Abstract
This study aimed to assess the association between oral health and rurality in an older Brazilian population. Population-based samples of 1,451 urban and 411 rural elders were obtained from two databases. Several oral health and related measures, including the number of teeth lost, use of dental prostheses, dental visits, self-reported oral health, and perceived need for a dental prosthesis, were compared. Oral health-related information was obtained by a trained research team with interviews conducted in the individuals' homes. Regression models were used to verify the association between living in rural areas and oral health outcomes after adjusting for possible confounding factors. The elderly population mostly comprised of women in rural or urban areas, and the mean age was 70 years in both locations. Less-educated individuals (without or with complete elementary schooling) were more common in rural regions than in urban areas. After adjustment for socioeconomic characteristics, living in rural areas was associated with a lower perceived need for dental prostheses (PR 0.68, 95% CI 0.56-0.84), poor self-reported oral health (OR 1.24; 95% CI 1.05-1.46), and having fewer teeth (β -1.31; 95% CI -2.18 to -0.45). The place of residence had a significant impact on oral health indicators, with rurality negatively influencing oral health. These findings suggest that preventive and curative strategies for dental services may be needed for the Brazilian rural population.
Highlights
It is well known that social factors affect health
In rural areas, there was a higher proportion of men, fewer black individuals, and more married persons
The perceived need for dental prosthesis was more evident among urban older individuals than those in the rural regions
Summary
It is well known that social factors affect health. A higher burden of disease is found in populations with poor socioeconomic conditions.[1] Social inequalities affect general health and oral health.[2,3] Better living conditions are generally associated with better general health, oral health, and quality of life. In the World Health Organization (WHO) conceptual model, the social determinants of health are characterized as structural and intermediary.[4] In this model, place of residence was included as an intermediate social determinant, influencing the unequal distribution of resources and health choices, contributing to oral health inequalities.[4] living in rural or remote areas may influence health outcomes
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