Socio-Economic Inequalities in Oral Health

Singh, Ankur; Antunes, José Leopoldo Ferreira; Peres, Marco Aurélio

doi:10.1007/978-3-030-50123-5_17

Cited by 5 publications

(5 citation statements)

References 141 publications

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“…This is in line with a study earlier conducted by Tubert-Jeannin and others (2012), in which an Oral Health Promotion program showed little impact in reducing disparities in oral health [26]. Therefore, the implementation of these interventions may unintentionally contribute to the persistent problem of oral health inequality [12,15,27,28].…”

Section: Introductionsupporting

confidence: 89%

“…To tackle the burden of poor oral health in young children, it is necessary to gain a better understanding of the determinants causing oral health inequalities [11,12]. Previous research has mainly focused on individual-level determinants resulting in behaviour change interventions, such as preventive strategies for oral hygiene and sugar control [8,13].…”

Section: Introductionmentioning

confidence: 99%

“…This led to the development of community-based interventions (i.e. oral health education and school-based fluoride application programs) containing high potential to promote oral health of children living in disadvantaged circumstances [12,21,22].…”

Section: Introductionmentioning

confidence: 99%

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Professionals’ perspectives on how to address persistent oral health inequality among young children: an exploratory multi-stakeholder analysis in a disadvantaged neighbourhood of Amsterdam, the Netherlands

et al. 2022

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Background Oral health promotion interventions have had limited success in reaching families in disadvantaged neighbourhoods resulting in persistent oral health inequality. This qualitative study provides insight into professionals’ perspectives on children’s poor oral health (≤ 4 years), their perceptions of the roles and responsibilities, and opportunities for child oral health promotion strategies. Methods Thirty-Eight professionals from different domains (community, social welfare, general health, dental care, public health, private sector) working in a disadvantaged neighbourhood in Amsterdam, the Netherlands, participated through 24 semi-structured (group) interviews. Transcripts and notes were analysed through thematic analysis. Results Professionals indicate that unhealthy diet, children’s non-compliance, poor parental coping, parental low oral health literacy, parent’s negative attitude, family’s daily struggles, and insufficient emphasis on childhood caries prevention in dental practices, general healthcare and social welfare organisations, underlie poor oral health. They hold parents most responsible for improving young children’s oral health, but recognise that families’ vulnerable living circumstances and lack of social support are important barriers. Interestingly, non-dental professionals acknowledge their beneficial role in child oral health promotion, and dental professionals stress the need for more collaboration. Conclusion A broad child-, parental-, and societal-centred educational communication strategy is perceived as promising. Professionals working within and outside the dental sector acknowledge that local and collective action is needed. This involves a better understanding of family’s complex daily reality. Furthermore, intensifying child oral health knowledge in dental practices is essential in collaboration with families, general health and social welfare organisations.

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Section: Introductionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

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Professionals’ perspectives on how to address persistent oral health inequality among young children: an exploratory multi-stakeholder analysis in a disadvantaged neighbourhood of Amsterdam, the Netherlands

et al. 2022

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“…However, this analytical approach is also subject to bias in the estimates, particularly in relation to the role of potential mediators (which in essence is what we refer to here as “pathways”) in the associations between a distal exposure (SEP) and a proximal outcome (oral health in this case). Longitudinal and causal inference methodologies, such as causal mediation analysis, are better suited to deal with the combined effect of exposure and mediator on the outcome, for example how lower SEP and health‐damaging behaviours can interact to impact on worse oral health, look at the dynamic nature of the pathways to oral health inequalities and also account well for confounding 81,82 . We have already called for studies that look at the role of those pathways combined, rather than in isolation, but it is also important that they employ the stronger available methodologies to comprehensively address this issue.…”

Section: Next Steps For Research Prioritiesmentioning

confidence: 99%

Reflections on oral health inequalities: Theories, pathways and next steps for research priorities

Tsakos

Watt

Guarnizo-Herreño

2023

Comm Dent Oral Epid

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Health inequalities have not decreased over the last decades and for some outcomes have even increased, with disadvantaged groups in contemporary societies still enduring higher burdens of mortality and morbidity, including oral diseases. 1,2 These stark inequalities in health most often take the pattern of a social gradient, whereby each lower socioeconomic position group has a higher health burden than the immediately less deprived group. 3 These social gradients are linked to structural factors like policies of economic liberalization, changes in labour markets and an austerity approach to social policies. 4,5 Moreover, the COVID-19 pandemic has both magnified previously existing inequalities and created new ones in what has been called the syndemic of COVID-19, non-communicable diseases (NCDs) and the social determinants of health. 6 The pandemic has exacerbated access barriers with the more disadvantaged population

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“…Additionally, since 1990 total disability-adjusted life years due to oral conditions have increased 64% to 16.9 million in 2015 [ 3 ]. Furthermore, LMIC have the lowest coverage and the highest socioeconomic inequality in terms of oral health care, which limits the opportunities for timely preventive and recuperative care [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Frequency, inequalities and spatial distribution of oral health services utilization in Peruvian children under twelve years of age: a population-based comparative analysis of the years 2017 and 2021

Azañedo,

Hernández-Vásquez,

Visconti-Lopez

et al. 2023

BMC Oral Health

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Background Oral diseases pose a significant public health challenge among Peruvian children. However, oral health services utilization among them is marked by inequalities, which may have been exacerbated by the COVID-19 pandemic. The objective was to compare the frequency, inequalities, determinants of inequality, and spatial distribution in oral health services utilization in Peruvian children under 12 years of age in 2017 and 2021. Methods Comparative secondary data analysis from the Demographic and Family Health Survey (ENDES) for the years 2017 (38,787 minors) and 2021 (36,729 minors). Age-adjusted prevalence ratios (PR) with 95% confidence intervals (CI) were calculated to assess the change in oral health services utilization in the last 12 months between the years 2017 and 2021, stratifying by demographic and socioeconomic covariates. Inequality was assessed by decomposing the Erreygers Concentration Index (ECI) and calculating the percentage contribution to inequality of the independent variables. Spatial analysis was performed using spatial autocorrelation methods, Hot Spot Analysis, Cluster and Outlier analysis, Inverse Distance Weighting, ordinary Kriging, and Kulldorff analysis. Results The probability of Peruvian children under 12 years of age using oral health services in the last 12 months was reduced by 45% in 2021 compared to 2017. The ECI identified a significant reduction in oral health services utilization inequalities at the national level (Diff: -0.0963; p < 0.001). The main contributor to inequality was higher tutor education level (55.2% in 2017 and 82.7% in 2021). In the comparison of spatial distribution, there was a greater dispersion of the conglomerates in which the use of oral health services is concentrated in 2021. Conclusions The frequency of oral health services utilization in the Peruvian children under 12 years of age was halved between 2017 and 2021. This problem is transversal to the entire population at the demographic and socioeconomic level. The key factor contributing to inequalities in the utilization of oral health services was the higher educational attainment of caregivers or guardians. Despite the improvement observed in inequalities and spatial distribution of the concentration of oral health services utilization, it is necessary to keep monitoring these patterns to guide decision-making.

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Socio-Economic Inequalities in Oral Health

Cited by 5 publications

References 141 publications

Professionals’ perspectives on how to address persistent oral health inequality among young children: an exploratory multi-stakeholder analysis in a disadvantaged neighbourhood of Amsterdam, the Netherlands

Professionals’ perspectives on how to address persistent oral health inequality among young children: an exploratory multi-stakeholder analysis in a disadvantaged neighbourhood of Amsterdam, the Netherlands

Reflections on oral health inequalities: Theories, pathways and next steps for research priorities

Frequency, inequalities and spatial distribution of oral health services utilization in Peruvian children under twelve years of age: a population-based comparative analysis of the years 2017 and 2021

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