<scp>T</scp>he role of potential mediators in racial inequalities in tooth loss: the Pró‐Saúde study

Celeste, Roger Keller; Gonçalves, Letícia Gomes; Faerstein, Eduardo; Bastos, João Luiz

doi:10.1111/cdoe.12051

Cited by 48 publications

(57 citation statements)

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“…33 The prevalence of self-reported discrimination was also higher than that found in studies that enrolled immigrants 9 and Latinos 34 in the United States; in both, the prevalence of discrimination was about 30.0%.…”

Section: Discussionmentioning

confidence: 66%

Moderators of the association between discrimination and alcohol consumption: findings from a representative sample of Brazilian university students

Coelho

Bastos

Celeste

2015

Trends Psychiatry Psychother.

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Introduction: Few studies about discrimination and patterns of alcohol consumption among youth populations have been conducted outside the United States addressing different types of discriminatory experiences, in addition to racially motivated events. This study investigated moderators of the association between discrimination attributed to single and multiple reasons and patterns of alcohol consumption. Methods: This cross-sectional study enrolled a representative sample (n = 1,264) of undergraduate students from Florianópolis, southern Brazil, in 2013. Analyses included adjustment of associations for covariates in ordinal logistic regression models and the examination of effect modification by common mental disorders, year of study and age. Results: Discrimination was reported by 65.8% of the students, and alcohol consumption, by 80.0%. Over half of the students reported being discriminated against for two or more reasons. The odds of alcohol-related problems were higher among lastyear students that reported discrimination (odds ratio [OR] = 1.9, 95% confidence interval [95%CI] 1.0-3.4) or multiple reasons for being discriminated against (OR = 2.3, 95%CI 1.3-4.3), when compared to first-year students that did not report discrimination. For the whole sample, there were no associations between discrimination, discrimination attributed to multiple reasons and patterns of alcohol consumption (OR = 1.0, 95%CI 0.8-1.4; and OR = 0.9, 95%CI 0.5-1.6). Conclusions:The effects of discrimination on the patterns of alcohol consumption are seen at a critical period in university life, specifically during the completion of undergraduate studies.

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Section: Discussionmentioning

confidence: 66%

Moderators of the association between discrimination and alcohol consumption: findings from a representative sample of Brazilian university students

Coelho

Bastos

Celeste

2015

Trends Psychiatry Psychother.

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“…The concept of estimating the effect of different factors and explaining tooth loss inequalities is not novel. In 2013, Celeste et al published a study with longitudinal data investigating ethnicity and tooth loss, and the mediating effect of behavioural factors. Their results showed that 1.4% of the ethnic inequality in tooth loss may be explained by the combination of dental visits, marital status, smoking and alcohol consumption.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have shown a negative effect of alcohol consumption, whereas others found an inverse association between alcohol consumption and tooth loss . Previous studies included variables such as age, gender, smoking, alcohol consumption, dental plaque, and social determinants as confounding factors and applied change‐in‐estimate regression models to understand pathways in social inequality in tooth loss …”

Section: Introductionmentioning

confidence: 99%

Social inequality in tooth loss, the mediating role of smoking and alcohol consumption

Hach

Christensen

Lange

et al. 2019

Comm Dent Oral Epid

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Objectives:The objective of the study was to investigate the mediated proportion of smoking and alcohol consumption in the association between education and tooth loss. Further, the objective was, on the additive scale, to decompose the total effect of education on tooth loss into the direct effect of education, the natural indirect effect through smoking and alcohol consumption (differential exposure) and the mediated interaction between education, smoking and alcohol consumption on tooth loss (differential susceptibility). Methods:The study was based on data from the Social Inequality in Cancer Cohort (SIC); a cohort constructed by seven pooled cohorts. The total study population comprised of 34 975 participants. With the use of natural effects models, we regarded smoking and alcohol consumption as intermediates; we investigated the role of smoking and alcohol consumption in mediating the effect of education on tooth loss. Results:In total, 4924 participants had tooth loss defined as <15 teeth present. The results of the analyses, on the additive scale, showed 1202 (95% CI: 623-1781) additional persons with tooth loss per 10 000 persons among low compared to highly educated men. Among women, the analyses showed 1159 (95% CI: 959-1359) additional persons with tooth loss per 10 000 persons. The results, on the relative scale, showed that 11% (95% CI: 8%-15%) of the social inequality in tooth loss was

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“…The effect of ethnicity on health conditions is influenced by a set of factors. A study on tooth loss identified that the material conditions of life and educational levels were the most important factors [37]. Thus, it is necessary to investigate this difference between individuals with brown and black skin color in greater detail and evaluate whether Brazilian program of the quotas for blacks in universities (implanted in the last decade) may have also benefitted their health, as higher levels of schooling are commonly associated with a better health status [3–6,23,24,36].…”

Section: Discussionmentioning

confidence: 99%

Functional Dentition in Brazilian Adults: An Investigation of Social Determinants of Health (SDH) Using a Multilevel Approach

et al. 2016

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ObjectivesEstimate the prevalence of functional dentition among Brazilian adults using four different definitions and identify associated factors.MethodsA cross-sectional study was conducted involving 9564 Brazilian adults aged 35–44 years who participated in the 2010 National Oral Health Survey. Data collection involved oral examinations and the administration of questionnaires. The following definitions were used: 1—WHO Functional Dentition (FDWHO: ≥ 20 teeth present); 2—well-distributed teeth (WDT: ≥ 10 teeth in each arch); 3 –Functional dentition classified by esthetics and occlusion (FDClass5: dentitions that sequentially exhibit at least one tooth in each arch, at least 10 teeth in each arch, all maxillary and mandibular anterior teeth, three or four premolar posterior occluding pairs [POPs], and at least one molar POP bilaterally); 4—Functional dentition classified by esthetics, occlusion and periodontal status (FDClass6: corresponds to FDClass5 with the addition of periodontal status of all sextants in the oral cavity with, at most, shallow pockets and/or clinical attachment level of 5 mm (CPI ≤ 3 and/or CAL ≤ 1). The independent variables were individual factors (gender, self-declared skin color, schooling, monthly household income, age group, self-rated treatment need, dental pain, dental appointment in the previous 12 months and dental services) and contextual factors (Municipal Human Development Index [MHDI]), Gini coefficient, fluoridated water supply and oral health coverage). Multilevel mixed-effect Poisson regression analyses were performed.ResultsThe prevalence of functional dentition based on the FDWHO, WDT, FDClass5 and FDClass6 definitions was 77.9%, 72.9%, 42.6% and 40.3%, respectively. Adults with ≥12 years of schooling and monthly household income from US$ 853 to 2557 had higher prevalence rates of FDWHO (PR: 1.41 and 1.10, respectively), WDT (PR: 1.58 and 1.14, respectively), FDClass5 (PR: 2.03 and 1.27, respectively) and FDClass6 (PR: 2.15 and 1.35, respectively). These values in the final models were adjusted for gender, self-declared skin color (FDClass5), age group, self-rated treatment need (FDWHO, FDClass5 and FDClass6), dental appointment in the previous 12 months (FDWHO and WDT), dental services (FDWHO and WDT) and contextual factors. A very high MHDI and presence of fluoridated water supply were associated with higher prevalence rates of the four outcomes.ConclusionsThe incorporation of the criteria of new definitions of functional dentition led to a lower prevalence rate among Brazilian adults. Striking individual and contextual inequalities were identified with regard to the four definitions analyzed, which need to be addressed through inter-sector efforts.

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The role of potential mediators in racial inequalities in tooth loss: the Pró‐Saúde study

Abstract: There is an association between race and tooth loss that is mainly explained by current and early life socioeconomic variables, but not by behavioural factors and self-reported discrimination.

Cited by 48 publications

References 38 publications

Moderators of the association between discrimination and alcohol consumption: findings from a representative sample of Brazilian university students

Moderators of the association between discrimination and alcohol consumption: findings from a representative sample of Brazilian university students

Social inequality in tooth loss, the mediating role of smoking and alcohol consumption

Functional Dentition in Brazilian Adults: An Investigation of Social Determinants of Health (SDH) Using a Multilevel Approach

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