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Inequity in access to dental care services explains current socioeconomic disparities in oral health: The Swedish National Surveys of Public Health 2004-2005

Wamala, Sarah ; Merlo, Juan LU orcid and Bostrom, Gunnel (2006) In Journal of Epidemiology and Community Health 60(12). p.1027-1033
Abstract
Objective: To analyse the effects of socioeconomic disadvantage on access to dental care services and on oral health. Design, setting and outcomes: Cross-sectional data from the Swedish National Surveys of Public Health 2004 and 2005. Outcomes were poor oral health (self-rated oral health and symptoms of periodontal disease) and lack of access to dental care services. A socioeconomic disadvantage index ( SDI) was developed, consisting of social welfare beneficiary, being unemployed, financial crisis and lack of cash reserves. Participants: Swedish population-based sample of 17 362 men and 20 037 women. Results: Every instance of increasing levels of socioeconomic disadvantage was associated with worsened oral health but, simultaneously,... (More)
Objective: To analyse the effects of socioeconomic disadvantage on access to dental care services and on oral health. Design, setting and outcomes: Cross-sectional data from the Swedish National Surveys of Public Health 2004 and 2005. Outcomes were poor oral health (self-rated oral health and symptoms of periodontal disease) and lack of access to dental care services. A socioeconomic disadvantage index ( SDI) was developed, consisting of social welfare beneficiary, being unemployed, financial crisis and lack of cash reserves. Participants: Swedish population-based sample of 17 362 men and 20 037 women. Results: Every instance of increasing levels of socioeconomic disadvantage was associated with worsened oral health but, simultaneously, with decreased utilisation of dental care services. After adjusting for age, men with a mild SDI compared with those with no SDI had 2.7(95% confidence interval (CI) 2.5 to 3.0) times the odds for self-rated poor oral health, whereas odds related to severe SDI were 6.8( 95% CI 6.2 to 7.5). The corresponding values among women were 2.3 ( 95% CI 2.1 to 2.5) and 6.8 ( 95% CI 6.3 to 7.5). Nevertheless, people with severe socioeconomic disparities were 7 - 9 times as likely to refrain from seeking the required dental treatment. These associations persisted even after controlling for living alone, education, occupational status and lifestyle factors. Lifestyle factors explained only 29% of the socioeconomic differences in poor oral health among men and women, whereas lack of access to dental care services explained about 60%. The results of the multilevel regression analysis indicated no additional effect of the administrative boundaries of counties or of municipalities in Sweden. Conclusions: Results call for urgent public health interventions to increase equitable access to dental care services. (Less)
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type
Contribution to journal
publication status
published
subject
in
Journal of Epidemiology and Community Health
volume
60
issue
12
pages
1027 - 1033
publisher
BMJ Publishing Group
external identifiers
  • wos:000242048000006
  • scopus:33845267246
ISSN
1470-2738
DOI
10.1136/jech.2006.046896
language
English
LU publication?
yes
id
600803df-668d-49e7-86d5-b53f09925fb1 (old id 376973)
date added to LUP
2016-04-01 12:30:29
date last changed
2020-12-29 01:58:37
@article{600803df-668d-49e7-86d5-b53f09925fb1,
  abstract     = {Objective: To analyse the effects of socioeconomic disadvantage on access to dental care services and on oral health. Design, setting and outcomes: Cross-sectional data from the Swedish National Surveys of Public Health 2004 and 2005. Outcomes were poor oral health (self-rated oral health and symptoms of periodontal disease) and lack of access to dental care services. A socioeconomic disadvantage index ( SDI) was developed, consisting of social welfare beneficiary, being unemployed, financial crisis and lack of cash reserves. Participants: Swedish population-based sample of 17 362 men and 20 037 women. Results: Every instance of increasing levels of socioeconomic disadvantage was associated with worsened oral health but, simultaneously, with decreased utilisation of dental care services. After adjusting for age, men with a mild SDI compared with those with no SDI had 2.7(95% confidence interval (CI) 2.5 to 3.0) times the odds for self-rated poor oral health, whereas odds related to severe SDI were 6.8( 95% CI 6.2 to 7.5). The corresponding values among women were 2.3 ( 95% CI 2.1 to 2.5) and 6.8 ( 95% CI 6.3 to 7.5). Nevertheless, people with severe socioeconomic disparities were 7 - 9 times as likely to refrain from seeking the required dental treatment. These associations persisted even after controlling for living alone, education, occupational status and lifestyle factors. Lifestyle factors explained only 29% of the socioeconomic differences in poor oral health among men and women, whereas lack of access to dental care services explained about 60%. The results of the multilevel regression analysis indicated no additional effect of the administrative boundaries of counties or of municipalities in Sweden. Conclusions: Results call for urgent public health interventions to increase equitable access to dental care services.},
  author       = {Wamala, Sarah and Merlo, Juan and Bostrom, Gunnel},
  issn         = {1470-2738},
  language     = {eng},
  number       = {12},
  pages        = {1027--1033},
  publisher    = {BMJ Publishing Group},
  series       = {Journal of Epidemiology and Community Health},
  title        = {Inequity in access to dental care services explains current socioeconomic disparities in oral health: The Swedish National Surveys of Public Health 2004-2005},
  url          = {http://dx.doi.org/10.1136/jech.2006.046896},
  doi          = {10.1136/jech.2006.046896},
  volume       = {60},
  year         = {2006},
}