Capurro Diego Alberto, Davidsen Michael
Faculty of Dentistry, National University of Asuncion, Yegros 1440 casi 2a. pyda., 1330, Asuncion, Paraguay.
National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 2nd floor, 1353, Copenhagen K, Denmark.
Int J Equity Health. 2017 Feb 16;16(1):34. doi: 10.1186/s12939-017-0529-7.
The goal of this analysis was to describe socioeconomic inequalities in dental health among Spanish middle-aged adults, and the role of behavioral and psychosocial factors in explaining these inequalities.
This cross-sectional study used survey data from the 2006 Spanish National Health Survey and focused on adults ages 30 - 64. The outcome was dental health status based on the presence of self-reported dental problems. We used education, income, and occupational class as indicators of socioeconomic position and applied logistic regression analysis to estimate associations. We included behavioral and psychosocial variables in the models and compared non-adjusted to adjusted estimates to assess their potential role in explaining socioeconomic gradients.
Results showed clear socioeconomic gradients in dental health among middle-aged adults. The percentage of people who reported more dental problems increased among those with lower levels of education, income, and occupation. These gradients were statistically significant (p < .001). Logistic regression showed that groups with lower education, income, and occupation had higher odds of reporting the outcome (p < .001). Associations were stronger when considering education as the indicator of socioeconomic position. Substantial unexplained associations remained significant after adjusting the model by behavioral and psychosocial variables.
This study shows significant socioeconomic gradients in dental health among middle-aged adults in Spain. Behavioral and psychosocial variables were insufficient to explain the inequalities described, suggesting the intervention of other factors. Further research should incorporate additional explanations to better understand and comprehensively address socioeconomic inequalities in dental health.
本分析的目的是描述西班牙中年成年人在口腔健康方面的社会经济不平等现象，以及行为和心理社会因素在解释这些不平等现象中所起的作用。
这项横断面研究使用了2006年西班牙国家健康调查的调查数据，研究对象为30至64岁的成年人。结果变量是基于自我报告的口腔问题存在情况的口腔健康状况。我们将教育程度、收入和职业阶层作为社会经济地位的指标，并应用逻辑回归分析来估计相关性。我们在模型中纳入了行为和心理社会变量，并比较了未调整估计值和调整后估计值，以评估它们在解释社会经济梯度方面的潜在作用。
结果显示中年成年人在口腔健康方面存在明显的社会经济梯度。报告有更多口腔问题的人群比例在教育程度、收入和职业水平较低的人群中有所增加。这些梯度具有统计学意义（p < 0.001）。逻辑回归显示，教育程度、收入和职业较低的人群报告该结果的几率更高（p < 0.001）。将教育作为社会经济地位指标时，相关性更强。在通过行为和心理社会变量对模型进行调整后，大量无法解释的相关性仍然显著。
本研究表明西班牙中年成年人在口腔健康方面存在显著的社会经济梯度。行为和心理社会变量不足以解释所描述的不平等现象，这表明还有其他因素的干预。进一步的研究应纳入更多解释，以更好地理解和全面解决口腔健康方面的社会经济不平等问题。
