社会经济相关的口腔卫生行为不平等：PERSIAN 队列研究的横断面分析。

Socioeconomic-related inequalities in oral hygiene behaviors: a cross-sectional analysis of the PERSIAN cohort study.

机构信息

Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.

出版信息

BMC Oral Health. 2020 Feb 28;20(1):63. doi: 10.1186/s12903-020-1036-6.

DOI:10.1186/s12903-020-1036-6

PMID:32111212

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7048098/

Abstract

BACKGROUND

Socioeconomic-related inequality in oral hygiene behaviors in Iran is poorly understood. This study aims to measure and decompose socioeconomic-related inequalities in oral hygiene behaviors among middle-aged and elderly adults in Iran.

METHODS

A cross-sectional analysis was performed using data from the Prospective Epidemiological Research Studies in IrAN (PERSIAN), a large national cohort study. A total of 130,016 individuals aged 35 years and above from 17 cohort centers in Iran were included in the study. The normalized concentration index (C) was used to measure the magnitude of inequality in oral hygiene behaviors, i.e. brushing at least twice and flossing once daily, among middle-aged and elderly Iranian adults included in the cohort centers. Decomposition analysis was performed to quantify the contribution of each determinant to the observed inequality in oral hygiene behaviors.

RESULTS

Totally, 65.5% of middle-aged and elderly adults brushed their teeth twice a day or more, 7.6% flossed at least once a day and 3.48% had both habits. The estimated C of the two habits combined, i.e. tooth brushing and dental flossing, for all provinces taken part in the PERSIAN cohort study was 0.399 (95% confidence interval [CI]: 0.383 to 0.417), indicating that the prevalence of the two habits combined is more concentrated among individuals with higher socioeconomic status. Inequality in oral hygiene behaviors was pro-rich in all cohort centers. The decomposition results suggested socioeconomic status as the main factor contributing to the overall inequality, followed by the level of education, and the province of residence.

CONCLUSION

A low prevalence of oral hygiene behaviors among middle-aged and elderly Iranian adults was observed. There was also a pro-rich inequality in oral hygiene behaviors among middle-aged and elderly adults in all cohort centers. These results suggest an urgent need for targeted policy interventions to increase the prevalence of preventive oral hygiene behaviors among the poor and less-educated middle-aged and elderly adults in Iran.

摘要

背景

伊朗口腔卫生行为的社会经济相关不平等现象尚未得到充分了解。本研究旨在衡量和分解伊朗中老年人群口腔卫生行为的社会经济相关不平等。

方法

本研究使用来自伊朗前瞻性流行病学研究（PERSIAN）的横截面数据分析，这是一项大型全国队列研究。研究共纳入了伊朗 17 个队列中心的 130016 名 35 岁及以上的个体。使用标准化集中指数（C）来衡量伊朗中老年人群中口腔卫生行为（每天至少刷牙两次和使用牙线一次）的不平等程度。进行分解分析以量化每个决定因素对观察到的口腔卫生行为不平等的贡献。

结果

共有 65.5%的中老年人每天刷牙两次或以上，7.6%的人每天至少使用牙线一次，3.48%的人同时有这两种习惯。所有参与 PERSIAN 队列研究的省份中，这两种习惯（刷牙和使用牙线）的综合 C 值估计为 0.399（95%置信区间[CI]：0.383 至 0.417），表明这两种习惯的流行程度在社会经济地位较高的个体中更为集中。所有队列中心的口腔卫生行为都存在富者愈富的不平等现象。分解结果表明，社会经济地位是导致整体不平等的主要因素，其次是教育水平和居住省份。