Socioeconomic Position and Oral Health in Chinese Older Adults: A Life Course Approach.

IF 2.2 Q2 DENTISTRY, ORAL SURGERY & MEDICINE JDR Clinical & Translational Research Pub Date : 2024-12-09 DOI:10.1177/23800844241297533
J Hong, R G Watt, G Tsakos, A Heilmann
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Abstract

Objectives: We investigated associations between socioeconomic position (SEP) across childhood, adulthood, and older age and number of teeth among Chinese older adults.

Methods: Data came from 15,136 participants aged 65 to 105 y in the Chinese Longitudinal Healthy Longevity Survey (2018 wave). The outcome was number of teeth. Pathways and sensitive period models were tested simultaneously via structural equation modeling. Ordinal logistic regression assessed the accumulation of risk and social mobility models. Differences were examined across 4 birth cohorts.

Results: Adult and older age SEP had direct effects on number of teeth in older age (adulthood, direct β = 0.182, P < 0.001; older age, direct β = 0.093, P = 0.005), supporting the sensitive period model. Childhood SEP had an indirect effect on number of teeth (indirect β = 0.130, P < 0.001) through adult and older age SEP, supporting the pathway/accumulation of risk and social mobility models. Effects of SEP on number of teeth were more pronounced in younger cohorts. Graded associations in the expected directions were found between the number of periods in which participants experienced disadvantaged SEP and number of teeth, as well as social mobility trajectories and number of teeth.

Conclusion: Among Chinese older adults, the number of remaining teeth is subject to marked social inequalities. Our findings document the simultaneous applicability of life course models and a widening of oral health inequalities in China across generations. Interventions earlier in child and adult life are needed to address this problem and reduce oral health inequalities.

Knowledge transfer statement: The findings of this study suggest marked socioeconomic inequalities in oral health among Chinese older adults. These inequalities are generated throughout the life course and appear to have widened across cohorts. This study emphasizes that interventions are needed to address the social determinants of oral health at all life stages.

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中国老年人的社会经济地位与口腔健康:一种生命历程方法。
目的:我们研究了中国老年人童年、成年和老年时期的社会经济地位(SEP)与牙齿数量之间的关系:我们研究了中国老年人在童年、成年和老年时期的社会经济地位(SEP)与牙齿数量之间的关系:数据来自中国健康长寿纵向调查(2018 年)的 15 136 名 65 至 105 岁的参与者。结果为牙齿数量。通过结构方程模型同时检验了路径模型和敏感期模型。顺序逻辑回归评估了风险积累和社会流动模型。对 4 个出生队列的差异进行了研究:成人和老年 SEP 对老年牙齿数量有直接影响(成人,直接 β = 0.182,P < 0.001;老年,直接 β = 0.093,P = 0.005),支持敏感期模型。儿童时期的 SEP 通过成年和老年时期的 SEP 对牙齿数量产生间接影响(间接 β = 0.130,P < 0.001),支持风险路径/积累模型和社会流动模型。SEP对牙齿数量的影响在年轻组群中更为明显。在参与者经历不利SEP的时期数与牙齿数量之间,以及社会流动轨迹与牙齿数量之间,发现了预期方向上的分级关联:结论:在中国老年人中,剩余牙齿数量存在明显的社会不平等。我们的研究结果证明了生命过程模型在中国的适用性,以及口腔健康不平等在代际间的扩大。要解决这一问题并减少口腔健康的不平等,需要在儿童和成人生命的早期进行干预:本研究结果表明,中国老年人口腔健康存在明显的社会经济不平等。这些不平等在整个生命过程中都会产生,而且似乎在不同人群中有所扩大。本研究强调,需要采取干预措施来解决各个生命阶段口腔健康的社会决定因素。
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来源期刊
JDR Clinical & Translational Research
JDR Clinical & Translational Research DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
6.20
自引率
6.70%
发文量
45
期刊介绍: JDR Clinical & Translational Research seeks to publish the highest quality research articles on clinical and translational research including all of the dental specialties and implantology. Examples include behavioral sciences, cariology, oral & pharyngeal cancer, disease diagnostics, evidence based health care delivery, human genetics, health services research, periodontal diseases, oral medicine, radiology, and pathology. The JDR Clinical & Translational Research expands on its research content by including high-impact health care and global oral health policy statements and systematic reviews of clinical concepts affecting clinical practice. Unique to the JDR Clinical & Translational Research are advances in clinical and translational medicine articles created to focus on research with an immediate potential to affect clinical therapy outcomes.
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