Abstract
Objectives Previous studies reported that childhood poverty is one of major determinants of caries among children. It was assumed that parenting mediate the association; however, the content and magnitude of mediation effect of parenting on the association remain unknown. The purpose of this study is to investigate what kind of and how much parenting mediate the association between childhood poverty and caries. Methods Data were taken from the Adachi Child Health Impact of Living Difficulty (A-CHILD) study, which involved the population-based participation of 4291 caregivers of first-grade children (6- to 7-years-old) living in Adachi City, Tokyo. Childhood poverty was defined based on low-income (less than JPY 3 million, equivalent to EUR 22,000), material deprivation, or unable to pay for lifeline utilities. Caries was assessed by school dentist during school health checkup. Parenting, including providing healthy lifestyle, interaction with children, and maltreatment, were assessed via questionnaire distributed through school, reported by caregivers. Parenting categories were confirmed by factor analysis. Mediation analysis was performed for each parenting category on the association between childhood poverty and caries using causal mediation analysis by Stata. Results Childhood poverty showed significant positive association with caries. Among three parenting categories, not providing healthy lifestyle showed significant natural indirect effect (1.18, 95% confidence interval: 1.15–1.21), proportion of mediation was 38%. However, maltreatment and no interaction with children did not show indirect effect (both proportion of mediation were −2% and 1%, respectively). Conclusion Among parenting, not providing healthy lifestyle, but not maltreatment and no interaction with children, was partially mediated the association between childhood poverty and caries. Intervention on unhealthy parenting may help to prevent caries among children under poverty.
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