scholarly journals Education and income-based inequality in tooth loss among Brazilian adults: does the place you live make a difference?

2019 ◽  
Author(s):  
Raquel Ferreira ◽  
Maria Inês Barreiros Senna ◽  
Lorrany Gabriele Rodrigues ◽  
Fernanda Lamounier Campos ◽  
Andrea Maria Eleuterio de Barros Lima Martins ◽  
...  
Keyword(s):  
Tooth Loss ◽  
Education Level ◽  
Socioeconomic Inequalities ◽  
Socioeconomic Indicators ◽  
Relative Index ◽  
Individual Level ◽  
Contextual Variation ◽  
Index Of Inequality ◽  
The Individual ◽  
Municipal Level

Abstract Background: Socioeconomic inequalities in tooth loss might be minimized or potentialized by the characteristics of the context where people live. We examined whether there is contextual variation in socioeconomic inequalities in tooth loss across Brazilian municipalities. Methods: Data from the 2010 National Oral Health Survey of 9,979 adults living in 177 Brazilian municipalities were used. Education and household income were used as the individual socioeconomic indicators. At the municipal level, we used the Municipal Human Development Index as our contextual indicator of socioeconomic status (low:<0.699 versus high: >0.70). The Relative Index of Inequality (RII) and the Slope Index of Inequality (SII) were calculated to compare the magnitude of education and income-based inequalities among municipalities with low versus high HDI. Multilevel Poisson regression models with random intercepts and slopes were developed. Results: At the individual level, adults with lower education & income reported more tooth loss. The mean number of lost teeth was 9.62 (95%CI: 8.02-11.23) and 7.03 (95%CI: 6.52-7.55) in municipalities with low and high HDI, respectively. Municipalities with high HDI showed higher relative and absolute education-based inequality. For income-based inequalities, higher SII was observed in municipalities with lower HDI. A significant cross-level interaction indicated that high-education adults reported fewer lost teeth when they lived in municipalities with high HDI compared to adults with the same education level living in low HDI municipalities. For individuals with the lowest education level, there was no difference in the number of teeth between those from municipalities with high and low HDI. Conclusions: There was a social gradient in tooth loss by education and income. Living in disadvantaged municipalities cannot overcome the risk associated with low schooling. The protective effect of higher education can be reduced when people live in disadvantaged areas.

scholarly journals Education and income-based inequality in tooth loss among Brazilian adults: does the place you live make a difference?

2020 ◽  
Author(s):  
Raquel Ferreira ◽  
Maria Inês Barreiros Senna ◽  
Lorrany Gabriele Rodrigues ◽  
Fernanda Lamounier Campos ◽  
Andrea Maria Eleuterio de Barros Lima Martins ◽  
...  
Keyword(s):  
Tooth Loss ◽  
Education Level ◽  
Socioeconomic Inequalities ◽  
Socioeconomic Indicators ◽  
Missing Teeth ◽  
Individual Level ◽  
Contextual Variation ◽  
Lower Education ◽  
The Individual ◽  
Municipal Level

Abstract Background: Socioeconomic inequalities in tooth loss might be minimized or potentialized by the characteristics of the context where people live. We examined whether there is contextual variation in socioeconomic inequalities in tooth loss across Brazilian municipalities. Methods: Data from the 2010 National Oral Health Survey of 9,633 adults living in 157 Brazilian municipalities were used. The individual socioeconomic indicators were education and household income. At the municipal level, we used the Municipal Human Development Index (HDI) as our contextual indicator of socioeconomic status (low:<0.699 versus high: >0.70). The Relative (RII) and Slope (SII) Indexes of Inequality, Relative (RCI), and Absolute (ACI) Concentration Indexes were calculated to compare the magnitude of education and income-based inequalities among municipalities with low versus high HDI. Multilevel Poisson regression models with random intercepts and slopes were developed. Results: At the individual level, adults with lower education & income reported more tooth loss. The mean number of missing teeth was 9.52 (95%CI: 7.93-11.13) and 6.95 (95%CI: 6.43-7.49) in municipalities with low and high HDI, respectively. Municipalities with high HDI showed higher relative and absolute education-based inequality. For income-based inequalities, higher SII and RCI was observed in municipalities with lower HDI. A significant cross-level interaction indicated that high-education adults reported fewer missing teeth when they lived in municipalities with high HDI compared to adults with the same education level living in low HDI municipalities. For individuals with the lowest education level, there was no difference in the number of teeth between those from municipalities with high and low HDI.Conclusions: There was a social gradient in tooth loss by education and income. Living in disadvantaged municipalities cannot overcome the risk associated with low schooling. The protective effect of higher education can be reduced when people live in disadvantaged areas.

scholarly journals Education and income-based inequality in tooth loss among Brazilian adults: does the place you live make a difference?

2020 ◽  
Author(s):  
Raquel Ferreira ◽  
Maria Inês Barreiros Senna ◽  
Lorrany Gabriele Rodrigues ◽  
Fernanda Lamounier Campos ◽  
Andrea Maria Eleuterio de Barros Lima Martins ◽  
...  
Keyword(s):  
Tooth Loss ◽  
Education Level ◽  
Socioeconomic Inequalities ◽  
Socioeconomic Indicators ◽  
Missing Teeth ◽  
Individual Level ◽  
Contextual Variation ◽  
Lower Education ◽  
The Individual ◽  
Municipal Level

Abstract Background: Socioeconomic inequalities in tooth loss might be minimized or potentialized by the characteristics of the context where people live. We examined whether there is contextual variation in socioeconomic inequalities in tooth loss across Brazilian municipalities. Methods: Data from the 2010 National Oral Health Survey of 9,633 adults living in 157 Brazilian municipalities were used. Education and household income were used as the individual socioeconomic indicators. At the municipal level, we used the Municipal Human Development Index (HDI) as our contextual indicator of socioeconomic status (low:<0.699 versus high: >0.70). The Relative (RII) and Slope (SII) Indexes of Inequality, Relative (RCI), and Absolute (ACI) Concentration Indexes were calculated to compare the magnitude of education and income-based inequalities among municipalities with low versus high HDI. Multilevel Poisson regression models with random intercepts and slopes were developed. Results: At the individual level, adults with lower education & income reported more tooth loss. The mean number of missing teeth was 9.52 (95%CI: 7.93-11.13) and 6.95 (95%CI: 6.43-7.49) in municipalities with low and high HDI, respectively. Municipalities with high HDI showed higher relative and absolute education-based inequality. For income-based inequalities, higher SII and RCI was observed in municipalities with lower HDI. A significant cross-level interaction indicated that high-education adults reported fewer missing teeth when they lived in municipalities with high HDI compared to adults with the same education level living in low HDI municipalities. For individuals with the lowest education level, there was no difference in the number of teeth between those from municipalities with high and low HDI. Conclusions: There was a social gradient in tooth loss by education and income. Living in disadvantaged municipalities cannot overcome the risk associated with low schooling. The protective effect of higher education can be reduced when people live in disadvantaged areas.

scholarly journals Prevalence, Changes, and Factors of the Double Burden of Malnutrition at the Individual Level: A Multilateral Analysis

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 915-915
Author(s):  
Yuko Teshima ◽  
Akira Shibanuma ◽  
Masamine Jimba
Keyword(s):  
Socioeconomic Inequalities ◽  
Double Burden ◽  
Children Under Five ◽  
Relative Index ◽  
Individual Level ◽  
Under Five ◽  
Country Level ◽  
Index Of Inequality ◽  
Double Burden Of Malnutrition ◽  
The Individual

Abstract Objectives The double burden of malnutrition (DBM) is a major public health problem in the world. Overweight and obesity with concurrent stunting (called stuntingoverweight) is one of the specific forms of DBM at the individual level, and it has been documented in several low- and middle-income countries (LMICs). However, the changes in country-level prevalence of stuntingoverweight has not been known. The impact of socioeconomic inequalities on the prevalence of stuntingoverweight also have not been done across LMICs. Thus, this study aimed to investigate the changes of stuntingoverweight prevalence among children under five-years, and to assess socioeconomic inequality in the prevalence in LMICs. Methods Secondary data analysis was conducted in 58 LMICs between 2006 and 2018, comprising 692,704 children under five years old by using the Demographic and Health Surveys (DHS). For stuntingoverweight, the following values were estimated: rate ratio, mean difference, the slope index of inequality (SII), and the relative index of inequality (RII). Results The range of the prevalence of stuntingoverweight was lower than the ranges in the country-level prevalence of stunting and overweight. The relative index of inequality (RII) by wealth status ranged from 0.16 (Peru) to 2.31 (Nepal). RII by maternal education ranged from 0.06 (Kyrgyz Republic) to 15.11 (Tajikistan). Stuntingoverweight was found more in the poorest households. Among 31 LMICs, 27 countries reduced the prevalence of stuntingoverweight except four countries. However, to what extent the prevalence of stuntingoverweight reduced varied between countries. Conclusions The prevalence of stuntingoverweight had been reduced in most countries, and socioeconomic inequalities existed in the prevalence and its change. Governments require health policies in addition to preventing stunting to ensure that children who are already stunted have a healthy life without becoming overweight concurrently. Funding Sources N/A.

scholarly journals Factors Determining Income among Real Estate Salespersons: The Impacts of Individual Conditions, Franchises, and Regular Chains

2015 ◽  
Vol 7 (11) ◽  
pp. 94
Author(s):  
Chun-Chang Lee ◽  
Cheng-Huang Tung ◽  
Yu-Heng Lee ◽  
Shu-Man You
Keyword(s):  
Real Estate ◽  
Hierarchical Linear Modeling ◽  
Positive Impact ◽  
Working Hours ◽  
Education Level ◽  
Linear Modeling ◽  
Individual Level ◽  
The Individual ◽  
The Given ◽  
Regular Chains

<p>This study explores the factors that affect the incomes of real estate salespersons by applying hierarchical linear modeling (HLM) to investigate the incomes of real estate salespersons in Kaohsiung. A total of 510 questionnaires were distributed to large chain housing agencies, of which a total of 319 effective samples were retrieved from 54 branch stores, for an effective return rate of 62.55%. The empirical results showed that individual incomes vary significantly from store to store. About 4.8% of the variation in individual incomes was due to differences among different branch stores. The individual income of a real estate salesperson is also significantly affected by individual-level factors such as age, working hours, and working experience. The marginal impact of education level, age, working hours, and working experience on real estate salesperson income is moderated by the type of store at which the given salesperson works. In addition, a branch store’s location has a direct, significant, and positive impact on a real estate salesperson’s income.</p>

scholarly journals Diabetes: Socioeconomic Inequalities in the Portuguese Population in 2014

2017 ◽  
Vol 30 (7-8) ◽  
pp. 561 ◽  
Author(s):  
Joana Santos ◽  
Irina Kislaya ◽  
Liliana Antunes ◽  
Ana João Santos ◽  
Ana Paula Rodrigues ◽  
...  
Keyword(s):  
Educational Level ◽  
Concentration Index ◽  
Public Health Problem ◽  
Universal Coverage ◽  
Socioeconomic Inequalities ◽  
Major Public Health Problem ◽  
Relative Index ◽  
The People ◽  
Access To Health ◽  
Index Of Inequality

Introduction: Diabetes is a major public health problem and it is related to socioeconomic factors. The aim of this study is to describe socioeconomic inequalities in the distribution of diabetes in the population with 25 years or more, resident in Portugal in 2014.Material and Methods: Data from the Health National Survey 2014 was analysed, n = 16 786. We estimated the prevalence of diabetes in the population and stratified by socioeconomic variables namely educational level and income. The extent of socioeconomic inequalities was assessed using concentration index and the relative index of inequality.Results: Diabetes was found to be concentrated among the people with lower educational levels (concentration index = -0.26) and lower income quintiles (concentration index = -0.14). Relative index of inequality also showed a lower degree of inequality among the most educated (0,20; CI 95% = [0,12; 0,32]) and with higher income (0,59; CI 95% = [0,48; 0,74]).Discussion: Distribution of diabetes is associated with education and income. Previous studies have shown that although income might reflect lifestyle patterns, education reflects better social factors that are important for establishing healthier behaviours. Also, the National Health Service, of universal coverage and free of charge, might have contributed to reduce inequalities in the access to health by those with the lowest income.Conclusion: Supporting ‘Health in All Policies’ might reduce inequalities, namely by improving population educational level and actions that promote health literacy.

scholarly journals Life course socioeconomic inequalities and oral health status in later life

2019 ◽  
Vol 52 (Suppl 2) ◽  
pp. 7s ◽  
Author(s):  
Fabíola Bof de Andrade ◽  
José Leopoldo Ferreira Antunes ◽  
Paulo Roberto Borges de Souza Junior ◽  
Maria Fernanda Lima-Costa ◽  
Cesar De Oliveira
Keyword(s):  
Oral Health ◽  
Life Course ◽  
Socioeconomic Position ◽  
Tooth Loss ◽  
Parental Education ◽  
Later Life ◽  
Socioeconomic Inequalities ◽  
Dental Prostheses ◽  
Absolute And Relative Inequalities ◽  
Index Of Inequality

OBJECTIVE: To investigate the association between life course socioeconomic conditions and two oral health outcomes (edentulism and use of dental prostheses among individuals with severe tooth loss) among older Brazilian adults. METHODS: This was a cross-sectional study with data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) which includes information on persons aged 50 years or older residing in 70 municipalities across the five great Brazilian regions. Regression models using life history information were used to investigate the relation between childhood (parental education) and adulthood (own education and wealth) socioeconomic circumstances and edentulism and use of dental prostheses. Slope index of inequality and relative index of inequality for edentulism and use of dental prostheses assessed socioeconomic inequalities in both outcomes. RESULTS: Approximately 28.8% of the individuals were edentulous and among those with severe tooth loss 80% used dental prostheses. Significant absolute and relative inequalities were found for edentulism and use of dental prostheses. The magnitude of edentulism was higher among individuals with lower levels of socioeconomic position during childhood, irrespective of their current socioeconomic position. Absolute and relative inequalities related to the use of dental prostheses were not related to childhood socioeconomic position. CONCLUSIONS: These findings substantiate the association between life course socioeconomic circumstances and oral health in older adulthood, although use of dental prostheses was not related to childhood socioeconomic position. The study also highlights the long-lasting relation between childhood socioeconomic inequalities and oral health through the life course.

scholarly journals Trends in socioeconomic inequalities in the prevalence of functional dentition among older people in Brazil

2018 ◽  
Vol 34 (10) ◽  
Author(s):  
Fabiola Bof de Andrade ◽  
Jose Leopoldo Ferreira Antunes
Keyword(s):  
Older Adults ◽  
Cross Sectional Study ◽  
Socioeconomic Inequalities ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Relative Index ◽  
Functional Dentition ◽  
Natural Teeth ◽  
Index Of Inequality ◽  
Position Measure

The objective of this research was to evaluate trends in socioeconomic inequalities in the prevalence of functional dentition among community-dwelling older adults in Brazil. This was a cross-sectional study with data from the last two SBBrasil Project surveys conducted in 2003 and 2010. Functional dentition was defined as the presence of 20 or more natural teeth and was assessed during the clinical examination of dentition status. Schooling was used as the socioeconomic position measure. Socioeconomic inequality was measured using two complex measures; the slope index of inequality (SII) and the relative index of inequality (RII). The prevalence of functional dentition was 10.8% (95%CI: 8.1-14.2) in 2003 and 13.6% (95%CI: 11.1-16.5) in 2010. The prevalence of functional dentition increased significantly over the educational rank in both years. Absolute inequalities were significant for both years and remained unaltered between 2003 and 2010. Significant relative inequality in the prevalence of functional dentition was found in both years of the survey. Socioeconomic inequalities in the prevalence of functional dentition among older adults in Brazil persisted significantly between both national oral health surveys.

scholarly journals A national pilot program for chronic diseases and health inequalities in South Korea

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rangkyoung Ha ◽  
Dongjin Kim ◽  
Jihee Choi ◽  
Kyunghee Jung-Choi
Keyword(s):  
Health Insurance ◽  
South Korea ◽  
Chronic Diseases ◽  
Health Inequalities ◽  
Socioeconomic Position ◽  
Prescription Medication ◽  
Socioeconomic Inequalities ◽  
Pilot Program ◽  
Individual Level ◽  
The Individual

Abstract Background To achieve the health equity, it is important to reduce socioeconomic inequalities when managing chronic diseases. In South Korea, a pilot program for chronic diseases was implemented at the national level. This study aimed to examine its effect on socioeconomic inequalities in chronic disease management at the individual and regional levels. Methods Korean National Health Insurance data from September 2016 to October 2017 were used. Study subjects in the national pilot program for chronic diseases included 31,765 participants and 5,741,922 non-participants. The dependent variable was continuity of prescription medication. Socioeconomic position indicators were health insurance contribution level and the area deprivation index. Covariates were gender, age, and the Charlson Comorbidity Index (CCI). A multilevel logistic regression model was used to address the effects at both the individual and regional levels. This is a cross-sectional study. Results Unlike the group of non-participants, the participants showed no inequality in prescription medication continuity according to individual-level socioeconomic position. However, continuity of prescription medication was higher among those in less deprived areas compared to those in more deprived areas in both the participation and non-participation groups. Conclusions This study found that the pilot program for chronic diseases at the least did not contribute to the worsening of health inequalities at the individual level in South Korea. However, there was a trend showing health inequalities based on the socioeconomic level of the area. These findings suggest that additional policy measures are needed to attain equality in the management of chronic diseases regardless of the regional socioeconomic position.

scholarly journals Trends in Socioeconomic Inequalities in Hypertension in Ontario, Canada, 2000-2012

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Simran Shokar ◽  
Laura Rosella ◽  
Peter Smith ◽  
Hong Chen ◽  
Heather ChenManson ◽  
...  
Keyword(s):  
Risk Factor ◽  
Household Income ◽  
Socioeconomic Inequalities ◽  
Material Deprivation ◽  
Discharge Abstract Database ◽  
Ontario Health Insurance Plan ◽  
Cross Sectional ◽  
Study Objective ◽  
Relative Index ◽  
Index Of Inequality

IntroductionHypertension is leading risk factor for cardiovascular disease and mortality. Low socioeconomic position (e.g., income or high material deprivation) is an important risk factor for hypertension. However, there is limited evidence monitoring the extent to which socioeconomic inequalities in hypertension exist and are changing over time in Ontario. Objectives and ApproachThe study objective was to estimate socioeconomic trends in prevalent hypertension by household income and material deprivation in Ontario from 2000 to 2012. A pooled cross-sectional study was conducted using data from 6 Canadian Community Health Surveys linked to the Discharge Abstract Database and Ontario Health Insurance Plan data (n=121,390 over 35 years, 54\% female). Relative-weighted Poisson regression models were used to estimate hypertension rates (adjusted for age, sex, ethnicity and immigration) across quintiles of equivalized household income and area-level material deprivation. Socioeconomic inequalities were estimated using the slope index of inequality (SII) and relative index of inequality (RII). ResultsSocioeconomic inequalities in hypertension were observed across income quintiles on both absolute (SII: 1428 per 10,000, 95\%CI:1126,1730) and relative (RII:1.74, 95\%CI:1.53,1.94) scales in 2000, decreasing by 2012 (SII:297 per 10,000, 95%CI: -82,676; RII:1.19, 95%CI:0.93,1.45). A similar pattern was observed across material deprivation quintiles, however with smaller inequalities in 2000 (SII:595 per 10,000, 95%CI:306,884; RII:1.25, 95%CI:1.11,1.39) and 2012 (SII:389 per 10,000, 95%CI:17,761; RII:1.24, 95%CI:0.99,1.49). Conclusion/ImplicationsSocioeconomic inequalities in hypertension were observed in Ontario, with decreasing trends between 2000 and 2012. Area-level material deprivation underestimated individual-level socioeconomic inequalities in hypertension.

scholarly journals Trends in socioeconomic inequalities in childhood BCG immunization coverage in Pakistan

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Zaheer ◽  
S Kanwal ◽  
K Shafique
Keyword(s):  
Vaccination Coverage ◽  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Socioeconomic Inequalities ◽  
Reproductive Age ◽  
Demographic And Health Surveys ◽  
High Burden ◽  
Relative Index ◽  
Bcg Vaccination ◽  
Index Of Inequality

Abstract Background Although, WHO notes that there has been 'tremendous progress' towards controlling spread of Tuberculosis (TB) by 2015, situation in endemic countries like Pakistan need global attention. Pakistan currently ranks fifth among TB-high burden countries and it accounts for 61% of the TB burden in the WHO Eastern Mediterranean Region. We aim to explore the trends in relative and absolute socioeconomic inequalities in BCG vaccination coverage. Methods Data from Pakistan Demographic and Health Surveys (PDHS) 2006-7 (n = 9177 data used 8442), and 20012-13 (n = 13558, used n = 6982) were used. Information was collected from all mothers in reproductive age group, regarding BCG vaccination of their children aged &lt; 5 years. Wealth index and education were used to assess socioeconomic position. Socioeconomic inequalities for BCG vaccination coverage were assessed by calculating Relative Index of Inequality (RII) and Absolute Index of Inequality (SII). Results Although reported frequency of not getting the child BCG vaccinated has decreased over the decade (25% in 2006, 18% in 2013). Nevertheless, socioeconomic inequalities in BCG vaccination have significantly widened over the last decade. Education related inequalities [2006-7 Urban: SII=-1.34 (-0.91, -1.76); 2012-13 Urban: SII=-1.88 (-1.43, -2.32)]; [2006-7 Rural: SII=-1.31 (-0.96, -1.65); 2012-13 Rural: SII=-1.54 (-1.13, -1.94)] have increased. Similarly, wealth related inequalities [2006-7 Urban: SII=-1.27 (-0.91, -1.62); 2012-13 Urban: SII=-1.75 (-1.37, -2.12)]; [2006-7 Rural: SII=-1.19 (-0.98, -1.39); 2012-13 Rural: SII=-1.72 (-1.43, -2.00)] have increased. Conclusions Widening absolute inequalities in BCG vaccination coverage among children over the last decade in a TB-high burden country gives rise to global concern, at a time when world aims for tuberculosis free future. The results warrant the essential public health efforts to avoid further widening in TB related socioeconomic inequalities in Pakistan. Key messages The results warrant the need to continue monitoring of TB control at population level. Study findings may help to improved TB management programs to initiate evidence-based guidelines for maternal and child health.

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