Socioeconomic inequalities in oral health in different European welfare state regimes
Identifieur interne : 001957 ( Istex/Corpus ); précédent : 001956; suivant : 001958Socioeconomic inequalities in oral health in different European welfare state regimes
Auteurs : Carol C. Guarnizo-Herre O ; Richard G. Watt ; Hynek Pikhart ; Aubrey Sheiham ; Georgios TsakosSource :
- Journal of Epidemiology and Community Health [ 0143-005X ] ; 2013-09.
English descriptors
- KwdEn :
- Absolute inequalities, Absolute inequalities scandinavian, Bambra, Bismarckian, Class managers, Community dent, Cultural differences, Dent, Dental status, Dentate participants, Dentition, Different countries, Different welfare regimes, Eastern regime, Economic crisis, Edentulousness, Educational inequalities, Educational level, Epidemiol, Epidemiol community health, Epidemiol community health bambra, European countries, Functional dentition, Further research, General health, Health equity, Health inequalities, Health outcomes, Higher levels, Highest rank, Income inequality, Inequalities scandinavian, Inequality, Larger inequalities, Lowest prevalence rates, Lowest rank, Manual workers, Measure welfare state regime education, National statistics, Natural teeth, Ndings, Older adults, Older years, Oral health, Oral health inequalities, Oral health measures, Oral health outcomes, Oxford university press, Periodontal disease, Political factors, Poor health, Population health, Population size, Potential mechanisms, Present study, Prevalence, Prevalence rates, Psychosocial factors, Public health, Regression models, Relative index, Relative inequalities, Research report, Research report table, Scandinavian, Scandinavian countries, Scandinavian regime, Scandinavian welfare regime, Slope index, Smallest inequalities, Social determinants, Social gradients, Social inequalities, Social status, Socioeconomic, Socioeconomic groups, Socioeconomic inequalities, Socioeconomic position, Southern regimes, Southern welfare regime, Statistical analysis, Tooth loss, Typology, University college london, Welfare capitalism, Welfare policies, Welfare provision, Welfare regime, Welfare regimes, Welfare state regime, Welfare state regimes, Welfare state types, Welfare states, Welfare type, Wide range, World health organization.
- Teeft :
- Absolute inequalities, Absolute inequalities scandinavian, Bambra, Bismarckian, Class managers, Community dent, Cultural differences, Dent, Dental status, Dentate participants, Dentition, Different countries, Different welfare regimes, Eastern regime, Economic crisis, Edentulousness, Educational inequalities, Educational level, Epidemiol, Epidemiol community health, Epidemiol community health bambra, European countries, Functional dentition, Further research, General health, Health equity, Health inequalities, Health outcomes, Higher levels, Highest rank, Income inequality, Inequalities scandinavian, Inequality, Larger inequalities, Lowest prevalence rates, Lowest rank, Manual workers, Measure welfare state regime education, National statistics, Natural teeth, Ndings, Older adults, Older years, Oral health, Oral health inequalities, Oral health measures, Oral health outcomes, Oxford university press, Periodontal disease, Political factors, Poor health, Population health, Population size, Potential mechanisms, Present study, Prevalence, Prevalence rates, Psychosocial factors, Public health, Regression models, Relative index, Relative inequalities, Research report, Research report table, Scandinavian, Scandinavian countries, Scandinavian regime, Scandinavian welfare regime, Slope index, Smallest inequalities, Social determinants, Social gradients, Social inequalities, Social status, Socioeconomic, Socioeconomic groups, Socioeconomic inequalities, Socioeconomic position, Southern regimes, Southern welfare regime, Statistical analysis, Tooth loss, Typology, University college london, Welfare capitalism, Welfare policies, Welfare provision, Welfare regime, Welfare regimes, Welfare state regime, Welfare state regimes, Welfare state types, Welfare states, Welfare type, Wide range, World health organization.
Abstract
Background There is very little information about the relationship between welfare regimes and oral health inequalities. We compared socioeconomic inequalities in adults’ oral health in five European welfare-state regimes: Scandinavian, Anglo-Saxon, Bismarckian, Southern and Eastern. Methods Using data from the oral health module of the Eurobarometer 72.3 survey, we assessed inequalities in two self-reported oral health measures: no functional dentition (less than 20 natural teeth) and edentulousness (no natural teeth). Occupational social class, education and subjective social status (SSS) were included as socioeconomic position indicators. We estimated age-standardised prevalence rates, ORs, the Relative Index of Inequality (RII) and the Slope Index of Inequality (SII). Results The Scandinavian regime showed the lowest prevalence rates of the two oral health measures while the Eastern showed the highest. In all welfare regimes there was a general pattern of social gradients by occupational social class and education. Relative educational inequalities in no functional dentition were largest in the Scandinavian welfare regime (RII=3.81; 95% CI 2.68 to 5.42). The Scandinavian and Southern regimes showed the largest relative inequalities in edentulousness by occupation and education, respectively. There were larger absolute inequalities in no functional dentition in the Eastern regime by occupation (SII=42.16; 95% CI 31.42 to 52.89) and in the Southern by SSS (SII=27.92; 95% CI 17.36 to 38.47). Conclusions Oral health inequalities in adults exist in all welfare-state regimes, but contrary to what may be expected from theory, they are not smaller in the Scandinavian regime. Future work should examine the potential mechanisms linking welfare provision and oral health inequalities.
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DOI: 10.1136/jech-2013-202714
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Watt</name><affiliation><mods:affiliation>Department of Epidemiology and Public Health, University College London, London, UK</mods:affiliation></affiliation></author><author><name sortKey="Pikhart, Hynek" sort="Pikhart, Hynek" uniqKey="Pikhart H" first="Hynek" last="Pikhart">Hynek Pikhart</name><affiliation><mods:affiliation>Department of Epidemiology and Public Health, University College London, London, UK</mods:affiliation></affiliation></author><author><name sortKey="Sheiham, Aubrey" sort="Sheiham, Aubrey" uniqKey="Sheiham A" first="Aubrey" last="Sheiham">Aubrey Sheiham</name><affiliation><mods:affiliation>Department of Epidemiology and Public Health, University College London, London, UK</mods:affiliation></affiliation></author><author><name sortKey="Tsakos, Georgios" sort="Tsakos, Georgios" uniqKey="Tsakos G" first="Georgios" last="Tsakos">Georgios Tsakos</name><affiliation><mods:affiliation>Department of Epidemiology and Public Health, University College London, London, UK</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:346530C57AC95EE480CE0D7D6CA970C9656C4392</idno><date when="2013" year="2013">2013</date><idno type="doi">10.1136/jech-2013-202714</idno><idno type="url">https://api.istex.fr/document/346530C57AC95EE480CE0D7D6CA970C9656C4392/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">001957</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">001957</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">Socioeconomic inequalities in oral health in different European welfare state regimes</title><author><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><affiliation><mods:affiliation>Department of Epidemiology and Public Health, University College London, London, UK</mods:affiliation></affiliation><affiliation><mods:affiliation>Departamento de Salud Colectiva, Facultad de Odontología, Universidad Nacional de Colombia, Bogotá, Colombia</mods:affiliation></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><mods:affiliation>Department of Epidemiology and Public Health, University College London, London, UK</mods:affiliation></affiliation></author><author><name sortKey="Pikhart, Hynek" sort="Pikhart, Hynek" uniqKey="Pikhart H" first="Hynek" last="Pikhart">Hynek Pikhart</name><affiliation><mods:affiliation>Department of Epidemiology and Public Health, University College London, London, UK</mods:affiliation></affiliation></author><author><name sortKey="Sheiham, Aubrey" sort="Sheiham, Aubrey" uniqKey="Sheiham A" first="Aubrey" last="Sheiham">Aubrey Sheiham</name><affiliation><mods:affiliation>Department of Epidemiology and Public Health, University College London, London, UK</mods:affiliation></affiliation></author><author><name sortKey="Tsakos, Georgios" sort="Tsakos, Georgios" uniqKey="Tsakos G" first="Georgios" last="Tsakos">Georgios Tsakos</name><affiliation><mods:affiliation>Department of Epidemiology and Public Health, University College London, London, UK</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Epidemiology and Community Health</title><title level="j" type="abbrev">J Epidemiol Community Health</title><idno type="ISSN">0143-005X</idno><idno type="eISSN">1470-2738</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2013-09">2013-09</date><biblScope unit="volume">67</biblScope><biblScope unit="issue">9</biblScope><biblScope unit="page" from="728">728</biblScope></imprint><idno type="ISSN">0143-005X</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0143-005X</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Absolute inequalities</term><term>Absolute inequalities scandinavian</term><term>Bambra</term><term>Bismarckian</term><term>Class managers</term><term>Community dent</term><term>Cultural differences</term><term>Dent</term><term>Dental status</term><term>Dentate participants</term><term>Dentition</term><term>Different countries</term><term>Different welfare regimes</term><term>Eastern regime</term><term>Economic crisis</term><term>Edentulousness</term><term>Educational inequalities</term><term>Educational level</term><term>Epidemiol</term><term>Epidemiol community health</term><term>Epidemiol community health bambra</term><term>European countries</term><term>Functional dentition</term><term>Further research</term><term>General health</term><term>Health equity</term><term>Health inequalities</term><term>Health outcomes</term><term>Higher levels</term><term>Highest rank</term><term>Income inequality</term><term>Inequalities scandinavian</term><term>Inequality</term><term>Larger inequalities</term><term>Lowest prevalence rates</term><term>Lowest rank</term><term>Manual workers</term><term>Measure welfare state regime education</term><term>National statistics</term><term>Natural teeth</term><term>Ndings</term><term>Older adults</term><term>Older years</term><term>Oral health</term><term>Oral health inequalities</term><term>Oral health measures</term><term>Oral health outcomes</term><term>Oxford university press</term><term>Periodontal disease</term><term>Political factors</term><term>Poor health</term><term>Population health</term><term>Population size</term><term>Potential mechanisms</term><term>Present study</term><term>Prevalence</term><term>Prevalence rates</term><term>Psychosocial factors</term><term>Public health</term><term>Regression models</term><term>Relative index</term><term>Relative inequalities</term><term>Research report</term><term>Research report table</term><term>Scandinavian</term><term>Scandinavian countries</term><term>Scandinavian regime</term><term>Scandinavian welfare regime</term><term>Slope index</term><term>Smallest inequalities</term><term>Social determinants</term><term>Social gradients</term><term>Social inequalities</term><term>Social status</term><term>Socioeconomic</term><term>Socioeconomic groups</term><term>Socioeconomic inequalities</term><term>Socioeconomic position</term><term>Southern regimes</term><term>Southern welfare regime</term><term>Statistical analysis</term><term>Tooth loss</term><term>Typology</term><term>University college london</term><term>Welfare capitalism</term><term>Welfare policies</term><term>Welfare provision</term><term>Welfare regime</term><term>Welfare regimes</term><term>Welfare state regime</term><term>Welfare state regimes</term><term>Welfare state types</term><term>Welfare states</term><term>Welfare type</term><term>Wide range</term><term>World health organization</term></keywords><keywords scheme="Teeft" xml:lang="en"><term>Absolute inequalities</term><term>Absolute inequalities scandinavian</term><term>Bambra</term><term>Bismarckian</term><term>Class managers</term><term>Community dent</term><term>Cultural differences</term><term>Dent</term><term>Dental status</term><term>Dentate participants</term><term>Dentition</term><term>Different countries</term><term>Different welfare regimes</term><term>Eastern regime</term><term>Economic crisis</term><term>Edentulousness</term><term>Educational inequalities</term><term>Educational level</term><term>Epidemiol</term><term>Epidemiol community health</term><term>Epidemiol community health bambra</term><term>European countries</term><term>Functional dentition</term><term>Further research</term><term>General health</term><term>Health equity</term><term>Health inequalities</term><term>Health outcomes</term><term>Higher levels</term><term>Highest rank</term><term>Income inequality</term><term>Inequalities scandinavian</term><term>Inequality</term><term>Larger inequalities</term><term>Lowest prevalence rates</term><term>Lowest rank</term><term>Manual workers</term><term>Measure welfare state regime education</term><term>National statistics</term><term>Natural teeth</term><term>Ndings</term><term>Older adults</term><term>Older years</term><term>Oral health</term><term>Oral health inequalities</term><term>Oral health measures</term><term>Oral health outcomes</term><term>Oxford university press</term><term>Periodontal disease</term><term>Political factors</term><term>Poor health</term><term>Population health</term><term>Population size</term><term>Potential mechanisms</term><term>Present study</term><term>Prevalence</term><term>Prevalence rates</term><term>Psychosocial factors</term><term>Public health</term><term>Regression models</term><term>Relative index</term><term>Relative inequalities</term><term>Research report</term><term>Research report table</term><term>Scandinavian</term><term>Scandinavian countries</term><term>Scandinavian regime</term><term>Scandinavian welfare regime</term><term>Slope index</term><term>Smallest inequalities</term><term>Social determinants</term><term>Social gradients</term><term>Social inequalities</term><term>Social status</term><term>Socioeconomic</term><term>Socioeconomic groups</term><term>Socioeconomic inequalities</term><term>Socioeconomic position</term><term>Southern regimes</term><term>Southern welfare regime</term><term>Statistical analysis</term><term>Tooth loss</term><term>Typology</term><term>University college london</term><term>Welfare capitalism</term><term>Welfare policies</term><term>Welfare provision</term><term>Welfare regime</term><term>Welfare regimes</term><term>Welfare state regime</term><term>Welfare state regimes</term><term>Welfare state types</term><term>Welfare states</term><term>Welfare type</term><term>Wide range</term><term>World health organization</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Background There is very little information about the relationship between welfare regimes and oral health inequalities. We compared socioeconomic inequalities in adults’ oral health in five European welfare-state regimes: Scandinavian, Anglo-Saxon, Bismarckian, Southern and Eastern. Methods Using data from the oral health module of the Eurobarometer 72.3 survey, we assessed inequalities in two self-reported oral health measures: no functional dentition (less than 20 natural teeth) and edentulousness (no natural teeth). Occupational social class, education and subjective social status (SSS) were included as socioeconomic position indicators. We estimated age-standardised prevalence rates, ORs, the Relative Index of Inequality (RII) and the Slope Index of Inequality (SII). Results The Scandinavian regime showed the lowest prevalence rates of the two oral health measures while the Eastern showed the highest. In all welfare regimes there was a general pattern of social gradients by occupational social class and education. Relative educational inequalities in no functional dentition were largest in the Scandinavian welfare regime (RII=3.81; 95% CI 2.68 to 5.42). The Scandinavian and Southern regimes showed the largest relative inequalities in edentulousness by occupation and education, respectively. There were larger absolute inequalities in no functional dentition in the Eastern regime by occupation (SII=42.16; 95% CI 31.42 to 52.89) and in the Southern by SSS (SII=27.92; 95% CI 17.36 to 38.47). Conclusions Oral health inequalities in adults exist in all welfare-state regimes, but contrary to what may be expected from theory, they are not smaller in the Scandinavian regime. Future work should examine the potential mechanisms linking welfare provision and oral health inequalities.</div></front></TEI><istex><corpusName>bmj</corpusName><keywords><teeft><json:string>inequality</json:string><json:string>oral health</json:string><json:string>epidemiol</json:string><json:string>dentition</json:string><json:string>health inequalities</json:string><json:string>functional dentition</json:string><json:string>edentulousness</json:string><json:string>welfare state regimes</json:string><json:string>socioeconomic inequalities</json:string><json:string>scandinavian countries</json:string><json:string>bismarckian</json:string><json:string>welfare regimes</json:string><json:string>natural teeth</json:string><json:string>european countries</json:string><json:string>oral health inequalities</json:string><json:string>bambra</json:string><json:string>oral health outcomes</json:string><json:string>scandinavian</json:string><json:string>social 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equity</json:string><json:string>welfare state types</json:string><json:string>world health organization</json:string><json:string>population size</json:string><json:string>university college london</json:string><json:string>oxford university press</json:string><json:string>potential mechanisms</json:string><json:string>epidemiol community health bambra</json:string><json:string>social inequalities</json:string><json:string>dental status</json:string><json:string>educational level</json:string><json:string>welfare capitalism</json:string></teeft></keywords><author><json:item><name>Carol C Guarnizo-Herreño</name><affiliations><json:string>Department of Epidemiology and Public Health, University College London, London, UK</json:string><json:string>Departamento de Salud Colectiva, Facultad de Odontología, Universidad Nacional de Colombia, Bogotá, Colombia</json:string></affiliations></json:item><json:item><name>Richard G Watt</name><affiliations><json:string>Department of Epidemiology and Public Health, University College London, London, UK</json:string></affiliations></json:item><json:item><name>Hynek Pikhart</name><affiliations><json:string>Department of Epidemiology and Public Health, University College London, London, UK</json:string></affiliations></json:item><json:item><name>Aubrey Sheiham</name><affiliations><json:string>Department of Epidemiology and Public Health, University College London, London, UK</json:string></affiliations></json:item><json:item><name>Georgios Tsakos</name><affiliations><json:string>Department of Epidemiology and Public Health, University College London, London, UK</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Health inequalities</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Oral health</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Social epidemiology</value></json:item></subject><articleId><json:string>jech-2013-202714</json:string></articleId><arkIstex>ark:/67375/NVC-G2HKBPPM-N</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>research-article</json:string></originalGenre><abstract>Background There is very little information about the relationship between welfare regimes and oral health inequalities. We compared socioeconomic inequalities in adults’ oral health in five European welfare-state regimes: Scandinavian, Anglo-Saxon, Bismarckian, Southern and Eastern. Methods Using data from the oral health module of the Eurobarometer 72.3 survey, we assessed inequalities in two self-reported oral health measures: no functional dentition (less than 20 natural teeth) and edentulousness (no natural teeth). Occupational social class, education and subjective social status (SSS) were included as socioeconomic position indicators. We estimated age-standardised prevalence rates, ORs, the Relative Index of Inequality (RII) and the Slope Index of Inequality (SII). Results The Scandinavian regime showed the lowest prevalence rates of the two oral health measures while the Eastern showed the highest. In all welfare regimes there was a general pattern of social gradients by occupational social class and education. Relative educational inequalities in no functional dentition were largest in the Scandinavian welfare regime (RII=3.81; 95% CI 2.68 to 5.42). The Scandinavian and Southern regimes showed the largest relative inequalities in edentulousness by occupation and education, respectively. There were larger absolute inequalities in no functional dentition in the Eastern regime by occupation (SII=42.16; 95% CI 31.42 to 52.89) and in the Southern by SSS (SII=27.92; 95% CI 17.36 to 38.47). Conclusions Oral health inequalities in adults exist in all welfare-state regimes, but contrary to what may be expected from theory, they are not smaller in the Scandinavian regime. Future work should examine the potential mechanisms linking welfare provision and oral health inequalities.</abstract><qualityIndicators><score>10</score><pdfWordCount>5653</pdfWordCount><pdfCharCount>39183</pdfCharCount><pdfVersion>1.3</pdfVersion><pdfPageCount>8</pdfPageCount><pdfPageSize>595.276 x 793.701 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractWordCount>252</abstractWordCount><abstractCharCount>1807</abstractCharCount><keywordCount>3</keywordCount></qualityIndicators><title>Socioeconomic inequalities in oral health in different European welfare state regimes</title><pmid><json:string>23814268</json:string></pmid><genre><json:string>research-article</json:string></genre><host><title>Journal of Epidemiology and Community Health</title><language><json:string>unknown</json:string></language><issn><json:string>0143-005X</json:string></issn><eissn><json:string>1470-2738</json:string></eissn><publisherId><json:string>jech</json:string></publisherId><volume>67</volume><issue>9</issue><pages><first>728</first></pages><genre><json:string>journal</json:string></genre></host><namedEntities><unitex><date><json:string>2009</json:string><json:string>2013-06-27</json:string><json:string>1990s</json:string></date><geogName></geogName><orgName><json:string>UK and Ireland</json:string><json:string>Finland, the UK, Germany and Australia</json:string><json:string>—Croatia, Turkey</json:string><json:string>Colombia, Bogotá, Colombia Correspondence</json:string><json:string>Department of Epidemiology and Public Health</json:string><json:string>Sweden and Guarnizo-Herreño</json:string><json:string>Czech Republic, Estonia, Hungary, Poland, Slovakia and Slovenia</json:string><json:string>Sweden, Norway and Denmark</json:string><json:string>Austria, Belgium, France, Germany, Luxemburg and Netherlands</json:string><json:string>Greece, Italy, Portugal and Spain</json:string><json:string>National Statistics</json:string><json:string>Finland, the UK and Australia</json:string><json:string>World Health Organization</json:string><json:string>Sweden, Finland and Denmark</json:string></orgName><orgName_funder></orgName_funder><orgName_provider></orgName_provider><persName><json:string>Research</json:string><json:string>Georgios Tsakos</json:string><json:string>Aubrey Sheiham</json:string><json:string>Eastern</json:string></persName><placeName><json:string>Germany</json:string><json:string>Australia</json:string><json:string>UK</json:string><json:string>Norway</json:string><json:string>Macedonia</json:string><json:string>Europe</json:string><json:string>European Union</json:string></placeName><ref_url></ref_url><ref_bibl><json:string>Borrell et al</json:string><json:string>Sanders et al</json:string><json:string>Eikemo et al</json:string></ref_bibl><bibl></bibl></unitex></namedEntities><ark><json:string>ark:/67375/NVC-G2HKBPPM-N</json:string></ark><categories><wos><json:string>1 - social science</json:string><json:string>2 - public, environmental & occupational health</json:string></wos><scienceMetrix><json:string>1 - health sciences</json:string><json:string>2 - public health & health services</json:string><json:string>3 - epidemiology</json:string></scienceMetrix><scopus><json:string>1 - Health Sciences</json:string><json:string>2 - Medicine</json:string><json:string>3 - Public Health, Environmental and Occupational Health</json:string><json:string>1 - Health Sciences</json:string><json:string>2 - Medicine</json:string><json:string>3 - Epidemiology</json:string></scopus><inist><json:string>1 - sciences humaines et sociales</json:string><json:string>2 - histoire et sciences de la litterature</json:string></inist></categories><publicationDate>2013</publicationDate><copyrightDate>2013</copyrightDate><doi><json:string>10.1136/jech-2013-202714</json:string></doi><id>346530C57AC95EE480CE0D7D6CA970C9656C4392</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/346530C57AC95EE480CE0D7D6CA970C9656C4392/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/346530C57AC95EE480CE0D7D6CA970C9656C4392/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/346530C57AC95EE480CE0D7D6CA970C9656C4392/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a">Socioeconomic inequalities in oral health in different European welfare state regimes</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher scheme="https://publisher-list.data.istex.fr">BMJ Publishing Group Ltd</publisher><availability><licence><p>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</p></licence><p scheme="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-7M42M2QJ-2">bmj</p></availability><date>2013-06-27</date></publicationStmt><notesStmt><note type="research-article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</note><note type="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a">Socioeconomic inequalities in oral health in different European welfare state regimes</title><author xml:id="author-0000"><persName><forename type="first">Carol C</forename><surname>Guarnizo-Herreño</surname></persName><affiliation>Department of Epidemiology and Public Health, University College London, London, UK</affiliation><affiliation>Departamento de Salud Colectiva, Facultad de Odontología, Universidad Nacional de Colombia, Bogotá, Colombia</affiliation></author><author xml:id="author-0001"><persName><forename type="first">Richard G</forename><surname>Watt</surname></persName><affiliation>Department of Epidemiology and Public Health, University College London, London, UK</affiliation></author><author xml:id="author-0002"><persName><forename type="first">Hynek</forename><surname>Pikhart</surname></persName><affiliation>Department of Epidemiology and Public Health, University College London, London, UK</affiliation></author><author xml:id="author-0003"><persName><forename type="first">Aubrey</forename><surname>Sheiham</surname></persName><affiliation>Department of Epidemiology and Public Health, University College London, London, UK</affiliation></author><author xml:id="author-0004"><persName><forename type="first">Georgios</forename><surname>Tsakos</surname></persName><affiliation>Department of Epidemiology and Public Health, University College London, London, UK</affiliation></author><idno type="istex">346530C57AC95EE480CE0D7D6CA970C9656C4392</idno><idno type="ark">ark:/67375/NVC-G2HKBPPM-N</idno><idno type="DOI">10.1136/jech-2013-202714</idno><idno type="href">jech-67-728.pdf</idno><idno type="article-id">jech-2013-202714</idno><idno type="PMID">23814268</idno><idno type="local">jech;67/9/728</idno></analytic><monogr><title level="j">Journal of Epidemiology and Community Health</title><title level="j" type="abbrev">J Epidemiol Community Health</title><idno type="pISSN">0143-005X</idno><idno type="eISSN">1470-2738</idno><idno type="publisher-id">jech</idno><idno type="PublisherID-hwp">jech</idno><idno type="PublisherID-nlm-ta">J Epidemiol Community Health</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2013-09"></date><biblScope unit="volume">67</biblScope><biblScope unit="issue">9</biblScope><biblScope unit="page" from="728">728</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2013-06-27</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>Background There is very little information about the relationship between welfare regimes and oral health inequalities. We compared socioeconomic inequalities in adults’ oral health in five European welfare-state regimes: Scandinavian, Anglo-Saxon, Bismarckian, Southern and Eastern. Methods Using data from the oral health module of the Eurobarometer 72.3 survey, we assessed inequalities in two self-reported oral health measures: no functional dentition (less than 20 natural teeth) and edentulousness (no natural teeth). Occupational social class, education and subjective social status (SSS) were included as socioeconomic position indicators. We estimated age-standardised prevalence rates, ORs, the Relative Index of Inequality (RII) and the Slope Index of Inequality (SII). Results The Scandinavian regime showed the lowest prevalence rates of the two oral health measures while the Eastern showed the highest. In all welfare regimes there was a general pattern of social gradients by occupational social class and education. Relative educational inequalities in no functional dentition were largest in the Scandinavian welfare regime (RII=3.81; 95% CI 2.68 to 5.42). The Scandinavian and Southern regimes showed the largest relative inequalities in edentulousness by occupation and education, respectively. There were larger absolute inequalities in no functional dentition in the Eastern regime by occupation (SII=42.16; 95% CI 31.42 to 52.89) and in the Southern by SSS (SII=27.92; 95% CI 17.36 to 38.47). Conclusions Oral health inequalities in adults exist in all welfare-state regimes, but contrary to what may be expected from theory, they are not smaller in the Scandinavian regime. Future work should examine the potential mechanisms linking welfare provision and oral health inequalities.</p></abstract><textClass><keywords scheme="keyword"><list><head>keywords</head><item><term>Health inequalities</term></item><item><term>Oral health</term></item><item><term>Social epidemiology</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2013-06-27">Created</change><change when="2013-09">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/346530C57AC95EE480CE0D7D6CA970C9656C4392/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article"><front><journal-meta><journal-id journal-id-type="hwp">jech</journal-id><journal-id journal-id-type="nlm-ta">J Epidemiol Community Health</journal-id><journal-id journal-id-type="publisher-id">jech</journal-id><journal-title>Journal of Epidemiology and Community Health</journal-title><abbrev-journal-title abbrev-type="publisher">J Epidemiol Community Health</abbrev-journal-title><abbrev-journal-title>J Epidemiol Community Health</abbrev-journal-title><issn pub-type="ppub">0143-005X</issn><issn pub-type="epub">1470-2738</issn><publisher><publisher-name>BMJ Publishing Group Ltd</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">jech-2013-202714</article-id><article-id pub-id-type="doi">10.1136/jech-2013-202714</article-id><article-id pub-id-type="other">jech;67/9/728</article-id><article-id pub-id-type="other">jech;jech-2013-202714</article-id><article-id pub-id-type="pmid">23814268</article-id><article-id pub-id-type="other">728</article-id><article-id pub-id-type="other">jech-2013-202714</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research report</subject></subj-group></article-categories><title-group><article-title>Socioeconomic inequalities in oral health in different European welfare state regimes</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Guarnizo-Herreño</surname><given-names>Carol C</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="aff" rid="af2">2</xref></contrib><contrib contrib-type="author"><name><surname>Watt</surname><given-names>Richard G</given-names></name><xref ref-type="aff" rid="af1">1</xref></contrib><contrib contrib-type="author"><name><surname>Pikhart</surname><given-names>Hynek</given-names></name><xref ref-type="aff" rid="af1">1</xref></contrib><contrib contrib-type="author"><name><surname>Sheiham</surname><given-names>Aubrey</given-names></name><xref ref-type="aff" rid="af1">1</xref></contrib><contrib contrib-type="author"><name><surname>Tsakos</surname><given-names>Georgios</given-names></name><xref ref-type="aff" rid="af1">1</xref></contrib></contrib-group><aff id="af1"><label>1</label><addr-line>Department of Epidemiology and Public Health</addr-line>, <institution>University College London</institution>, <addr-line>London</addr-line>, <country>UK</country></aff><aff id="af2"><label>2</label><addr-line>Departamento de Salud Colectiva, Facultad de Odontología</addr-line>, <institution>Universidad Nacional de Colombia</institution>, <addr-line>Bogotá</addr-line>, <country>Colombia</country></aff><author-notes><corresp><label>Correspondence to</label> Carol C Guarnizo-Herreño, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, Room 315, London WC1E 7HB, UK; <email>c.guarnizo-herreno.11@ucl.ac.uk</email></corresp></author-notes><pub-date pub-type="ppub"><month>9</month><year>2013</year></pub-date><pub-date pub-type="epub-original"><day>27</day><month>6</month><year>2013</year></pub-date><pub-date pub-type="epub"><day>27</day><month>6</month><year>2013</year></pub-date><volume>67</volume><volume-id pub-id-type="other">67</volume-id><volume-id pub-id-type="other">67</volume-id><issue>9</issue><issue-id pub-id-type="other">jech;67/9</issue-id><issue-id pub-id-type="other">9</issue-id><issue-id pub-id-type="other">67/9</issue-id><fpage>728</fpage><history><date date-type="received"><day>6</day><month>4</month><year>2013</year></date><date date-type="rev-recd"><day>23</day><month>5</month><year>2013</year></date><date date-type="accepted"><day>27</day><month>5</month><year>2013</year></date></history><permissions><copyright-statement>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</copyright-statement><copyright-year>2013</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="jech-67-728.pdf"></self-uri><abstract><sec><title>Background</title><p>There is very little information about the relationship between welfare regimes and oral health inequalities. We compared socioeconomic inequalities in adults’ oral health in five European welfare-state regimes: Scandinavian, Anglo-Saxon, Bismarckian, Southern and Eastern.</p></sec><sec><title>Methods</title><p>Using data from the oral health module of the Eurobarometer 72.3 survey, we assessed inequalities in two self-reported oral health measures: no functional dentition (less than 20 natural teeth) and edentulousness (no natural teeth). Occupational social class, education and subjective social status (SSS) were included as socioeconomic position indicators. We estimated age-standardised prevalence rates, ORs, the Relative Index of Inequality (RII) and the Slope Index of Inequality (SII).</p></sec><sec><title>Results</title><p>The Scandinavian regime showed the lowest prevalence rates of the two oral health measures while the Eastern showed the highest. In all welfare regimes there was a general pattern of social gradients by occupational social class and education. Relative educational inequalities in no functional dentition were largest in the Scandinavian welfare regime (RII=3.81; 95% CI 2.68 to 5.42). The Scandinavian and Southern regimes showed the largest relative inequalities in edentulousness by occupation and education, respectively. There were larger absolute inequalities in no functional dentition in the Eastern regime by occupation (SII=42.16; 95% CI 31.42 to 52.89) and in the Southern by SSS (SII=27.92; 95% CI 17.36 to 38.47).</p></sec><sec><title>Conclusions</title><p>Oral health inequalities in adults exist in all welfare-state regimes, but contrary to what may be expected from theory, they are not smaller in the Scandinavian regime. Future work should examine the potential mechanisms linking welfare provision and oral health inequalities.</p></sec></abstract><kwd-group><kwd>Health inequalities</kwd><kwd>Oral health</kwd><kwd>Social epidemiology</kwd></kwd-group></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><title>Socioeconomic inequalities in oral health in different European welfare state regimes</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Socioeconomic inequalities in oral health in different European welfare state regimes</title></titleInfo><name type="personal"><namePart type="given">Carol C</namePart><namePart type="family">Guarnizo-Herreño</namePart><affiliation>Department of Epidemiology and Public Health, University College London, London, UK</affiliation><affiliation>Departamento de Salud Colectiva, Facultad de Odontología, Universidad Nacional de Colombia, Bogotá, Colombia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Richard G</namePart><namePart type="family">Watt</namePart><affiliation>Department of Epidemiology and Public Health, University College London, London, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Hynek</namePart><namePart type="family">Pikhart</namePart><affiliation>Department of Epidemiology and Public Health, University College London, London, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Aubrey</namePart><namePart type="family">Sheiham</namePart><affiliation>Department of Epidemiology and Public Health, University College London, London, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Georgios</namePart><namePart type="family">Tsakos</namePart><affiliation>Department of Epidemiology and Public Health, University College London, London, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre><originInfo><publisher>BMJ Publishing Group Ltd</publisher><dateIssued encoding="w3cdtf">2013-09</dateIssued><dateCreated encoding="w3cdtf">2013-06-27</dateCreated><copyrightDate encoding="w3cdtf">2013</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><abstract>Background There is very little information about the relationship between welfare regimes and oral health inequalities. We compared socioeconomic inequalities in adults’ oral health in five European welfare-state regimes: Scandinavian, Anglo-Saxon, Bismarckian, Southern and Eastern. Methods Using data from the oral health module of the Eurobarometer 72.3 survey, we assessed inequalities in two self-reported oral health measures: no functional dentition (less than 20 natural teeth) and edentulousness (no natural teeth). Occupational social class, education and subjective social status (SSS) were included as socioeconomic position indicators. We estimated age-standardised prevalence rates, ORs, the Relative Index of Inequality (RII) and the Slope Index of Inequality (SII). Results The Scandinavian regime showed the lowest prevalence rates of the two oral health measures while the Eastern showed the highest. In all welfare regimes there was a general pattern of social gradients by occupational social class and education. Relative educational inequalities in no functional dentition were largest in the Scandinavian welfare regime (RII=3.81; 95% CI 2.68 to 5.42). The Scandinavian and Southern regimes showed the largest relative inequalities in edentulousness by occupation and education, respectively. There were larger absolute inequalities in no functional dentition in the Eastern regime by occupation (SII=42.16; 95% CI 31.42 to 52.89) and in the Southern by SSS (SII=27.92; 95% CI 17.36 to 38.47). Conclusions Oral health inequalities in adults exist in all welfare-state regimes, but contrary to what may be expected from theory, they are not smaller in the Scandinavian regime. Future work should examine the potential mechanisms linking welfare provision and oral health inequalities.</abstract><subject><genre>keywords</genre><topic>Health inequalities</topic><topic>Oral health</topic><topic>Social epidemiology</topic></subject><relatedItem type="host"><titleInfo><title>Journal of Epidemiology and Community Health</title></titleInfo><titleInfo type="abbreviated"><title>J Epidemiol Community Health</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><identifier type="ISSN">0143-005X</identifier><identifier type="eISSN">1470-2738</identifier><identifier type="PublisherID">jech</identifier><identifier type="PublisherID-hwp">jech</identifier><identifier type="PublisherID-nlm-ta">J Epidemiol Community Health</identifier><part><date>2013</date><detail type="volume"><caption>vol.</caption><number>67</number></detail><detail type="issue"><caption>no.</caption><number>9</number></detail><extent unit="pages"><start>728</start></extent></part></relatedItem><identifier type="istex">346530C57AC95EE480CE0D7D6CA970C9656C4392</identifier><identifier type="ark">ark:/67375/NVC-G2HKBPPM-N</identifier><identifier type="DOI">10.1136/jech-2013-202714</identifier><identifier type="href">jech-67-728.pdf</identifier><identifier type="ArticleID">jech-2013-202714</identifier><identifier type="PMID">23814268</identifier><identifier type="local">jech;67/9/728</identifier><accessCondition type="use and reproduction" contentType="copyright">Published by the BMJ Publishing Group Limited. 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