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Decomposing early and adult life social position effects on oral health and chronic diseases in a cross‐sectional study of Southern Brazil
Author(s) -
Vendrame Édina,
Goulart Mariél de Aquino,
Hilgert Juliana B.,
Hugo Fernando N.,
Celeste Roger Keller
Publication year - 2018
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.12410
Subject(s) - structural equation modeling , medicine , oral health , tooth loss , cross sectional study , demography , quality of life (healthcare) , estimator , gerontology , environmental health , dentistry , statistics , pathology , mathematics , nursing , sociology
Objectives As the socio‐economic trajectory can influence on individual health during the life course, the aim of this study was to test a model of socio‐economic life course effects on chronic diseases, tooth loss and on oral health‐related quality of life using structural equation model ( SEM ) to decompose direct and indirect effects. Methods This cross‐sectional study was performed in southern Brazil, within public healthcare users with 18 years old or more (n = 433). Latent variables were the Oral Health Impact Profile ( OHIP ), Childhood Socio‐economic Status ( SESC ) and Adulthood ( SESA ), and Chronic Diseases ( CD ), and observed variables were sex, age, smoking status and tooth loss. The statistical analysis was performed using structural equation modelling ( SEM ) using WLSMV estimator. For the final model, we kept only plausible significant paths with P < 0.30. Results Final model presented an adequate fit: RMSA 0.03, Comparative Fit Index ( CFI ) 0.97, TLI 0.97, and Weighted Root Mean Square Residual ( WRMR ) 1.19. The direct effect from SESC to tooth loss was β = −0.08 ( P = 0.19) and the indirect was β = −0.12 ( P = 0.02). The indirect effect from SESC to OHIP was β = −0.14 ( P = 0.01) and there is no direct effect. The direct effect from SESA to tooth loss was β = −0.21 ( P < 0.01) and there is no indirect effect. The direct effect from SESA to OHIP was β = −0.14 ( P = 0.05). The association of SESA on SESC was β = 0.59 ( P < 0.01). Conclusions SESC had indirect effects on OHIP and number of teeth via SESA , supporting the chain of effects theory, but not for chronic diseases.