Golkari Ali, Sabokseir Aira, Sheiham Aubrey, Watt Richard G
Department of Dental Public Health, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, 71345-1836, Iran; Research Department of Epidemiology and Public Health, University College London, London, WC1E 7HB, UK.
Department of Dental Public Health, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, 71345-1836, Iran.
F1000Res. 2016 Apr 27;5:767. doi: 10.12688/f1000research.8641.1. eCollection 2016.
Health status is largely determined by socio-economic status. The general health of individuals at higher social hierarchy is better than people in lower levels. Likewise, people with higher socio-economic status have better oral health than lower socio-economic groups. There has not been much work regarding the influence of socio-economic status on the health conditions of children in developing countries, particularly in Iran. The aim of this study was to compare the oral and general health conditions of primary school children of three different socio-economic areas in the city of Shiraz, Iran.
This cross-sectional study was conducted on 335, 8- to 11-year-old primary schoolchildren in Shiraz. The children were selected by a three-stage cluster sampling method from three socio-economically different areas. Tools and methods used by the United Kingdom's Medical Research Council were used to obtain anthropometric variables as indicators of general health. The Decay, Missing, Filled Teeth (DMFT) Index for permanent teeth, dmft Index for primary teeth, the Modified Developmental Defects of Enamel (DDE) Index, the Gingival Index (GI) and the Debris Index-Simplified (DI-S) were used for oral health assessment.
Height (P<0.001), weight (P<0.001), and BMI (P=0.001) significantly increased as the socio-economic status of area increased. GI score (P<0.001), DI-S score (P<0.001), number of permanent teeth with DDE (P=0.008), and number of DDE lesions in permanent teeth (P=0.008) significantly decreased as the socio-economic status of area increased.
Findings of this study generally confirmed that social gradients exist in both general and oral health status of the primary schoolchildren of Shiraz. The influence of socio-economic status on health condition means children have different life chances based on their socio-economic conditions. These findings emphasize the significance of interventions for tackling socio-economic inequalities in order to improve the health status of children in lower socio-economic areas.
健康状况很大程度上由社会经济地位决定。社会等级较高的个体总体健康状况优于等级较低者。同样，社会经济地位较高的人群口腔健康状况也优于社会经济地位较低的群体。关于社会经济地位对发展中国家儿童健康状况的影响，相关研究较少，尤其是在伊朗。本研究旨在比较伊朗设拉子市三个不同社会经济区域的小学生的口腔和总体健康状况。
本横断面研究针对设拉子市335名8至11岁的小学生开展。通过三阶段整群抽样法从三个社会经济状况不同的区域选取儿童。采用英国医学研究理事会使用的工具和方法获取人体测量变量，作为总体健康的指标。使用恒牙的龋失补牙指数（DMFT）、乳牙的dmft指数、改良釉质发育缺陷指数（DDE）、牙龈指数（GI）和简化牙面菌斑指数（DI-S）进行口腔健康评估。
随着区域社会经济地位的提高，身高（P<0.001）、体重（P<0.001）和体重指数（BMI，P=0.001）显著增加。随着区域社会经济地位的提高，GI评分（P<0.001）、DI-S评分（P<0.001）、恒牙患有DDE的数量（P=0.008）以及恒牙的DDE病变数量（P=0.008）显著减少。
本研究结果总体证实，设拉子市小学生的总体健康和口腔健康状况均存在社会梯度。社会经济地位对健康状况的影响意味着儿童因其社会经济状况而有不同的生活机遇。这些发现强调了为解决社会经济不平等问题而进行干预以改善社会经济地位较低地区儿童健康状况的重要性。
