Socioeconomic position and subjective oral health: findings for the adult population in England, Wales and Northern Ireland
Socioeconomic position and subjective oral health: findings for the adult population in England, Wales and Northern Ireland
复制标题
DOI：
10.1186/1471-2458-14-827
复制
发表时间：
2014-08-09
影响因子：
4.5
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
背景：本研究的目的是评估英格兰、威尔士和北爱尔兰成年人在主观口腔健康测量方面的社会经济不平等。方法：我们分析了来自2009年成人牙齿健康调查的8765名21岁及以上成年人的数据。我们检查了三项口腔健康测量的不平等：自评口腔健康、口腔健康影响概况（OHIP-14）和口腔对日常表现的影响（OIDP）。社会经济地位（SEP）指标包括受教育程度、职业社会阶层和家庭收入。拟合多变量logistic回归模型，并从回归系数中估计预测边际和条件边际效应，以比较不同SEP水平下结果的预测概率。我们还通过在输入缺失数据后重新估计回归模型来评估缺失数据对结果的影响。结果：不同SEP水平对结果的预测概率在有齿人群中存在显著差异，但在无齿人群中无显著差异。例如，与有学位或同等学历的人相比，没有学历的人报告口腔健康不良的预测概率更高（高出9.1个百分点，95%置信区间：6.54,11.68）。同样，与最高收入水平的参与者相比，低收入五分之一的参与者预测口腔健康状况不佳和口腔影响的概率显著更高（p < 0.001）。与教育或收入相比，职业社会阶层对所有结果的边际效应较弱。教育和收入相关的不平等在年轻人中更大，在65岁以上的人群中不明显。使用估算数据证实了上述结果。结论：在英格兰、威尔士和北爱尔兰的成年人中，主观口腔健康存在明显的社会经济不平等，年龄越小，差异越大。
Background: 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.Methods: 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.Results: 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.Conclusions: 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.