| 1. |
- Celeste, Roger Keller, et al.
(author)
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The relationship between levels of income inequality and dental caries and periodontal diseases
- 2011
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In: Cadernos de Saúde Pública. - 0102-311X .- 1678-4464. ; 27:6, s. 1111-1120
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Journal article (peer-reviewed)abstract
- The objective of this study was to evaluate the association between income inequality at a lagged time of 2 and 11 years with two short latency outcomes (untreated dental caries and gingivitis) and two long latency outcomes (edentulism and periodontal attachment loss > 8mm). We used data from the Brazilian oral health survey in 2002-2003. Our analysis included 13,405 subjects aged 35-44 years. Different lagged Gini at municipal level were fitted using logistic and negative binomial multilevel analyses. Covariates included municipal per capita income, equivalized income, age, sex, time since last dental visit and place of residence (rural versus urban). Crude estimates showed that only untreated dental caries was associated with current and lagged Gini, but in adjusted models only current Gini remained significant with a ratio of 1.19 (95%CI: 1.09-1.30) for every ten-point increase in the Gini coefficient We conclude that lagged Gini showed no association with oral health; and current income Gini was associated with current dental caries hut not with periodontal disease.
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| 2. |
- Celeste, Roger Keller, et al.
(author)
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Trends in socioeconomic disparities in the utilization of dental care in Brazil and Sweden
- 2011
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In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 39:6, s. 640-648
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Journal article (peer-reviewed)abstract
- Aims: To describe trends in socioeconomic disparities in utilization of dental care. Methods: We obtained cross-sectional data from Sweden in the period 1968-2000 and from Brazil in 1986 and 2002 for 16 state capitals. The outcome was the percentage of people who reported that they had visited the dentist in the last 12 months, calculated for a higher and a lower income group and stratified by sex, age (two groups: young and adults) and dental status. Adjusted prevalence differences and prevalence ratios were produced using Poisson regression. Results: In Brazil, there was a decline in use of dental care among the 15-19 year olds in the period 1986-2002, but not among the 35-44 year olds. In Sweden, there was a decline among the young and adults between 1991 and 2000. Overall, socioeconomic disparities in use of dental services between the higher and the lower economic groups showed a decline in both countries. The reduction in disparities among young Brazilians was 1.1 percentage points per year (p < 0.01), but among the other age groups the decline was not significant (p>0.01). In the last surveys, the gap remained in both countries and age groups (p < 0.01). Conclusions: The recent decline in utilization of dental care and in the socioeconomic gap may mirror improvements in oral health. However, there are still relevant and persistent disparities in utilization of dental care in both countries, with a higher proportion of people of higher socioeconomic status visiting the dentist.
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| 3. |
- Darin-Mattsson, Alexander, et al.
(author)
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Linking financial hardship throughout the life-course with psychological distress in old age : Sensitive period, accumulation of risks, and chain of risks hypotheses.
- 2018
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In: Social Science and Medicine. - : Elsevier. - 0277-9536 .- 1873-5347. ; 201, s. 111-119
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Journal article (peer-reviewed)abstract
- The primary objective was to investigate the life course hypotheses - sensitive period, chain of risks, and accumulation of risks - in relation to financial hardship and psychological distress in old age. We used two Swedish longitudinal surveys based on nationally representative samples. The first survey includes people 18-75 years old with multiple waves, the second survey is a longitudinal continuation, including people 76 + years old. The analytical sample included 2990 people at baseline. Financial hardship was assessed in childhood (retrospectively), at the mean ages of 54, 61, 70, and 81 years. Psychological distress (self-reported anxiety and depressive symptoms) was assessed at the same ages. Path analysis with WLSMV estimation was used. There was a direct path from financial hardship in childhood to psychological distress at age 70 (0.26, p = 0.002). Financial hardship in childhood was associated with increased risk of psychological distress and financial hardship both at baseline (age 54), and later. Financial hardship, beyond childhood, was not independently associated with psychological distress at age 81. Higher levels of education and employment decreased the negative effects of financial hardship in childhood on the risk of psychological distress and financial hardship later on. There was a bi-directional relationship between psychological distress and financial hardship; support for health selection was slightly higher than for social causation. We found that psychological distress in old age was affected by financial hardship in childhood through a chain of risks that included psychological distress earlier in life. In addition, financial hardship in childhood seemed to directly affect psychological distress in old age, independent of other measured circumstances (i.e., chains of risks). Education and employment could decrease the effect of an adverse financial situation in childhood on later-life psychological distress. We did not find support for accumulation of risks when including tests of all hypotheses in the same model.
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| 4. |
- Keller Celeste, Roger, et al.
(author)
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Do socioeconomic inequalities in pain, psychological distress and oral health increase or decrease over the life course? Evidence from Sweden over 43 years of follow-up
- 2018
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In: Journal of Epidemiology and Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 72:2, s. 160-167
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Journal article (peer-reviewed)abstract
- Background Inequalities over the life course may increase due to accumulation of disadvantage or may decrease because ageing can work as a leveller. We report how absolute and relative socioeconomic inequalities in musculoskeletal pain, oral health and psychological distress evolve with ageing. Methods Data were combined from two nationally representative Swedish panel studies: the Swedish Level-of-Living Survey and the Swedish Panel Study of Living Conditions of the Oldest Old. Individuals were followed up to 43 years in six waves (1968, 1974, 1981, 1991/1992, 2000/2002, 2010/2011) from five cohorts: 1906-1915 (n=899), 1925-1934 (n=906), 1944-1953 (n=1154), 1957-1966 (n=923) and 1970-1981 (n=1199). The participants were 15-62 years at baseline. Three self-reported outcomes were measured as dichotomous variables: teeth not in good conditions, psychological distress and musculoskeletal pain. The fixed-income groups were: (A) never poor and (B) poor at least once in life. The relationship between ageing and the outcomes was smoothed with locally weighted ordinary least squares, and the relative and absolute gaps were calculated with Poisson regression using generalised estimating equations. Results All outcomes were associated with ageing, birth cohort, sex and being poor at least once in live. Absolute inequalities increased up to the age of 45-64 years, and then they decreased. Relative inequalities were large already in individuals aged 15-25years, showing a declining trend over the life course. Selective mortality did not change the results. The socioeconomic gap was larger for current poverty than for being poor at least once in life. Conclusion Inequalities persist into very old age, though they are more salient in midlife for all three outcomes observed.
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| 5. |
- Lennartsson, Carin, et al.
(author)
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Social class and infirmity. The role of social class over the life-course
- 2018
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In: SSM - Population Health. - : Elsevier BV. - 2352-8273. ; 4, s. 169-177
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Journal article (peer-reviewed)abstract
- In an aging society, it is important to promote the compression of poor health. To do so, we need to know more about how life-course trajectories influence late-life health and health inequalities. In this study, we used a life-course perspective to examine how health and health inequalities in late-midlife and in late-life are influenced by socioeconomic position at different stages of the life course. We used a representative sample of the Swedish population born between 1925 and 1934 derived from the Swedish Level of Living Survey (LNU) and the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) to investigate the impact of socioeconomic position during childhood (social class of origin) and of socioeconomic position in young adulthood (social class of entry) and late-midlife (social class of destination) on infirmity in late-midlife (age 60) and late-life (age 80). The results of structural equation modelling showed that poor social class of origin had no direct effect on late-midlife and late-life infirmity, but the overall indirect effect through chains of risks was significant. Thus, late-midlife and late-life health inequalities are the result of complex pathways through different social and material conditions that are unevenly distributed over the life course. Our findings suggest that policies that break the chain of disadvantage may help reduce health inequalities in late-midlife and in late-life.
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