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Measuring and decomposing oral health inequalities in an UK population
Author(s) -
Shen Jing,
Wildman John,
Steele Jimmy
Publication year - 2013
Publication title -
community dentistry and oral epidemiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.061
H-Index - 101
eISSN - 1600-0528
pISSN - 0301-5661
DOI - 10.1111/cdoe.12071
Subject(s) - medicine , oral health , inequality , demography , gini coefficient , population , dentistry , gerontology , environmental health , economic inequality , mathematics , mathematical analysis , sociology
Abstract Objectives With health inequalities high on the policy agenda, this study measures oral health inequalities in the UK . Methods We compare an objective clinical measure of oral health (number of natural teeth) with a self‐reported measure of the impact of oral health (the O ral H ealth I mpact P rofile, OHIP ) to establish whether the type of measure affects the scale of inequality measured. Gini coefficients and C oncentration I ndices ( CI s) are calculated with subsequent decompositions using data from the 1998 UK A dult D ental H ealth S urvey. Because the information on OHIP is only available on dentate individuals, analyses on the number of natural teeth are conducted for two samples – the entire sample and the sample with dentate individuals only, the latter to allow direct comparison with OHIP . Results We find considerable overall pure oral health inequalities (number of teeth: G ini = 0.68 (including edentate), G ini = 0.40 (excluding edentate); OHIP : G ini = 0.33) and income‐related inequalities for both measures (number of teeth: CI = 0.35 (including edentate), CI = 0.15 (excluding edentate); OHIP : CI = 0.03), and the CI is generally higher for the number of teeth than for OHIP . There are differences across age groups, with CI increasing with age for the number of teeth (excluding edentate: 16–30 years: CI = 0.01, 65 + years: CI = 0.11; including edentate: 16–30 years: CI = 0.01, 65 + years: CI = 0.19). However, inequalities for OHIP were highest in the youngest age group ( CI = 0.05). Number of teeth reflects the accumulation of damage over a lifetime, while OHIP records more immediate concerns. Conclusions There are considerable pure oral health inequalities and income‐related oral health inequalities in the UK . Using sophisticated methods to measure oral health inequality, we have been able to compare inequality in oral health with inequality in general health. The results provide a benchmark for future comparisons but also indicate that the type of health measure may be of considerable significance in how we think about and measure oral health inequalities.