Socioeconomic Inequalities in Self-Perceived Oral Health Among College-Going Students in Karachi, Pakistan

Abstract

Background: Oral health inequalities are becoming a major threat to public health, and they excessively burden disadvantaged communities, especially within low and middle-income countries. This study explored the socioeconomic inequalities in self-perceived oral health behaviors among college-going students in Karachi, Pakistan. Methods: A cross-sectional study was conducted among 328 college-going students using a convenient sampling technique from three different socioeconomic groups including urban slums, middle, and rich class neighborhoods. Oral health was assessed using three measures: daily tooth brushing, weekly sweet consumption, and substance abuse. Socio-economic inequalities were measured using binary logistic regression (odds ratios), relative index of inequality, and slope index of inequality. Results: Out of 328 participants, 56.4% perceived their oral health as fair, 24.1% good, 14.9% poor, while only 4.6% had an excellent perception of oral health. Significant inequalities were found regarding oral health behaviours with fraternal income, occupation, and education level. Education-related absolute inequalities among college-going students were1.28(95% CI -2.19, -0.36 p-value<0.01), -1.34(95% CI -2.16, -0.52, p-value<0.01), -1.43(95% CI -2.70, -0.15, p-value<0.01) with tooth brushing, high sweet consumption, and substance abuse respectively. Similarly, income and occupation-related absolute inequalities were also existent. Conclusions: In Pakistan, data among college-going students regarding oral healthcare is scarce. Significant inequalities were found in oral health behaviours among college-going students. Thus, there is a need to design equity-based health system provisions specifically to address the needs of poor segments of society.