Inequalities in Oral Health: Understanding the Contributions of Education and Income

Overview

Journal Can J Public Health

Publisher Springer Nature

Specialty Public Health

Date 2017 Sep 15

PMID 28910244

Citations 13

Authors

Julie Farmer

Rebecca C Phillips

Sonica Singhal

Carlos Quinonez

Affiliations

Soon will be listed here.

Abstract

Objective: To quantify the extent to which income and education explain gradients in oral health outcomes.

Methods: Using data from the Canadian Community Health Survey (CCHS 2003), binary logistic regression models were constructed to examine the relationship between income and education on self-reported oral health (SROH) and chewing difficulties (CD) while controlling for age, sex, ethnicity, employment status and dental insurance coverage. The relative index of inequality (RII) was utilized to quantify the extent to which income and education explain gradients in poor SROH and CD.

Results: Income and education gradients were present for SROH and CD. From fully adjusted models, income inequalities were greater for CD (RIIinc = 2.85) than for SROH (RIIinc = 2.75), with no substantial difference in education inequalities between the two. Income explained 37.4% and 42.4% of the education gradient in SROH and CD respectively, whereas education explained 45.2% and 6.1% of income gradients in SROH and CD respectively. Education appears to play a larger role than income when explaining inequalities in SROH; however, it is the opposite for CD.

Conclusion: In this sample of the Canadian adult population, income explained over one third of the education gradient in SROH and CDs, whereas the contribution of education to income gradients varied by choice of self-reported outcome. Results call for stakeholders to improve affordability of dental care in order to reduce inequalities in the Canadian population.

Citing Articles

Evaluating socioeconomic inequalities in self-rated oral health and its contributing factors in Brazilian older adults.

Andrade F, Antunes J PLoS One. 2025; 20(1):e0316145.

PMID: 39752470 PMC: 11698338. DOI: 10.1371/journal.pone.0316145.

Decrease in Socioeconomic Disparities in Self-Rated Oral Health among Brazilian Adults between 2013 and 2019: Results from the National Health Survey.

Soares A, Fonseca M, Malta D, Chalub L, Ferreira R Int J Environ Res Public Health. 2024; 21(9).

PMID: 39338081 PMC: 11431346. DOI: 10.3390/ijerph21091198.

Assessment of Oral Health Status and Pregnancy Outcomes Among Women in Saudi Arabia.

AlHumaid G, Alshehri T, Alwalmani R, Alsubaie R, Alshehri A, AlJoghaiman E Patient Prefer Adherence. 2024; 18:1027-1038.

PMID: 38826504 PMC: 11141704. DOI: 10.2147/PPA.S456721.

Zwick L, Schmitz N, Shojaa M BMC Oral Health. 2023; 23(1):1029.

PMID: 38124069 PMC: 10734100. DOI: 10.1186/s12903-023-03722-4.

The educational gradient in dental caries experience in Northern- Norway: a cross-sectional study from the seventh survey of the Tromsø study.

Moltubakk S, Jonsson B, Lukic M, Stangvaltaite-Mouhat L BMC Oral Health. 2023; 23(1):779.

PMID: 37875913 PMC: 10594764. DOI: 10.1186/s12903-023-03487-w.

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