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Socioeconomic inequalities in oral health in different European welfare state regimes

Identifieur interne : 001957 ( Istex/Curation ); précédent : 001956; suivant : 001958

Socioeconomic inequalities in oral health in different European welfare state regimes

Auteurs : Carol C. Guarnizo-Herre O [Royaume-Uni, Colombie] ; Richard G. Watt [Royaume-Uni] ; Hynek Pikhart [Royaume-Uni] ; Aubrey Sheiham [Royaume-Uni] ; Georgios Tsakos [Royaume-Uni]

Source :

Journal of Epidemiology and Community Health [ 0143-005X ] ; 2013-09.

RBID : ISTEX:346530C57AC95EE480CE0D7D6CA970C9656C4392

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Wicri :
- topic : Statistique nationale, Santé publique, Rapport de recherche, Statut social.

English descriptors

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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https://api.istex.fr/document/346530C57AC95EE480CE0D7D6CA970C9656C4392/fulltext/pdf

DOI: 10.1136/jech-2013-202714

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<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>
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<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Statistique nationale</term>
<term>Santé publique</term>
<term>Rapport de recherche</term>
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<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>
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Socioeconomic inequalities in oral health in different European welfare state regimes

Socioeconomic inequalities in oral health in different European welfare state regimes

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Abstract

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