Income-related inequality in perceived oral health among adult Finns before and after a major dental subsidization reform

Abstract

Objectives In Finland, a dental subsidization reform, implemented in 2001-2002, abolished age restrictions on subsidized dental care. The aim of this study was to investigate income-related inequality in the perceived oral health and its determinants among adult Finns before and after the reform. Materials and methods Three identical cross-sectional nationally representative postal surveys, concerning perceived oral health and the use of dental services among people born before 1971, were conducted in 2001 (n = 2157), in 2004 (n = 1814) and in 2007 (n = 1671). Three measures of perceived oral health were used: toothache or oral discomfort during the past 12 months, current need for dental care and self-reported oral health status. Concentration index was used to analyse the income-related inequalities. Its decomposition was used to study factors related to the inequalities. Results The proportion of respondents reporting need for dental care decreased from 2001 to 2007, while no changes were seen in reports of toothache or self-reported oral health status. Income-related inequalities in reports of toothache and perceived need for care widened, while the inequality in self-reported oral health remained stable. Most of the inequalities were related to income itself, perceived general health and the time since the last visit to dental care. Conclusions It seems that the income-related inequalities in perceived oral health remained or even widened after the reform.

Preventive dental care use for children with special health care needs in Washington's Access to Baby and Child Dentistry program

“…21-22 Under such circumstances, concerns have been raised about the potential for widening disparities associated with public health programs that are not tailored to high-risk subgroups like CSHCN. 23 The idea is that such programs “skim off the top” by benefitting individuals who are best positioned to take advantage of the program, leaving behind less advantaged program participants. The current data support the concept of widening disparities pertaining to CSHCN in the ABCD Program.…”

“…14 This raises specific concerns about vulnerable child subgroups within ABCD, like CSHCN, because of the potential for programs like ABCD to widen oral health inequalities. 23 …”

Twenty‐five‐year follow‐up of educational differences in toothache prevalence

“…A recent Australian study on socioeconomic gradients in toothache prevalence during 1994‐2013 detected two‐ to three‐fold differences in toothache prevalence between the highest and lowest household income tertiles. On the other hand, Finnish studies have found clearly smaller, even minimal, differences in toothache prevalence both by household income and by educational levels among + 30‐year‐olds in the 2000s . However, in both countries, studies found that socioeconomic differences increased during the follow‐up .…”

“…On the other hand, Finnish studies have found clearly smaller, even minimal, differences in toothache prevalence both by household income and by educational levels among + 30‐year‐olds in the 2000s . However, in both countries, studies found that socioeconomic differences increased during the follow‐up . It has been found that perceived general health and income itself explained most of the income‐related differences in toothache prevalence in Finland, possibly due to differences in access to oral healthcare services by socioeconomic status .…”

“…6 However, in both countries, studies found that socioeconomic differences increased during the follow-up. 1,6 It has been found that perceived general health and income itself explained most of the income-related differences in toothache prevalence in Finland, possibly due to differences in access to oral healthcare services by socioeconomic status. 7 In addition, Australian researchers 1 explained their findings also by referring to differences in access to oral healthcare services by income levels and more favourable visiting patterns among the well-off.…”