oral health in a national sample of adults in England, Wales and Northern Ireland.</p></sec><sec><title>Methods</title><p>We analysed data from the 2009 Adult Dental Health Survey for 8,765 adults aged 21 years and over. We examined inequalities in three oral health measures: self-rated oral health, Oral Health Impact Profile (OHIP-14), and Oral Impacts on Daily Performance (OIDP). Educational attainment, occupational social class and household income were included as socioeconomic position (SEP) indicators. Multivariable logistic regression models were fitted and from the regression coefficients, predictive margins and conditional marginal effects were estimated to compare predicted probabilities of the outcome across different SEP levels. We also assessed the effect of missing data on our results by re-estimating the regression models after imputing missing data.</p></sec><sec><title>Results</title><p>There were significant differences in predicted probabilities of the outcomes by SEP level among dentate, but not among edentate, participants. For example, persons with no qualifications showed a higher predicted probability of reporting bad oral health (9.1 percentage points higher, 95% CI: 6.54, 11.68) compared to those with a degree or equivalent. Similarly, predicted probabilities of bad oral health and oral impacts were significantly higher for participants in lower income quintiles compared to those in the highest income level (p < 0.001). Marginal effects for all outcomes were weaker for occupational social class compared to education or income. Educational and income-related inequalities were larger among young people and non-significant among 65+ year-olds. Using imputed data confirmed the aforementioned results.</p></sec><sec><title>Conclusions</title><p>There were clear socio-economic inequalities in subjective oral health among adults in England, Wales and Northern Ireland with stronger gradients for those at younger ages.</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (doi:10.1186/1471-2458-14-827) contains supplementary material, which is available to authorized users.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Watt, R" uniqKey="Watt R">R Watt</name></author><author><name sortKey="Sheiham, A" uniqKey="Sheiham A">A Sheiham</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Locker, D" uniqKey="Locker D">D Locker</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sanders, Ae" uniqKey="Sanders A">AE Sanders</name></author><author><name sortKey="Spencer, 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McCarron</name></author><author><name sortKey="Jeffreys, M" uniqKey="Jeffreys M">M Jeffreys</name></author><author><name sortKey="Gilthorpe, Ms" uniqKey="Gilthorpe M">MS Gilthorpe</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Coburn, D" uniqKey="Coburn D">D Coburn</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Marmot, Mg" uniqKey="Marmot M">MG Marmot</name></author><author><name sortKey="Allen, J" uniqKey="Allen J">J Allen</name></author><author><name sortKey="Goldblatt, P" uniqKey="Goldblatt P">P Goldblatt</name></author><author><name sortKey="Boyce, T" uniqKey="Boyce T">T Boyce</name></author><author><name sortKey="Mcneish, D" uniqKey="Mcneish D">D McNeish</name></author><author><name sortKey="Grady, M" uniqKey="Grady M">M Grady</name></author><author><name sortKey="Geddes, I" uniqKey="Geddes I">I Geddes</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li></region><settlement><li>Londres</li></settlement><orgName><li>University College de Londres</li></orgName></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Guarnizo Herre O, Carol C" sort="Guarnizo Herre O, Carol C" uniqKey="Guarnizo Herre O C" first="Carol C" last="Guarnizo-Herre O">Carol C. Guarnizo-Herre O</name></region><name sortKey="Fuller, Elizabeth" sort="Fuller, Elizabeth" uniqKey="Fuller E" first="Elizabeth" last="Fuller">Elizabeth Fuller</name><name sortKey="Morris, Stephen" sort="Morris, Stephen" uniqKey="Morris S" first="Stephen" last="Morris">Stephen Morris</name><name sortKey="Shen, Jing" sort="Shen, Jing" uniqKey="Shen J" first="Jing" last="Shen">Jing Shen</name><name sortKey="Steele, Jimmy G" sort="Steele, Jimmy G" uniqKey="Steele J" first="Jimmy G" last="Steele">Jimmy G. Steele</name><name sortKey="Tsakos, Georgios" sort="Tsakos, Georgios" uniqKey="Tsakos G" first="Georgios" last="Tsakos">Georgios Tsakos</name><name sortKey="Watt, Richard G" sort="Watt, Richard G" uniqKey="Watt R" first="Richard G" last="Watt">Richard G. Watt</name><name sortKey="Wildman, John" sort="Wildman, John" uniqKey="Wildman J" first="John" last="Wildman">John Wildman</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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