Periodontol 2000. 2012 Feb;58(1):69-83. doi: 10.1111/j.1600-0757.2011.00416.x.
Disparities in the prevalence and severity of periodontal disease are associated with socioeconomic factors, such as education and income, and have been recognized since the1960s. Epidemiologic reports have consistently shown that i) periodontal disease is inversely related to education and income after controlling for age and gender, and ii) differences in education and income explain mode if not all of the observed disparities in periodontal disease between blacks and whites. Although race/ethnicity has been the main focus of differences in periodontal diseases in the U.S., disparities in socioeconomic position (SEP) indicators (i.e., education, income, poverty-income ratio) have remained pervasive in the U.S. over the years. SEP indicators, as used in the epidemiologic literature, allocate assignment of socioeconomic measures as a proxy for one's place, position and power in society. Thus, understanding these disparities in periodontal health status may provide insight and context more generally into why racial/ethnic disparities persist. In this paper, we review recent prevalence estimates of periodontitis, according to SEP indicators, and critically assess the importance of SEP factors in periodontal epidemiolgy. The majority of the data available for review comes from the U.S. However, data from other countries is included where available. Specifically, we aim to identify the advantages and disadvantages of the most commonly used SEP indicators in studying periodontal disease; summarize existing evidence on the association between SEP indicators and periodontitis; discuss the analytical issues associated with SEP indicators; and finally, discuss and present, future and alternative research directions on examining the association between SEP indicators and periodontitis.
牙周病的患病率和严重程度存在差异,与社会经济因素有关,如教育和收入,这一现象自 20 世纪 60 年代以来就已被认识到。流行病学报告一直表明:i)在控制年龄和性别因素后,牙周病与教育和收入呈负相关;ii)教育和收入方面的差异可以解释黑人和白人之间牙周病差异的部分原因,如果不是全部原因。尽管种族/民族一直是美国牙周病差异的主要关注点,但多年来,社会经济地位(SEP)指标(即教育、收入、贫困收入比)方面的差异在美国一直普遍存在。在流行病学文献中,SEP 指标用于将社会经济措施的分配作为一个人在社会中的地位、位置和权力的替代指标。因此,了解这些牙周健康状况的差异可能会更深入地了解为什么种族/民族差异仍然存在。在本文中,我们根据 SEP 指标综述了牙周炎的最新患病率估计,并批判性地评估了 SEP 因素在牙周流行病学中的重要性。可用于综述的大多数数据来自美国,但也包括其他国家的数据。具体而言,我们旨在确定在研究牙周病时最常用的 SEP 指标的优缺点;总结 SEP 指标与牙周炎之间关联的现有证据;讨论与 SEP 指标相关的分析问题;最后,讨论并提出关于检查 SEP 指标与牙周炎之间关联的未来和替代研究方向。