Bof de Andrade Fabíola, Antunes José Leopoldo Ferreira
Oswaldo Cruz Foundation, Rene Rachou Institute, Belo Horizonte, Brazil.
Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil.
PLoS One. 2025 Jan 3;20(1):e0316145. doi: 10.1371/journal.pone.0316145. eCollection 2025.
This study aimed to evaluate socioeconomic inequalities in self-reported oral health among community-dwelling Brazilian older adults and evaluate the oral health factors contributing to the inequalities.
This was a cross-sectional study with data from the Brazilian National Health Survey conducted in 2019. The dependent variable is the self-report of oral health categorized as good or poor. Household per capita income in quintiles and schooling were used as socioeconomic variables. The explanatory covariates were age; gender; limitation in basic activities of daily living; number of teeth, use of dental prostheses; difficulty in eating; and recent dental visit. The Oaxaca-Blinder two-fold decomposition for binary outcomes was used to evaluate the factors contributing to the inequalities in self-reported oral health.
Self-reported poor oral health was found among 35.8% of the dentate and 29.6% of the edentulous individuals. Poor self-reported oral health was more prevalent among older adults with low income and educational levels. Among dentate individuals, the difference in the proportion of poor self-reported oral health (the gap) between those with no schooling and those with some schooling was 12.8 percent points (p.p.), favoring the poor. The gap between dentate in the lowest and highest income groups was 14.8 p.p. favoring the poor. Among edentulous individuals, those with no schooling had a higher proportion of self-reported oral health (total gap 10.6 p.p.). Concerning income inequalities, the gap favored the poorer group and was 5.4 p.p. higher among individuals in the lowest income group.
The decomposition analyses suggested that oral health variables explained most of the education and income inequalities; difficulties in eating were the most contributing factor in both the dentate and edentulous groups. There was a relatively reduced contribution of recent dental visits to socioeconomic inequality.
本研究旨在评估巴西社区居住的老年人自我报告的口腔健康方面的社会经济不平等情况，并评估导致这些不平等的口腔健康因素。
这是一项横断面研究，数据来自2019年进行的巴西国家健康调查。因变量是自我报告的口腔健康状况，分为良好或不佳。家庭人均收入五分位数和受教育程度被用作社会经济变量。解释性协变量包括年龄、性别、日常生活基本活动受限情况、牙齿数量、假牙使用情况、进食困难以及最近一次看牙情况。采用二元结果的奥瓦卡-布林德双重分解法来评估导致自我报告口腔健康不平等的因素。
在有牙人群中，35.8%的人自我报告口腔健康不佳；在无牙人群中，这一比例为29.6%。自我报告口腔健康不佳在低收入和低教育水平的老年人中更为普遍。在有牙人群中，未受过教育者与受过一定教育者之间自我报告口腔健康不佳比例的差异（差距）为12.8个百分点，有利于贫困人群。收入最低和最高组的有牙人群之间的差距为14.8个百分点，有利于贫困人群。在无牙人群中，未受过教育者自我报告口腔健康不佳的比例更高（总差距为10.6个百分点）。关于收入不平等，差距有利于较贫困群体，在收入最低组的个体中高出5.4个百分点。
分解分析表明，口腔健康变量解释了大部分教育和收入不平等；进食困难是有牙和无牙组中最主要的促成因素。最近看牙对社会经济不平等的贡献相对较小。
