Abstract
BackgroundThe goal of this analysis was to describe socioeconomic inequalities in dental health among Spanish middle-aged adults, and the role of behavioral and psychosocial factors in explaining these inequalities.MethodsThis cross-sectional study used survey data from the 2006 Spanish National Health Survey and focused on adults ages 30 – 64. The outcome was dental health status based on the presence of self-reported dental problems. We used education, income, and occupational class as indicators of socioeconomic position and applied logistic regression analysis to estimate associations. We included behavioral and psychosocial variables in the models and compared non-adjusted to adjusted estimates to assess their potential role in explaining socioeconomic gradients.ResultsResults showed clear socioeconomic gradients in dental health among middle-aged adults. The percentage of people who reported more dental problems increased among those with lower levels of education, income, and occupation. These gradients were statistically significant (p < .001). Logistic regression showed that groups with lower education, income, and occupation had higher odds of reporting the outcome (p < .001). Associations were stronger when considering education as the indicator of socioeconomic position. Substantial unexplained associations remained significant after adjusting the model by behavioral and psychosocial variables.ConclusionsThis study shows significant socioeconomic gradients in dental health among middle-aged adults in Spain. Behavioral and psychosocial variables were insufficient to explain the inequalities described, suggesting the intervention of other factors. Further research should incorporate additional explanations to better understand and comprehensively address socioeconomic inequalities in dental health.
Highlights
The goal of this analysis was to describe socioeconomic inequalities in dental health among Spanish middle-aged adults, and the role of behavioral and psychosocial factors in explaining these inequalities
A robust and consistent body of evidence demonstrates that dental problems are unequally distributed across socioeconomic groups: individuals at the lower end of the socioeconomic ladder have a higher burden of dental diseases, compared to those who are better off [5,6,7]
Theoretical explanations and models identify a range of intermediate factors through which socioeconomic position affects health: these are material, behavioral and psychosocial factors which operate at different levels and over the life course [12,13,14]
Summary
The goal of this analysis was to describe socioeconomic inequalities in dental health among Spanish middle-aged adults, and the role of behavioral and psychosocial factors in explaining these inequalities. A robust and consistent body of evidence demonstrates that dental problems are unequally distributed across socioeconomic groups: individuals at the lower end of the socioeconomic ladder have a higher burden of dental diseases, compared to those who are better off [5,6,7] These inequalities often follow a stepwise gradient pattern, with oral health improving incrementally as socioeconomic position (SEP) improves [8, 9]. In Spain, studies measuring and explaining socioeconomic dental health inequalities at the national level are lacking This gap of knowledge is relevant for middle-aged adults since this is usually the period of life in which the transition from relatively simple to more complex oral health care needs takes place [20, 21]. The aims of the present study were to describe socioeconomic inequalities in dental health among middle-aged adults and to assess the role of behavioral and psychosocial factors in explaining the relationship between socioeconomic status and dental health
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