Korean Journal of Health Education and Promotion (보건교육건강증진학회지)

Korean Society for Health Education and Promotion (한국보건교육건강증진학회)
권호 표지

The Role of Selected Health-Related Behaviors in the Socioeconomic Disparities in Oral Health among Adults

성인 구강건강수준의 사회경제적 불평등에서 일부 구강건강관련 행태 요인의 역할

  • Lee, Weon-Young (Department of Preventive Medicine, Chung-Ang University, College of Medicine)
  • 이원영 (중앙대학교 의과대학 예방의학교실)
  • Published : 2009.03.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: This study aimed to examined the socioeconomic disparities in oral health related behaviors and to assess if those behaviors eliminate socioeconomic disparities in oral health in a nationally representative sample of adults aged 30-64. Methods: Data are from the Korea Third National Health and Nutrition Examination Survey (2005). Behaviors were indicated by smoking, over intake of daily calories from carbohydrate, perceived stress, frequency of daily tooth brushing, use of oral hygiene goods, insufficient oral treatment. Oral health outcomes were self-reported dental caries and periodontitis during the last 12 months and perceived oral health. Education, household income, and employed status indicated socioeconomic position. Sex, age, residential area, marital status were adjusted for in the logistic regression analysis. Logistic regression analysis was used to assess socioeconomic disparities in behaviors. Logistic regression model adjusting and not adjusting for behaviors were compared to assess the change in socioeconomic disparities in oral health. Results: Clear socioeconomic disparities in all behaviors were showed. After adjusting for behaviors, the association between oral health and socioeconomic indicators attenuated but did not disappear. For example, the odd ratios of reporting poorer oral health for persons in no education or elementary school education and middle school education groups, compared with college or higher education group, were 1.77 (95% CI: 1.36-2.29) and 1.56 (1.19-1.97), respectively. After adjusting for all indicators of behaviors, these odds ratios attenuated to 1.54 (1.17-2.03) and 1.48 (1.15-1.91) for those groups, respectively. Conclusion: These findings suggest that the presence of more complex determinants of socioeconomic disparities in oral health should be considered with developing preventive policies for those disparities.

Keywords

References

  1. 강영호, 김혜련. 우리 나라의 사회경제적 사망률 불평등: 1998 년도 국민건강영양조사 자료의 사망추적 결과. 예방의학회지 2006;39(2):115-122
  2. 강은정외 5명. 국민건강영양조사 제3기(2005): 아동 및 청소년의 건강수준 및 보건의식행태. 서울: 보건복지부, 한국보건사회연구원, 2006
  3. 김유미, 김명희. 한국 건강불평등의 현황과 문제점 예방의학회지 2007;40(6):431-438 https://doi.org/10.3961/jpmph.2007.40.6.431
  4. 김진욱, 박창원. 소득계층의 실태와 특성에 관한 분석. 재정연구 2003;3:1-15
  5. 김혜영. 사회경제적 수준과 구강진료필요도의 연관성에 대한건강행위, 구강진료이용도의 영향평가. 대한구강보건학회지 2006;30(1):85-94
  6. 신선정, 안용순, 정세환. 한국 청소년의 구강보건행태와 사회경제적지위의 연관성. 대한구강보건학회지 2008;32(2): 223-230
  7. 정세환. 국민건강영양조사 제3기(2005) 심층분석: 건강면접 및 보건의식부문. 서울: 질병관리본부, 한국보건사회연구원, 2007. 쪽 157-179
  8. 최용준외 6명. 건강 불평등 연구에서 사회경제적 위치 지표의개념과 활용. 예방의학회지 2007;40(6):475-486 https://doi.org/10.3961/jpmph.2007.40.6.475
  9. Brunner E, Marmot M. Social organization, stress and health. In: Marmot M, Wilkinson, RG. ediotrs. Social Determinants of Health. Oxford: Oxford University Press, 1999. p.17-43
  10. Chen M. Oral health of disadvantaged populations. In: Cohen L, Gift H, editors. Disease prevention and oral health promotion: Socio-dental science in action. Copenhagen: Munksgaard, 1995. p153-172
  11. Heitz-Mayfield LJ. Disease progression: identification of high-risk groups and individuals for periodontitis. J Clin Periodontol 2005;32(Suppl 6):196-209 https://doi.org/10.1111/j.1600-051X.2005.00803.x
  12. Lynch JW, Kaplan G. Socioeconomic position in Social Epidemiology. In: Berkman LF KI, editors. Social Epidemiology. New York: Oxford University Press, 2000. p.13-35
  13. Marmot MG. Understanding social inequalities in health. Perspect Biol Med 2003;46:S9-23
  14. Marmot MG. Status syndrome: a challenge to medicine. JAMA 2006;295:1304-1307 https://doi.org/10.1001/jama.295.11.1304
  15. McKinlay JB. Paradigmatic obstacles to improving the health of populations--implications for health policy. Salud Publica Mex 1998;40:369-379
  16. Moynihan P, Petersen PE. Diet, nutrition and the prevention of dental diseases. Public Health Nutr 2004;7:201-226
  17. Newton JT, Bower EJ. The social determinants of oral health: new approaches to conceptualizing and researching complex causal networks. Community Dent Oral Epidemiol 2005; 33:25-34 https://doi.org/10.1111/j.1600-0528.2004.00190.x
  18. Petersen PE: The World Oral Health Report 2003: continuous improvement of oral health in the 21st century--the approach of the WHO Global Oral Health Programme. Community Dent Oral Epidemiol 2003;31(Supp l):3-23 https://doi.org/10.1046/j..2003.com122.x
  19. Petersen PE: Sociobehavioural risk factors in dental caries - international perspectives. Community Dent Oral Epidemiol 2005;33:274-279 https://doi.org/10.1111/j.1600-0528.2005.00235.x
  20. Pine CM, Adair PM, Petersen PE, et al.: Developing explanatory models of health inequalities in childhood dental caries. Community Dent Health 2004;21:86-95
  21. Sabbah W, Tsakos G, Sheiham A, et al.: The role of health-related behaviors in the socioeconomic disparities in oral health. Soc Sci Med 2009;68:298-303 https://doi.org/10.1016/j.socscimed.2008.10.030
  22. Sanders AE, Slade GD, Turrell G, et al.: The shape of the socioeconomic-oral health gradient: implications for theoretical explanations. Community Dent Oral Epidemiol 2006a;34:310-319 https://doi.org/10.1111/j.1600-0528.2006.00286.x
  23. Sanders AE, Spencer AJ, Slade GD: Evaluating the role of dental behaviour in oral health inequalities. Community Dent Oral Epidemiol 2006b;34:71-79 https://doi.org/10.1111/j.1600-0528.2006.00261.x
  24. Sheiham A, Watt RG: The common risk factor approach: a rational basis for promoting oral health. Community Dent Oral Epidemiol 2000;28:399-406 https://doi.org/10.1034/j.1600-0528.2000.028006399.x
  25. van Oort FV, van Lenthe FJ, Mackenbach JP: Material, psychosocial, and behavioural factors in the explanation of educational inequalities in mortality in The Netherlands. J Epidemiol Community Health 2005;59:214-220 https://doi.org/10.1136/jech.2003.016493
  26. Wamala S, Merlo J, Bostrom G: Inequity in access to dental care services explains current socioeconomic disparities in oral health: the Swedish National Surveys of Public Health 2004-2005. J Epidemiol Community Health 2006;60:1027- 1033 https://doi.org/10.1136/jech.2006.046896
  27. Watt R, Sheiham A: Inequalities in oral health: a review of the evidence and recommendations for action. Br Dent J 1999;187:6-12 https://doi.org/10.1038/sj.bdj.4800191a
  28. Watt RG: From victim blaming to upstream action: tackling the social determinants of oral health inequalities. Community Dent Oral Epidemiol 2007;35:1-11 https://doi.org/10.1111/j.1600-0528.2007.00348.x