Department of Stomatology, School of Dentistry, Universidade Federal de Santa Maria - UFSM, Santa Maria, Brazil.
Department of Oral Health, School of Dentistry, Centro Universitário FAI - UCEFF, Itapiranga, Brazil.
Community Dent Oral Epidemiol. 2023 Oct;51(5):879-886. doi: 10.1111/cdoe.12780. Epub 2022 Aug 14.
Knowledge of the possible pathways linking socioeconomic status (SES) to oral health-related behaviours can improve the understanding of inequalities in oral health. Therefore, in this study, it was investigated whether social capital mediates the relationship between SES and oral health behaviours.
Through a cross-sectional study, data were analysed from participants aged ≥60 years from the Brazilian National Health Survey 2019 (n = 21 575). Structural equation modelling was used to test the direct and indirect pathways from a latent variable for SES to a latent variable for oral health behaviours: daily flossing, toothbrushing frequency and the use of dental care services.
The maximum likelihood estimator was used for complex samples with robust standard errors, and the final model demonstrated an adequate fit. The findings demonstrated that a higher SES was directly associated with better oral health-related behaviours (standardized coefficient [SC]: 0.82; [90% CI: 0.78-0.85]) and indirectly via structural social capital (SC: 0.05; [90% CI: 0.02-0.07]). The total effect of SES on oral health-related behaviours was (SC: 0.87, [90% CI: 0.85-0.89]).
The findings demonstrate that structural social capital in older Brazilian adults might partly mediate the pathways to socioeconomic inequalities in oral health behaviours. However, there is a direct effect on oral health behaviours, reinforcing the hypothesis that SES is associated with oral health, based on paths that link income inequality to oral health.
了解社会经济地位（SES）与口腔健康相关行为之间可能存在的关联途径，可以帮助我们更好地理解口腔健康不平等现象。因此，本研究旨在探讨社会资本是否在 SES 与口腔健康行为之间起中介作用。
通过横断面研究，对 2019 年巴西国家健康调查中≥60 岁的参与者（n=21575）的数据进行分析。采用结构方程模型检验 SES 到口腔健康行为（每日使用牙线、刷牙频率和使用牙科保健服务）的潜在变量之间的直接和间接途径。
采用复杂样本最大似然估计和稳健标准误，最终模型拟合度良好。研究结果表明，SES 与更好的口腔健康相关行为呈直接相关（标准化系数[SC]：0.82；[90%置信区间：0.78-0.85]），并且通过结构性社会资本呈间接相关（SC：0.05；[90%置信区间：0.02-0.07]）。SES 对口腔健康相关行为的总效应为（SC：0.87，[90%置信区间：0.85-0.89]）。
研究结果表明，在巴西老年人群中，结构性社会资本可能部分中介 SES 与口腔健康行为的社会经济不平等之间的关系。然而，SES 对口腔健康行为仍有直接影响，这进一步证实了 SES 与口腔健康之间存在关联的假设，这种关联可能是通过收入不平等与口腔健康之间的联系而产生的。
