Abstract
BackgroundMost studies on socioeconomic inequalities in oral health have not considered the effects of behavioral and biological factors and age differences. Furthermore, the nationwide status of inequalities remains unclear in Japan.MethodsWe analyzed data from 2,089 residents aged ≥40 years throughout Japan. The lowest quartile of the number of remaining teeth for each 10-year age category was defined as poor oral health. Behavioral and biological factors included smoking status, obesity, diabetes mellitus, high-sensitivity C-reactive protein, and the use of dental devices. Multiple logistic regression analyses were conducted to examine the associations of educational attainment and equivalent household expenditure (EHE) with oral health, and stratified analyses by age category were also conducted (40–64 years and ≥65 years).ResultsLower education and lower EHE were significantly associated with an increased risk of poor oral health after adjusting for age, sex, employment status, marital and living statuses, and EHE/education; the odds ratio for junior high school education compared with ≥college education was 1.84 (95% confidence interval [CI], 1.36–2.49), and the odds ratio of the lowest compared with the highest EHE quartile was 1.91 (95% CI, 1.43–2.56). Further adjustments for behavioral and biological factors attenuated but did not eliminate these associations. EHE was significantly associated with oral health among elderly adults only, with a significant interaction by age category.ConclusionsThose with a lower education and those with lower EHE had a significantly higher risk of poor oral health, even after adjustments for behavioral and biological factors.
Highlights
Oral health is integral and essential to quality of life and social functioning.[1]
A large number of epidemiological studies have reported an association between socioeconomic status (SES) and oral health in developed countries; lower socioeconomic groups are more likely than higher ones to have poor oral health.[3,4]
Significantly associated with an increased risk of poor oral health after adjusting for age, sex, type of house, employment status, marital and living statuses, and equivalent household expenditure (EHE)=education; the multivariable-adjusted odds ratio (OR) of junior high school education compared with college education or higher was 1.84, and the multivariable-adjusted OR of the lowest compared with the highest EHE quartile was 1.91
Summary
Oral health is integral and essential to quality of life and social functioning.[1] oral health has a profound effect on general health,[1] as evidenced by the association between poor oral health and chronic diseases, such as cardiovascular diseases.[2]. A large number of epidemiological studies have reported an association between socioeconomic status (SES) and oral health in developed countries; lower socioeconomic groups are more likely than higher ones to have poor oral health.[3,4] Public health research into socioeconomic inequalities in oral health has suggested causal pathways linking behavioral and biological factors to oral health.[5] very few studies have examined the effects of these factors, physiological markers, on the association between SES and oral health.[6,7,8,9,10] identifying the underlying causes may be useful for effective action to tackle oral health inequalities. The nationwide status of inequalities remains unclear in Japan
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