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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DOI：
10.1136/jech-2013-202714
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发表时间：
2013-09-01
影响因子：
6.3
通讯作者：
Tsakos, Georgios
中科院分区：
文献类型：
--
作者：
Guarnizo-Herreno, Carol C.;Watt, Richard G.;Tsakos, Georgios
关于福利制度和口腔健康不平等之间关系的信息很少。我们比较了五种欧洲福利国家体制中成年人口腔健康的社会经济不平等：斯堪的纳维亚、盎格鲁-撒克逊、俾斯麦、南部和东部。方法使用Eurobarometer 72.3调查口腔健康模块的数据，我们评估了两项自我报告的口腔健康指标的不平等：无功能牙列（少于20颗天然牙齿）和无牙（没有天然牙齿）。社会经济地位指标包括职业社会阶层、教育程度和主观社会地位。我们估计了年龄标准化患病率、or、相对不平等指数（RII）和不平等斜率指数（SII）。结果两项口腔健康措施的患病率斯堪的纳维亚地区最低，而东部地区最高。在所有福利制度中，按职业、社会阶层和教育程度划分的社会梯度普遍存在。在斯堪的纳维亚福利制度中，无功能牙列的相对教育不平等最大（RII=3.81; 95% CI 2.68至5.42）。斯堪的纳维亚和南方的政权分别在职业和教育方面显示出最大的相对不平等。在东部地区（SII=42.16, 95% CI 31.42 ~ 52.89）和南部地区（SII=27.92, 95% CI 17.36 ~ 38.47），无功能牙列的绝对不平等更大。成人健康不平等在所有福利国家制度中都存在，但与理论上的预期相反，在斯堪的纳维亚制度中，这种不平等并不小。未来的工作应该研究福利提供和口腔健康不平等之间的潜在机制。
BackgroundThere is very little information about the relationship between welfare regimes and oralhealth inequalities. We compared socioeconomic inequalities in adults' oral health in five European welfare-state regimes: Scandinavian, Anglo-Saxon, Bismarckian, Southern and Eastern.MethodsUsing data from the oral health module of the Eurobarometer 72.3 survey, we assessed inequalities in two self-reported oralhealth 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).ResultsThe 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).ConclusionsOralhealth 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.