Explaining income inequities in tooth loss among Brazilian adults

IF 1.8 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Journal of public health dentistry Pub Date : 2023-01-26 DOI:10.1111/jphd.12556

Rafael Aiello Bomfim DDS, MDS, PhD, Helena Mendes Constante DDS, MDS, PhD, Andreia Morales Cascaes DDS, MDS, PhD

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Abstract

Objective

To determine the extent to which individual and contextual variables explain income inequities in tooth loss in Brazilian adults.

Methods

A nationally representative sample of 65,784 Brazilian adults aged 18–59 who participated in the Brazilian National Health Survey 2019 was analyzed. Self-reported tooth loss was the outcome. Per capita income was the main exposure, and minimum wage was the cutoff point. Individual covariates included sex, race, and schooling, dental visits, smoking status, use of dental floss, and self-reported chronic conditions. Contextual covariates included access to treated water and geographic region of residence. Blinder-Oaxaca decomposition analysis was used to estimate the share of each factor in income-related tooth loss inequities by age groups.

Results

Age-standardized tooth loss showed large income inequities. The average difference in tooth loss related to income inequities in the 18-34-year-old group was 0.50 (95% CI 0.39; 0.60), increasing to 4.51 (95% CI 4.09; 4.93) in the 45–59 years. Individual and contextual covariates explained almost 90% of income inequities in the 45–59 year group. Use of dental floss, schooling, and geographic region of residence (a proxy for human development level) had a higher proportion of contribution to the inequities examined.

Conclusions

Individual and contextual covariates (proxy for human development level and water fluoridation coverage) explained a large share of income-related tooth loss inequities. Tailored strategies to act at both levels can help reduce tooth loss inequities among Brazilian adults.

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解释巴西成年人牙齿脱落的收入不平等

目的确定个体和背景变量在多大程度上解释巴西成年人牙齿脱落中的收入不平等。方法对参与2019年巴西国家健康调查的65784名18-59岁巴西成年人的全国代表性样本进行分析。结果是自己报告的牙齿脱落。人均收入是主要的风险敞口，最低工资是临界点。个体协变量包括性别、种族和学校教育、牙科就诊、吸烟状况、牙线使用和自我报告的慢性病。情境协变量包括获得处理过的水和居住的地理区域。Blinder Oaxaca分解分析用于估计各因素在各年龄组与收入相关的牙齿脱落不平等中所占的份额。结果年龄标准化的牙齿脱落显示出巨大的收入不平等。18-34岁组与收入不平等相关的牙齿脱落的平均差异为0.50（95%CI 0.39；0.60），45-59岁组增至4.51（95%CI 4.09；4.93）年。个体和情境协变量解释了45-59岁人群中近90%的收入不平等年份组。牙线的使用、学校教育和居住地理区域（代表人类发展水平）对所调查的不平等现象的贡献比例更高。结论个体和情境协变量（代表人类发展水平和饮水氟化覆盖率）解释了很大一部分与收入相关的牙齿脱落不平等。在这两个层面采取量身定制的行动策略可以帮助减少巴西成年人的牙齿脱落不平等现象。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of public health dentistry 医学-公共卫生、环境卫生与职业卫生

CiteScore

3.80

自引率

4.30%

发文量

审稿时长

6-12 weeks

期刊介绍： The Journal of Public Health Dentistry is devoted to the advancement of public health dentistry through the exploration of related research, practice, and policy developments. Three main types of articles are published: original research articles that provide a significant contribution to knowledge in the breadth of dental public health, including oral epidemiology, dental health services, the behavioral sciences, and the public health practice areas of assessment, policy development, and assurance; methods articles that report the development and testing of new approaches to research design, data collection and analysis, or the delivery of public health services; and review articles that synthesize previous research in the discipline and provide guidance to others conducting research as well as to policy makers, managers, and other dental public health practitioners.