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Income gradients in oral health according to child age
Authors:Eduardo Bernabé  Wael Sabbah  Elsa K Delgado‐Angulo  Jason E Murasko  Stuart A Gansky
Institution:1. Division of Population and Patient Health, King's College London Dental Institute at Guy's, King's College and St Thomas' Hospitals, London, UK;2. Departamento Académico de Odontología Social, Universidad Peruana Cayetano Heredia, Lima, Perú;3. Department of Economics, University of Houston ‐ Clear Lake, Houston, TX, USA;4. Department of Preventive & Restorative Dental Sciences, University of California San Francisco School of Dentistry, San Francisco, CA, USA
Abstract:This study aimed to confirm whether the well‐known income disparities in oral health seen over the life course are indeed absent in 9‐ to 11‐yr‐old children, and to explore the role of access to dental care in explaining the age‐profile of the income gradient in child oral health. We used data from the 2007 United States National Survey of Children's Health. Income gradients in parental reports of children's decayed teeth or cavities, toothache, broken teeth, bleeding gums, and fair/poor condition of teeth were assessed in stratified analyses according to age of child (1–5, 6–8, 9–11, 12–14, and 15–17 yr), using survey logistic regression to control for family‐, parental‐, and child‐level covariates. Health insurance status and use of preventive dental care were the indicators for children's access to dental care. The adjusted ORs for the effect of family income on having decayed teeth or cavities, toothache, and fair/poor condition of teeth were not significant in 9‐ to 11‐yr‐old children. Different age‐patterns were found for broken teeth and bleeding gums. The attenuation of the income gradients in having decayed teeth or cavities, toothache, and fair/poor condition of teeth, previously seen in 9‐ to 11‐yr‐old children, was also seen in 15‐ to 17‐, 12‐ to 14‐, and 6‐ to 8‐yr‐old children, respectively, after controlling for children's access to dental care. This study supports the attenuation of income inequalities in oral health in 9‐ to 11‐yr‐old children. Access to dental care could attenuate income gradients in oral health in other age groups.
Keywords:cross‐sectional  family income  oral health  parental reports  public health dentistry
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