Abstract
Very little is known about the potential relationship between welfare state regimes and oral health. This study assessed the oral health of adults in a range of European countries clustered by welfare regimes according to Ferrera's typology and the complementary Eastern type. We analysed data from Eurobarometer wave 72.3, a cross-sectional survey of 31 European countries carried out in 2009. We evaluated three self-reported oral health outcomes: edentulousness, no functional dentition (<20 natural teeth), and oral impacts on daily living. Age-standardized prevalence rates were estimated for each country and for each welfare state regime. The Scandinavian regime showed lower prevalence rates for all outcomes. For edentulousness and no functional dentition, there were higher prevalence rates in the Eastern regime but no significant differences between Anglo-Saxon, Bismarckian, and Southern regimes. The Southern regime presented a higher prevalence of oral impacts on daily living. Results by country indicated that Sweden had the lowest prevalences for edentulousness and no functional dentition, and Denmark had the lowest prevalence for oral impacts. The results suggest that Scandinavian welfare states, with more redistributive and universal welfare policies, had better population oral health. Future research should provide further insights about the potential mechanisms through which welfare-state regimes would influence oral health.
Highlights
IntroductionThe typology most widely used was proposed by ESPING-ANDERSEN [20, 26,27,28] and defines three types of welfare states: liberal (most welfare goods and services are provided by the market), conservative (a key role is played by the family, and certain earnings-related welfare benefits are provided by the state), and social-democratic (universal and comprehensive benefits are provided by the state and there is a high level of decommodification)
The typology most widely used was proposed by ESPING-ANDERSEN [20, 26,27,28] and defines three types of welfare states: liberal, conservative, and social-democratic
Our results support the idea that a welfare regime with more redistributive and universal welfare policies would result in better population oral health
Summary
The typology most widely used was proposed by ESPING-ANDERSEN [20, 26,27,28] and defines three types of welfare states: liberal (most welfare goods and services are provided by the market), conservative (a key role is played by the family, and certain earnings-related welfare benefits are provided by the state), and social-democratic (universal and comprehensive benefits are provided by the state and there is a high level of decommodification). While the first three types resemble the Esping-Andersen social-democratic, liberal, and conservative groups, respectively, the additional Southern type clusters countries with fragmented welfare benefits These are: generosity in certain provisions, but weak in others; a marked public–private mix in benefits and services; and some corruption in the selective distribution of cash subsidies [30, 33]. Public health researchers have increasingly used five regime types within Europe: Scandinavian, Anglo-Saxon, Bismarckian, Southern, and Eastern [28, 32, 34, 35]
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