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 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?

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 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 Socioeconomic status and lifestyle behaviours in cancer survivors: smoking and physical activity

2016 ◽  
Vol 23 (6) ◽  
pp. 546 ◽  
Author(s):  
H. Naik ◽  
X. Qiu ◽  
M. C. Brown ◽  
L. Eng ◽  
D. Pringle ◽  
...  
Keyword(s):  
Physical Activity ◽  
Socioeconomic Status ◽  
Cancer Survivors ◽  
Smoking Status ◽  
Education Level ◽  
Socioeconomic Indicators ◽  
Cross Sectional ◽  
Lifestyle Behaviours ◽  
Lower Education Level ◽  
Lower Education

Purpose Smoking cessation and increased physical activity (pa) have been linked to better outcomes in cancer survivors. We assessed whether socioeconomic factors influence changes in those behaviours after a cancer diagnosis.Methods As part of a cross-sectional study, a diverse group of cancer survivors at the Princess Margaret Cancer Centre (Toronto, ON), completed a questionnaire about past and current lifestyle behaviours and perceptions about the importance of those behaviours with respect to their health. The influence of socioeconomic indicators on smoking status and physical inactivity at 1 year before and after diagnosis were assessed using multivariable logistic regression with adjustment for clinico-demographic factors.Results Of 1222 participants, 1192 completed the smoking component. Of those respondents, 15% smoked before diagnosis, and 43% of those smokers continued to smoke after. The proportion of survivors who continued to smoke increased with lower education level (p = 0.03). Of the 1106 participants answering pa questions, 39% reported being physically inactive before diagnosis, of whom 82% remained inactive afterward. Survivors with a lower education level were most likely to remain inactive after diagnosis (p = 0.003). Lower education level, household income, and occupation were associated with the perception that pa had no effect or could worsen fatigue and quality of life (p ≤ 0.0001).Conclusions In cancer survivors, education level was a major modifier of smoking and pa behaviours. Lower socioeconomic status was associated with incorrect perceptions about pa. Targeting at-risk survivors by education level should be evaluated as a strategy in cancer survivorship programs.

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.

Zambia and e-Government

2010 ◽  
pp. 137-161 ◽  
Author(s):  
Neal Coates ◽  
Lisa Nikolaus
Keyword(s):  
Communication Systems ◽  
Access To Health Care ◽  
Individual Level ◽  
Access To Health ◽  
Sub Saharan ◽  
Government Websites ◽  
The Individual ◽  
Municipal Level ◽  
Ict Policy

E-government can benefit developing countries by enhancing the economy, increasing access to health care, improving bureaucracy, and consolidating democracy. Sub-Saharan countries have lagged behind the world in adopting this system of communications. A variety of reasons explain the lag, namely lack of national resources and an illiterate population. Zambia serves an example of democracy on a continent where freedom and peace are lacking, but also as a country where e-government is only beginning. This evaluation is the first to examine e-government there, and is carried out at five distinct levels: Current communication systems; Zambia’s ICT policy; key central e-government websites; e-government at the provincial/municipal level; and at the individual level. As a result, this case study will evaluate how a developing country is struggling to provide government access and enhance the economy and suggests improvements needed if Zambia’s e-government will become adequate and sustainable.

scholarly journals Contextual and individual determinants of tooth loss in adults: a multilevel study

2020 ◽  
Author(s):  
Luana Leal Roberto ◽  
Marise Fagundes Silveira ◽  
Alfredo Mauricio Batista De Paula ◽  
Efigênia Ferreira Ferreira ◽  
Andréa Maria Eleutério De Barros Lima Martins ◽  
...  
Keyword(s):  
Oral Health ◽  
Tooth Loss ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Cross Sectional Study ◽  
Social Characteristics ◽  
Dental Services ◽  
Cross Sectional ◽  
Individual Level ◽  
The Individual

Abstract Background: Tooth loss represents a known marker of health inequality. The association between tooth loss and unfavorable socioeconomic conditions is evident when analyzed at an individual level. However, the effects of contextual characteristics on tooth loss need to be better investigated and understood. The objective of this study was to analyze tooth loss among Brazilian adults (35-44 years of age), in accordance with individual and contextual social characteristics. Methods: This was a multilevel cross-sectional study with data from 9,564 adult participants from the Brazilian Oral Health Survey - SBBrasil 2010. The dependent variable was the number of lost teeth and the independent variables were grouped into structural (socioeconomic & political context) and intermediary (socioeconomic position, behavioral & biological factors, and health services) determinants. Multilevel Hierarchical Negative Binomial Regression was conducted and the Mean Ratio (MR) was estimated. Results: Brazilian adults lost a mean of 7.57 (95% CI 7.1-8.1) teeth. Among the contextual variables, the number of teeth lost was higher among residents of municipalities with high and medium/low Municipal Human Development Index (MHDI) and in municipalities that did not have public water fluoridation. Among the individual variables, dental loss was higher among those who declared themselves yellow/black/brown/indigenous, were older, who had lower income, who had never visited a dentist, who had used dental services for more than a year and those whose most recent visit to the dentist was due to oral health problems. On the other hand, dental loss was lower among adults with higher education levels and males. Conclusions: The number of missing teeth was associated with unfavorable contextual and individual conditions, which reinforces the need to reduce social inequality and guarantee regular, lifetime access to dental services.

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.

Local News, Social Integration, and Community Participation: Hierarchical Linear Modeling of Contextual and Cross-Level Effects

2005 ◽  
Vol 82 (3) ◽  
pp. 587-606 ◽  
Author(s):  
Hye-Jin Paek ◽  
So-Hyang Yoon ◽  
Dhavan V. Shah
Keyword(s):  
Social Interaction ◽  
Community Participation ◽  
Hierarchical Linear Modeling ◽  
Home Ownership ◽  
Linear Modeling ◽  
Community Factors ◽  
Individual Level ◽  
Print News ◽  
Contextual Variation ◽  
The Individual

This study explores the cross-level interactions of local media use with individual and community factors, in particular, local print news use, using a multi-level analysis of community participation. Findings show local print news readership, an essential constituent of communal solidarity, increases the likelihood of community participation both at the individual level and as a function of readership in communities with higher levels of social interaction. Cross-level effects are also observed between individual-level differences in social interaction and home ownership and contextual variation in print news readership.

scholarly journals Contextual and individual determinants of tooth loss in adults: a multilevel study

2020 ◽  
Author(s):  
Luana Leal Roberto ◽  
Marise Fagundes Silveira ◽  
Alfredo Mauricio Batista De Paula ◽  
Efigênia Ferreira Ferreira ◽  
Andréa Maria Eleutério De Barros Lima Martins ◽  
...  
Keyword(s):  
Oral Health ◽  
Tooth Loss ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Cross Sectional Study ◽  
Social Characteristics ◽  
Dental Services ◽  
Cross Sectional ◽  
Individual Level ◽  
The Individual

Abstract Background: Tooth loss represents a known marker of health inequality. The association between tooth loss and unfavorable socioeconomic conditions is evident when analyzed at an individual level. However, the effects of contextual characteristics on tooth loss need to be better investigated and understood. The objective of this study was to analyze tooth loss among Brazilian adults (35-44 years of age), in accordance with individual and contextual social characteristics. Methods: This was a multilevel cross-sectional study with data from 9,564 adult participants from the Brazilian Oral Health Survey - SBBrasil 2010. The dependent variable was the number of lost teeth and the independent variables were grouped into structural (socioeconomic & political context) and intermediary (socioeconomic position, behavioral & biological factors, and health services) determinants. Multilevel Hierarchical Negative Binomial Regression was conducted and the Mean Ratio (MR) was estimated. Results: Brazilian adults lost a mean of 7.57 (95% CI 7.1-8.1) teeth. Among the contextual variables, the number of teeth lost was higher among residents of municipalities with high and medium/low Municipal Human Development Index (MHDI) and in municipalities that did not have public water fluoridation. Among the individual variables, dental loss was higher among those who declared themselves yellow/black/brown/indigenous, were older, who had lower income, who had never visited a dentist, who had used dental services for more than a year and those whose most recent visit to the dentist was due to oral health problems. On the other hand, dental loss was lower among adults with higher education levels and males. Conclusions: The number of missing teeth was associated with unfavorable contextual and individual conditions, which reinforces the need to reduce social inequality and guarantee regular, lifetime access to dental services.

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