Towards an understanding of the structural determinants of oral health inequalities: A comparative analysis between Canada and the United States
Objective: To compare the magnitude of, and contributors to, income-related inequalities in oral health outcomes within and between Canada and the United States over time. Methods: The concentration index was used to estimate income-related inequalities in three oral health outcomes from the Nutriti...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2016-12-01
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| Series: | SSM: Population Health |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352827316300088 |
| _version_ | 1818565306534068224 |
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| author | Julie Farmer Logan McLeod Arjumand Siddiqi Vahid Ravaghi Carlos Quiñonez |
| author_facet | Julie Farmer Logan McLeod Arjumand Siddiqi Vahid Ravaghi Carlos Quiñonez |
| author_sort | Julie Farmer |
| collection | DOAJ |
| description | Objective: To compare the magnitude of, and contributors to, income-related inequalities in oral health outcomes within and between Canada and the United States over time. Methods: The concentration index was used to estimate income-related inequalities in three oral health outcomes from the Nutrition Canada National Survey 1970–1972, Canadian Health Measures Survey 2007–2009, Health and Nutrition Examination Survey I 1971–1974, and National Health and Nutrition Examination Survey 2007–2008. Concentration indices were decomposed to determine the contribution of demographic and socioeconomic factors to oral health inequalities. Results: Our estimates show that over time in both countries, inequalities in decayed teeth and edentulism were concentrated among the poor and inequalities in filled teeth were concentrated among the rich. Over time, inequalities in decayed teeth increased and decreased for measures of filled teeth and edentulism in both countries. Inequalities were higher in the United States compared to Canada for filled and decayed teeth outcomes. Socioeconomic characteristics (education, income) contributed greater to inequalities than demographic characteristics (age, sex). As well, income contributed more to inequalities in recent surveys in both Canada and the United States. Conclusions: Inequalities in oral health have persisted over the past 35 years in Canada and the United States, and are associated with age, sex, education, and income and have varied over time. Keywords: Canada, United States, Oral health, Social determinants of health, Health status disparities, Income, Comparative study |
| first_indexed | 2024-12-14T01:39:38Z |
| format | Article |
| id | doaj.art-91a0f318aad44d0d815843e9e36164d8 |
| institution | Directory Open Access Journal |
| issn | 2352-8273 |
| language | English |
| last_indexed | 2024-12-14T01:39:38Z |
| publishDate | 2016-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | SSM: Population Health |
| spelling | doaj.art-91a0f318aad44d0d815843e9e36164d82022-12-21T23:21:47ZengElsevierSSM: Population Health2352-82732016-12-012226236Towards an understanding of the structural determinants of oral health inequalities: A comparative analysis between Canada and the United StatesJulie Farmer0Logan McLeod1Arjumand Siddiqi2Vahid Ravaghi3Carlos Quiñonez4Discipline of Dental Public Health, Faculty of Dentistry, University of Toronto, Ontario, Canada; Correspondence to: Discipline of Dental Public Health, Faculty of Dentistry University of Toronto. Tel.: +1 416 979 4908x4497; fax: +1 416 979 4936.Department of Economics, Lazaridis School of Business & Economics, Wilfrid Laurier University, Waterloo, Ontario, CanadaDalla Lana School of Public Health, University of Toronto, Ontario, Canada; Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina – Chapel Hill, Chapel Hill, NCSchool of Dentistry, University of Birmingham, Birmingham, UKDiscipline of Dental Public Health, Faculty of Dentistry, University of Toronto, Ontario, CanadaObjective: To compare the magnitude of, and contributors to, income-related inequalities in oral health outcomes within and between Canada and the United States over time. Methods: The concentration index was used to estimate income-related inequalities in three oral health outcomes from the Nutrition Canada National Survey 1970–1972, Canadian Health Measures Survey 2007–2009, Health and Nutrition Examination Survey I 1971–1974, and National Health and Nutrition Examination Survey 2007–2008. Concentration indices were decomposed to determine the contribution of demographic and socioeconomic factors to oral health inequalities. Results: Our estimates show that over time in both countries, inequalities in decayed teeth and edentulism were concentrated among the poor and inequalities in filled teeth were concentrated among the rich. Over time, inequalities in decayed teeth increased and decreased for measures of filled teeth and edentulism in both countries. Inequalities were higher in the United States compared to Canada for filled and decayed teeth outcomes. Socioeconomic characteristics (education, income) contributed greater to inequalities than demographic characteristics (age, sex). As well, income contributed more to inequalities in recent surveys in both Canada and the United States. Conclusions: Inequalities in oral health have persisted over the past 35 years in Canada and the United States, and are associated with age, sex, education, and income and have varied over time. Keywords: Canada, United States, Oral health, Social determinants of health, Health status disparities, Income, Comparative studyhttp://www.sciencedirect.com/science/article/pii/S2352827316300088 |
| spellingShingle | Julie Farmer Logan McLeod Arjumand Siddiqi Vahid Ravaghi Carlos Quiñonez Towards an understanding of the structural determinants of oral health inequalities: A comparative analysis between Canada and the United States SSM: Population Health |
| title | Towards an understanding of the structural determinants of oral health inequalities: A comparative analysis between Canada and the United States |
| title_full | Towards an understanding of the structural determinants of oral health inequalities: A comparative analysis between Canada and the United States |
| title_fullStr | Towards an understanding of the structural determinants of oral health inequalities: A comparative analysis between Canada and the United States |
| title_full_unstemmed | Towards an understanding of the structural determinants of oral health inequalities: A comparative analysis between Canada and the United States |
| title_short | Towards an understanding of the structural determinants of oral health inequalities: A comparative analysis between Canada and the United States |
| title_sort | towards an understanding of the structural determinants of oral health inequalities a comparative analysis between canada and the united states |
| url | http://www.sciencedirect.com/science/article/pii/S2352827316300088 |
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