Place of Birth Inequalities in Dental Care Use before and after the Economic Crisis in Spain

Elena Rodriguez-Alvarez,Nerea Lanborena,Luisa N Borrell

doi:10.3390/ijerph16101691

Abstract

This study evaluates inequalities in the use of dental services according to place of birth before and after the economic crisis in Spain. A cross-sectional study was performed in adults aged 18 to 65 years in Spain. We used data from three Spanish National Health Surveys for the years 2006 (before the crisis), 2014, and 2017 (after the crisis). Log-binomial regression was used to quantify the association between place of birth and use of dental care services before and after controlling for the selected covariates. In 2006, we found a greater probability of not using dental care services in immigrants from Asia (PR: 1.36, 95% CI: 1.10–1.67) and Africa (PR: 1.16, 95% CI: 1.05–1.28) compared to the natives. For 2014, the probability of not using dental care services was greater for all immigrants relative to natives, with the greatest probability for those from Africa (PR: 1.71, 95% CI: 1.46–2.01) and Asia (PR: 1.3, 95% CI: 1.23–1.47). The associations for 2017 were weaker in magnitude than the ones observed for 2014, although stronger than for 2006. This study suggests that the economic recovery did not have the same impact for natives and immigrants regardless of regions of origin, given the observed inequalities in use of dental services.

Highlights

Oral health is an important component of populations’ health status
There are few studies accounting for place of birth on the inequalities in the use of dental services, and even fewer including some of the immigrant groups considered in our study, their findings are consistent with ours, showing lower use of dental services in immigrants from
Our findings show that the economic recovery has not had the same impact for natives and immigrants, given the observed inequalities in access to dental services and their increase among natives and immigrants regardless of regions of origin

Summary

Introduction

Oral health is an important component of populations’ health status. evidence points to the relationship between oral health and cancer mortality [1], cardiovascular and respiratory diseases [2]diabetes [3], obesity [4], premature births [5], and quality of life [6]. Poor oral health follows a clear socioeconomic pattern as a result of increased exposure to risk factors among individuals with low educational attainment, income, and employment status. This pattern of inequality has been described systematically both between and within countries [7,8]. Inequalities in access to dental care services have been described in some countries [9,10,11,12], they are more pronounced in countries where dental care is not covered by the public system compared to those countries with at least some dental care coverage [9,12,13,14,15]

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Discussion

Conclusion