Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
PLoS One. 2023 May 18;18(5):e0286006. doi: 10.1371/journal.pone.0286006. eCollection 2023.
To assess the extent of the association of psychosocial stress with oral health in an Ontario population stratified by age groups, and whether any association is modified by indicators of social and economic capital.
We retrieved data of 21,320 Ontario adults, aged 30-74 years old, from the Canadian Community Health Survey (CCHS: 2017-2018), which is a Canada-wide, cross-sectional survey. Using binomial logistic regression models that adjusted for age, sex, education, and country of birth, we examined the association of psychosocial stress (indicated by perceived life stress) with inadequate oral health (indicated as having at least one of the following: bleeding gums, fair/poor self-perceived oral health, persistent oral pain). We assessed the effect measure modification of indicators of social (sense of belonging to the local community, living/family arrangements) and economic capital (household income, dental insurance, dwelling ownership) on the perceived life stress-oral health relationship, stratified by age (30-44, 45-59, 60-74 yrs). We then calculated the Relative Excess Risk due to Interaction (RERI) which indicates the risk that is above what would be expected if the combination of low capital (social or economic) and high psychosocial stress was entirely additive.
Respondents with higher perceived life stress were at a significantly higher risk of having inadequate oral health (PR = 1.39; 95% CI: 1.34, 1.44). Adults with low social and economic capital were also at an increased risk of inadequate oral health. Effect measure modification showed an additive effect of indicators of social capital on the perceived life stress-oral health relationship. This effect was evident across all three age groups (30-44, 45-59, 60-74 yrs), with the highest attributable proportion of social and economic capital indicators in the psychosocial stress-oral health relationship in older adults (60-74 yrs).
Our findings suggest an exacerbating effect for low social and economic capital in the relationship of perceived life stress with inadequate oral health among older adults.
评估安大略省人群中，按年龄组分层的心理社会压力与口腔健康之间关联的程度，以及任何关联是否因社会和经济资本的指标而改变。
我们从加拿大社区健康调查（CCHS：2017-2018）中检索了 21320 名年龄在 30-74 岁的安大略省成年人的数据，这是一项加拿大全国性的横断面调查。我们使用二项逻辑回归模型，调整了年龄、性别、教育程度和出生国家，来研究心理社会压力（由感知生活压力表示）与口腔健康不足（表示至少有以下一种情况：牙龈出血、自我感觉口腔健康一般/差、持续口腔疼痛）之间的关联。我们评估了社会资本（对当地社区的归属感、居住/家庭安排）和经济资本（家庭收入、牙科保险、住房所有权）指标对感知生活压力与口腔健康关系的效应修饰作用，按年龄（30-44 岁、45-59 岁、60-74 岁）进行分层。然后我们计算了交互的相对超额风险（RERI），这表明如果低资本（社会或经济）和高心理社会压力的组合完全相加，则风险超过预期的风险。
感知生活压力较高的受访者患有口腔健康不足的风险显著增加（PR = 1.39；95%CI：1.34，1.44）。社会和经济资本较低的成年人也有更高的口腔健康不足风险。效应修饰表明，社会资本指标对感知生活压力与口腔健康关系具有相加效应。这种影响在所有三个年龄组（30-44 岁、45-59 岁、60-74 岁）中都存在，社会和经济资本指标在老年人群中（60-74 岁）对感知生活压力与口腔健康关系的归因比例最高。
我们的研究结果表明，在老年人群中，低社会和经济资本在感知生活压力与口腔健康不足之间的关系中具有加重作用。
