Medical Sociology Unit, Hannover Medical School, Hannover, Germany.
Community Dent Oral Epidemiol. 2010 Apr;38(2):120-8. doi: 10.1111/j.1600-0528.2009.00520.x. Epub 2010 Jan 14.
To consider differential effects of income and education on oral health for each indicator separately and in combination. Finally the combined effects of the lowest income level and the lowest level of education were examined.
Data were drawn from the Fourth German Oral Health Study. They were collected using proportional random sampling in order to obtain information also for less densely populated regions. The subjects included in the study were between 35 and 44 years of age (n = 925). It included a clinical dental examination and a sociological survey. Social differentiation was depicted by education and income (divided into categories), oral health was measured using the DMFT-index.
Social gradients emerged for both indicators of social differentiation. The effects derived from single analyses were somewhat higher than those obtained by simultaneous estimations. The odds ratio of the lowest as compared with the highest income category was OR = 3.74 and OR = 2.34 in the analysis with both indicators. For education the respective effects were OR = 3.75 and OR = 2.95. The cumulative effect of the lowest income and the lowest educational level combined was OR = 6.06.
Education and income are shaping social inequalities in oral health independently from each other, and they are only moderately correlated. They refer to different dimensions of disadvantage thus making preventive measures more complicated.
分别考虑收入和教育对每个口腔健康指标的差异影响，并将其结合起来考虑。最后，还检查了最低收入水平和最低教育水平的综合影响。
数据来自第四次德国口腔健康研究。采用比例随机抽样收集数据，以便为人口较少的地区提供信息。研究对象的年龄在 35 至 44 岁之间（n=925）。研究包括临床牙科检查和社会学调查。社会分化通过教育和收入（分为几类）来描述，口腔健康使用 DMFT 指数进行测量。
两种社会分化指标都出现了社会梯度。单因素分析得出的影响略高于同时估计得出的影响。与最高收入类别相比，最低收入类别的优势比（OR）分别为 3.74 和 2.34，同时考虑两个指标时的 OR 分别为 3.75 和 2.95。教育方面的相应影响分别为 OR=3.75 和 OR=2.95。最低收入和最低教育水平相结合的累积效应为 OR=6.06。
教育和收入独立于彼此塑造口腔健康的社会不平等，并且它们的相关性中等。它们涉及不同的劣势维度，从而使预防措施更加复杂。
