Social gradients and cumulative effects of income and education on dental health in the Fourth German Oral Health Study

Abstract

Education and income are shaping social inequalities in oral health independently from each other, and they are only moderately correlated. They refer to different dimensions of disadvantage thus making preventive measures more complicated.

Inequalities in oral health: Understanding the contributions of education and income

“…29 These discrepancies may also be attributed to differences in oral health care systems, as preventive dental coverage exists for individuals up to the age of 18 in Germany, whereas public coverage only exists for targeted populations in Canada. 6,28 This further suggests that social, political and economic contexts of jurisdictions might play a role in how socio-economic factors contribute to inequalities. Our results identified the contribution of income and education to socio-economic inequalities in two self-reported oral health outcomes.…”

“…27,28 Conversely, using the Fourth German Oral Health Study data, Geyer et al examined the effects of income and education on clinical oral health outcomes (DMFT) and determined that education may be a more important factor in oral health. 6 Differences may be due to the use of a conflated measure of oral health and disease in their analysis, as DMFT encompasses both treated and untreated dental disease. 29 These discrepancies may also be attributed to differences in oral health care systems, as preventive dental coverage exists for individuals up to the age of 18 in Germany, whereas public coverage only exists for targeted populations in Canada.…”

“…[1][2][3] Socio-economic gradients in oral health are often attributed to factors such as occupation, social class, income and education; among which, income and education are most commonly utilized. 5 The potential contribution of income to oral health inequalities can be explained by increased acquisition of material resources with increased income (financial access to care), 6 whereas education allows for the acquisition of non-material resources (such as knowledge) that promote healthy behaviours and better navigation of health resources. 6 However, the relative contribution of education to the income gradient in oral health outcomes, and that of income to the education gradient in oral health outcomes, remains unclear.…”

“…5 The potential contribution of income to oral health inequalities can be explained by increased acquisition of material resources with increased income (financial access to care), 6 whereas education allows for the acquisition of non-material resources (such as knowledge) that promote healthy behaviours and better navigation of health resources. 6 However, the relative contribution of education to the income gradient in oral health outcomes, and that of income to the education gradient in oral health outcomes, remains unclear. This is a fundamental consideration given that this knowledge can help determine what policy approaches may best narrow gaps and/or reduce oral health inequalities between social groups.…”

İzmir-Bornova’da Gebelerin Ağız-Diş Sağlığı Hizmeti Gereksinimi Ve Bu Hizmetlerden Yararlanma Düzeyinin Sosyoekonomik Değişkenlerle İlişkisi,

“…Sosyal, ekonomik ve çevresel faktörlerin ağız-diş sağlığı üzerin-deki etkisini yansıtan kanıtlar dikkate alınırsa bu belirleyiciler açısından yaşanan eşitsizliklerin gebelik döneminde de söz konusu olması beklenen bir durumdur (19)(20)(21)(22)(23).…”