Abstract
This study aimed to evaluate the influence of choosing different socioeconomic status indicators in research regarding older adults' oral health. This is a cross-sectional study that analyzed baseline data from the Brazilian Longitudinal Study on Aging (ELSI-Brazil). The outcomes were edentulism (n = 9,073) and self-reported oral health (n = 9,365). The following socioeconomic indicators were assessed: individual income, per capita household income, and wealth index. Poisson regression analysis with robust variance was performed to estimate prevalence ratios (PR), with their respective 95% confidence intervals (CI), after adjusting for socioeconomic and oral health behavior variables. Absolute inequality measures were also estimated. The individual income indicator was not statistically associated with the results after adjustments. When using per capita household income indicator, individuals in the richest quintile showed a 12% lower prevalence of poor self-reported oral health [PR: 0.88 (CI: 0.78-0.98)], relative to the poorest, and there was no association with edentulism. When the wealth index was chosen, there was a 22% lower prevalence of edentulism [PR: 0.78 (CI: 0.64-0.94)] and 15% lower prevalence of self-reported poor oral health [PR: 0.85 (CI: 0.78-0.93)] in individuals of the richest quintile, both relative to the poorest quintile. Regarding absolute inequality measures, for edentulism, the wealth index showed the highest absolute inequality. When considering self-reported oral health, per capita household income showed the greatest absolute inequality. Despite scientific challenges and the difficulty of socioeconomic indicator metrics, further investments in its development are critical to measure, promote, and improve population oral health.
Highlights
Social determinants of health (SDH) are specific characteristics of daily living that can affect individuals’ health, like the circumstances in which people are born, grow up, live, work and grow old.[1]
Individuals in the richest quintile showed a 12% lower prevalence of poor self-reported oral health [prevalence ratios (PR): 0.88 (95%confidence intervals (CI): 0.78–0.98)], when compared to the poorest quintile of per capita household income
Individuals in the richest quintile of wealth showed a 22% lower prevalence of edentulism [PR: 0.78 (95%CI: 0.64–0.94)] and 15% lower in reporting poor oral health [PR: 0.85 (95%CI: 0.78–0.93)], both relative to the poorest quintile of wealth
Summary
Social determinants of health (SDH) are specific characteristics of daily living that can affect individuals’ health, like the circumstances in which people are born, grow up, live, work and grow old.[1]. Previous studies have shown that almost half of the global population has their oral health unfairly affected by unequal social conditions.[5,6]
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