DOI QR코드

DOI QR Code

The relationship between regional socioeconomic position and oral health behavior: A multilevel approach analysis

지역의 사회경제적 상태와 구강건강행위의 관련성: 다수준 분석방법의 적용

  • Kim, Cheoul-Sin (Research Institute for Dental Care Policy, Korean Dental Association) ;
  • Han, Sun-Young (Research Institute for Dental Care Policy, Korean Dental Association) ;
  • Kim, Chul-Woung (Department of Preventive Medicine, Chungnam National University)
  • 김철신 (대한치과의사협회 치과의료정책연구소) ;
  • 한선영 (대한치과의사협회 치과의료정책연구소) ;
  • 김철웅 (충남대학교 예방의학교실)
  • Received : 2013.08.20
  • Accepted : 2013.11.25
  • Published : 2013.12.30

Abstract

Objectives: This study was conducted to identify discrepancies in oral health behaviors among communities in cities, counties, and districts (si, gun, and gu administrative divisions of South Korea) and to determine their correlations with socioeconomic status, examined in terms of the social deprivation index. Methods: Data for 220,258 individuals, covering 247 communities, were extracted from a 2008 community health survey, and the frequency of brushing the teeth after lunch, flossing and interdental brushing was calculated and analyzed. Considering the characteristics of the data collected at individual and regional levels, a multilevel random-intercept logistic regression model was used for the analysis. Results: A regional-level discrepancy was found in after-lunch brushing and the use of auxiliary oral hygiene items, with interclass correlations of 0.03 and 0.04, respectively. In particular, the odds ratio of using auxiliary oral hygiene items in the communities with the lowest socioeconomic status was as low as 0.49, compared to the highest level, thus demonstrating a conspicuous intercommunity difference. Conclusions: The regional-level correlation between socioeconomic status and oral health behaviors indicates the need for the establishment of oral health-related intervention policies based on community characteristics.

Keywords

References

  1. Forbes A, Wainwright SP. On the methodological, theoretical and philosophical context of health inequalities research: a critique. Soc Sci Med 2001;53:801-816. https://doi.org/10.1016/S0277-9536(00)00383-X
  2. 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
  3. Singh A, Rouxel P, Watt RG, Tsakos G. Social inequalities in clustering of oral health related behaviors in a national sample of British adults. Prev Med 2013;57:102-106. https://doi.org/10.1016/j.ypmed.2013.04.018
  4. 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
  5. Tada A, Matsukubo T. Relationship between oral health behaviors and general health behaviors in a Japanese adult population. J Public Health Dent 2003;63:250-254. https://doi.org/10.1111/j.1752-7325.2003.tb03508.x
  6. Berkman LF, Kawachi I. Social epidemiology. 1st ed. New York: Oxford University Press;2000:28-29.
  7. Kim HY. Oral health status and behavior according to socio-economic status [dissertation]. Seoul:Seoul National University;2002. [Korean].
  8. Shin SJ, Ahn YS, Jung SH. The relation between dental health behaviors and socioeconomic status among Korean adolescents. J Korean Acad Oral Health 2008;32:223-230.
  9. Jung SW, Cho YT. Neighborhood characteristics and individual health under Korean context. J Prev Med Public Health 2005;38:259-266.
  10. Yen IH, Syme SL. The social environment and health : a discussion of the epidemiologic literature. Annu Rev Public Health 1999;20:287-308. https://doi.org/10.1146/annurev.publhealth.20.1.287
  11. Pattussi MP, Hardy R, Sheiham A. The potential impact of neighborhood empowerment on dental caries among adolescents. Community Dent Oral Epidemiol 2006;34:344-350. https://doi.org/10.1111/j.1600-0528.2006.00283.x
  12. Turrell G, Sanders AE, Slade GD, Spencer AJ, Marcenes W. The independent contribution of neighborhood disadvantage and individual-level socioeconomic position to self-reported oral health: a multilevel analysis. Community Dent Oral Epidemiol 2007;35:195-206. https://doi.org/10.1111/j.1600-0528.2006.00311.x
  13. Emmons KM. Health behaviors in a social context. In: Berkman LF, Kawachi I. Social epidemiology. 1st ed. New York:Oxford University Press Inc;2000:242-266.
  14. The Korean Society for Equity in Health. Methods in health inequalities measurement. 1st ed. Seoul:Hanul Publishing Group;2007:84-86.
  15. Pickett KE, Pearl M. Multilevel analyses of neighbourhood socieconomic contest and health outcomes: a critical review. J Epidemiol Community Health 2001;55:111-122. https://doi.org/10.1136/jech.55.2.111
  16. Bower E, Gulliford M, Steele J, Newton T. Area deprivation and oral health in Scottish adults: a multilevel study. Community Dent Oral Epidemiol 2007;35:118-129. https://doi.org/10.1111/j.1600-0528.2007.00308.x
  17. Lumme S, Leyland AH, Keskimaki I. Multilevel modeling of regional variation in equity in health care. Med Care 2008;46:976-983. https://doi.org/10.1097/MLR.0b013e3181791970
  18. Antunes JL, Peres MA, de Campos Mello TR, Waldman EA. Multilevel assessment of determinants of dental caries experience in Brazil. Community Dent Oral Epidemiol 2006;34:146-152. https://doi.org/10.1111/j.1600-0528.2006.00274.x
  19. Aida J, Ando Y, Oosaka M, Niimi K, Morita M. Contributions of social context to inequality in dental caries: a multilevel analysis of Japanese 3-year-old children. Community Dent Oral Epidemiol 2008;36:149-156. https://doi.org/10.1111/j.1600-0528.2007.00380.x
  20. Hox JJ. Multilevel analysis: techniques and applications. 2nd ed. Mahwah:Lawrence Erlbaum Associates;2002:1-36.
  21. Salmond C, Crampton P, Atkinson J. NZDep2006 index of deprivation user's manual. Wellington:Depratment of Public Health University of Otago;2007:1-16.
  22. Shin YJ, Yoon TH, Kim MH. Health promotion strategies and programs development for health inequalities alleviation. Seoul:Industry-University Cooperation Foundation Hanyang University.Korea Health Promotion Foundation;2009:228-233.
  23. Locker D. Deprivation and oral health: a review. Community Dent Oral Epidemiol 2000;28:161-169. https://doi.org/10.1034/j.1600-0528.2000.280301.x
  24. Von Korff M, Koepsell T, Curry S, Diehr P. Multi-level analysis in epidemiologic research on health behaviors and outcomes. Am J Epidemiol 1992;135:1077-1082. https://doi.org/10.1093/oxfordjournals.aje.a116207
  25. Kim SI, Lee HR, Ma DS, Park DY, Jung SH. The differences of oral health-related behaviors by type of school among high school students in Gangneung city. J Korean Acad Oral Health 2012;36:309-314. https://doi.org/10.11149/jkaoh.2012.36.4.309
  26. Macintyre S, Ellaway A. Ecological approaches: rediscovering the role of the physical and social environment. In: Berkman LF, Kawach I. Social Epidemiology. 1st ed. New York:Oxford University Press Inc;2000:345.

Cited by

  1. Detection of early changes in caries lesion using QLF-D and OCT vol.38, pp.1, 2013, https://doi.org/10.11149/jkaoh.2014.38.1.10
  2. 해외 어학연수생과 한국 대학생 간의 구강보건행태 평가 vol.14, pp.3, 2014, https://doi.org/10.13065/jksdh.2014.14.03.399
  3. 청소년들의 학교 보건교육 수혜 현황 및 건강위험행동과의 관련성 vol.29, pp.2, 2015, https://doi.org/10.5932/jkphn.2015.29.2.257
  4. A Systematic Review of Studies on Public Health Using Multilevel Analysis: Focused on Research Trends and The Assessment of Risk of Bias vol.35, pp.4, 2013, https://doi.org/10.15709/hswr.2015.35.4.157
  5. 지역사회 스케일링경험률에 영향을 미치는 요인: 지역사회건강조사 자료이용 vol.15, pp.6, 2015, https://doi.org/10.13065/jksdh.2015.15.06.1053
  6. 대전 시민의 인구사회학적 특성, 일반건강행위, 칫솔질행위의 관련성 vol.16, pp.2, 2013, https://doi.org/10.17135/jdhs.2016.16.2.165
  7. Contextual Effects of Neighborhood Poverty on Residents’ Neighborship : Roles of Neighborhood-Level Residential Instability and Disorder vol.47, pp.2, 2013, https://doi.org/10.16999/kasws.2016.47.2.5
  8. Effects of socioeconomic level on dental scaling experience in the community: a multilevel analysis vol.40, pp.2, 2016, https://doi.org/10.11149/jkaoh.2016.40.2.118
  9. A Study on the Poor Residing in the Deprived Areas : Double Poverty, Neighborship, and Mental Health vol.47, pp.4, 2016, https://doi.org/10.16999/kasws.2016.47.4.43
  10. 류마티스 관절염 진단자의 치석제거 경험과 관련요인 vol.16, pp.6, 2013, https://doi.org/10.13065/jksdh.2016.16.06.1105