Delgado-Angulo Elsa K, Bernabé Eduardo
Division of Population and Patient Health, King's College London Dental Institute at Guy's, King's College and St. Thomas' Hospitals, London, UK; Departamento Académico de Odontología Social, Universidad Peruana Cayetano Heredia, Lima, Peru.
Community Dent Oral Epidemiol. 2015 Jun;43(3):255-61. doi: 10.1111/cdoe.12149. Epub 2015 Feb 6.
This study aimed to characterize trajectories of intergeneration mobility from birth to age 33 years and to assess the influence of these trajectories on adult oral health.
Repeated data on occupational social class (birth and 7, 11, 16, 23 and 33 years) and two subjective oral health indicators (lifetime and past-year prevalence of persistent trouble with gums or mouth) measured at age 33 years, from the 1958 National Child Development Study, were used for this analysis. Latent class growth analysis (LCGA) was used to identify different trajectories of exposure to manual social class over time. Binary logistic regression was then used to explore the association between these trajectories and each oral health indicator, adjusting for participants' sex.
Latent class growth analysis showed that a four trajectory model provided the best fit to the data. The four trajectories that emerged were identified as stable manual, stable nonmanual, late steep increase (those who were likely to be in the manual social class until age 16 years but ended up in the nonmanual social class afterwards) and steady increase (those whose likelihood of leaving the manual social class increased gradually over time). Lifetime and past-year prevalence of persistent trouble with gums or mouth was significantly higher in the stable manual trajectory than in all other trajectories. No differences were found between the stable nonmanual, late steep increase and steady increase trajectories.
Although four distinctive trajectories were identified in the 1958 NCDS, only those who remained in the manual social class over time reported worse oral health by age 33 years. Proximal socioeconomic experiences may be more relevant to adult oral health than early life experiences.
本研究旨在描述从出生到33岁的代际流动轨迹,并评估这些轨迹对成人口腔健康的影响。
本分析使用了1958年全国儿童发展研究中的重复数据,包括职业社会阶层(出生时、7岁、11岁、16岁、23岁和33岁)以及33岁时测量的两个主观口腔健康指标(牙龈或口腔持续问题的终生患病率和过去一年患病率)。潜在类别增长分析(LCGA)用于识别随时间暴露于体力劳动者社会阶层的不同轨迹。然后使用二元逻辑回归来探讨这些轨迹与每个口腔健康指标之间的关联,并对参与者的性别进行了调整。
潜在类别增长分析表明,四轨迹模型最适合数据。出现的四条轨迹被确定为稳定体力劳动者、稳定非体力劳动者、后期急剧上升(那些在16岁之前可能处于体力劳动者社会阶层但后来进入非体力劳动者社会阶层的人)和稳步上升(那些离开体力劳动者社会阶层的可能性随时间逐渐增加的人)。稳定体力劳动者轨迹中牙龈或口腔持续问题的终生患病率和过去一年患病率显著高于所有其他轨迹。稳定非体力劳动者、后期急剧上升和稳步上升轨迹之间未发现差异。
尽管在1958年的全国儿童发展研究中确定了四条不同的轨迹,但只有那些长期处于体力劳动者社会阶层的人在33岁时口腔健康状况较差。近期的社会经济经历可能比早年经历与成人口腔健康更相关。