Centre for Health Sciences, Barts and The London School of Medicine and Dentistry, London, UK.
J Public Health Dent. 2012 Summer;72(3):198-207. doi: 10.1111/j.1752-7325.2012.00330.x. Epub 2012 Apr 16.
This study investigated health inequality for self-reported oral health outcomes among adolescents. The role of oral health behaviors and psychological factors in explaining oral health inequality was investigated using the hypothesis of mediation.
This was a cross-sectional study that used self-completed questionnaires. This study sampled 639 (315 male and 324 female) 15- to 17-year-old adolescents (second and third grade high school students) of both sexes in the city of Sanandaj in the province of Kurdistan, western Iran. Socioeconomic indicators of the study were subjective socioeconomic status, wealth index, and parental education. Oral health behaviors were measured as toothbrushing frequency, dental flossing frequency, and dental visits. Psychological factors were self-esteem, anxiety, and depression. Self-reported oral health outcomes were single item self-rated oral health and the experience of dental pain. Regression analysis was used to test four conditions for the hypothesis of mediation.
The results showed that the inequality is present in oral health for some pairs of relationships between socioeconomic status and oral health outcomes. Adjustment for oral health behaviors and psychological factors, individually and simultaneously, led to loss of statistical significance for some pairs of the relationships. However, adjustment for oral health behaviors and psychological factors led to only small changes in the associations between socioeconomic status and self-reported oral health outcomes.
This study found a graded oral health inequality, but no strong evidence to support the hypothesis that oral health behaviors and psychological factors mediate oral health inequality for self-reported oral health outcomes.
本研究调查了青少年自我报告的口腔健康结果的健康不平等现象。本研究采用中介假设的方法，研究了口腔健康行为和心理因素在解释口腔健康不平等方面的作用。
这是一项横断面研究，使用了自我完成的问卷。本研究在伊朗西部库尔德斯坦省萨南达杰市抽取了 639 名（男 315 名，女 324 名）15 至 17 岁的青少年（高二和高三学生）。研究的社会经济指标包括主观社会经济地位、财富指数和父母教育程度。口腔健康行为测量指标包括刷牙频率、牙线使用频率和看牙医的频率。心理因素包括自尊、焦虑和抑郁。自我报告的口腔健康结果是单项自我评估口腔健康和经历牙痛。回归分析用于检验中介假设的四个条件。
结果表明，在一些社会经济地位与口腔健康结果之间的关系中，存在口腔健康不平等。单独和同时调整口腔健康行为和心理因素后，一些关系的统计学意义丧失。然而，调整口腔健康行为和心理因素仅导致社会经济地位与自我报告的口腔健康结果之间的关联发生微小变化。
本研究发现了一种渐进式的口腔健康不平等现象，但没有强有力的证据支持口腔健康行为和心理因素可以中介自我报告的口腔健康结果的口腔健康不平等的假设。
