Trend of Income-related Inequality of Child Oral Health in Australia

Abstract

It is important that we monitor socio-economic inequality in health. Inequality in child oral health has been expected to widen because of widening socio-economic inequality. This study aimed to evaluate trends in income-related inequality in caries experience of Australian children. Cross-sectional studies in 1992/93 and 2002/03 collected data on deciduous caries experience of 5- to 10-year-olds and permanent caries experience of 6- to 12-year-olds. Household composition and income was used to calculate quartiles of equivalized income. Slope Index of Inequality (SII), Concentration Index (CI), and regression-based rate ratios were used to quantify income-related inequality and to evaluate trends. Income-related inequality in caries experience was evident regardless of time and dentition. The three indicators of inequality indicate a significant increase in income-related inequality in child deciduous caries experience during the decade. The income inequality in permanent caries experience did not change significantly. Income inequalities increased in deciduous teeth, but not in permanent teeth, among Australian children.

Trends in Social Inequality in Tooth Brushing among Adolescents: 1991-2014

“…Kuusela et al [1997] also showed fluctuations and that the social inequality in twice-a-day tooth brushing almost disappeared among boys from 1977 to 1995 but their study concerns an earlier time period than ours. The present study does not provide any explanation for the increasing social inequality in tooth brushing but the findings correspond with the hypothesis by Do et al [2010] and Do [2012] that social inequality in oral health variables may reflect the general level of income inequality in the society, as measured by the Gini index. The Gini index increased in Denmark from <20 in 1994 [Hansen, 2011] to >27 in 2012[Statistics Denmark, 2015.…”

Dental caries disparities in early childhood: A study of kindergarten children in British Columbia

“…This finding is consistent with the large body of evidence indicating the influence that individual-and neighbourhood-level socio-economic circumstances have on disparate health outcomes across geographic areas. [27][28][29][30][31][32] In 2006/07 and 2009/10, the average rate of visible dental decay was highest in the most socio-economically disadvantaged neighbourhoods, with approximately half of the children experiencing visible dental decay; whereas in the moderately high SES neighbourhoods, approximately one third of children experienced visible dental decay. The results indicated that although the highest rates of visible dental decay were found in the most socio-economically disadvantaged neighbourhoods, the highest numbers of children with dental decay were in the middle SES neighbourhoods.…”

Income-related Inequalities in Dental Service Utilization by Europeans Aged 50+

“…The CI (Appendix, formula F.3) quantifies the degree of relative socioeconomic inequality in a health variable and is derived from the "concentration curve" (Kakwani et al, 1997). It has been used, e.g., to measure the degree of socio-economic-related inequality in childhood caries (Do et al, 2010) and oral health care utilization (Somkotra and Detsomboonrat, 2009;Somkotra and Vachirarojpisan, 2009). The definition of the CI in our study is as follows: If the CI is zero, it indicates that there is no incomerelated inequality regarding utilization of dental services; a positive (negative) value of the CI indicates a disproportionate concentration of the utilization variable among the rich (poor).…”

“…It has been well documented that there exists a socio-economic gradient in oral health, i.e., individuals from the lower end of the socio-economic scale usually have a worse oral health status than do individuals with higher socio-economic status (Watt and Sheiham, 1999;Locker, 2000;Gilbert et al, 2003;Enjary et al, 2006;Jamieson and Thomson, 2006;López et al, 2006;Makhija et al, 2006;Sanders et al, 2006;Tellez et al, 2006;Armfield, 2007;Watt, 2007;Holst, 2008;Du et al, 2009;Tsakos et al, 2009;Do et al, 2010;Ståhlnacke et al, 2010;Bernabé and Marcenes, 2010). While there is disagreement about the exact explanation for such a socio-economic gradient in oral health (Petersen, 2005;Brunner and Marmot, 2006;Sisson, 2007), it has frequently been suggested that dental attendance patterns are one pathway through which differences in oral health may emerge.…”