The Effect of Socioeconomic Status, Oral Health Consciousness and Behaviors on the Periodontal-health Disparities among Korean Adults

한국 성인의 치주건강 불평등에 미치는 사회경제적 요인과 구강건강의식 및 행태의 효과

  • 박희정 (서울대학교 치과대학 치학연구소) ;
  • 이준협 (고려대학교 보건과학대학 보건행정학과)
  • Received : 2010.03.04
  • Accepted : 2010.03.13
  • Published : 2010.03.31

Abstract

Objectives: The aim of this study was to examine socioeconomic inequalities in oral health and to investigate the extent to which socioeconomic disparities in oral health are attenuated by oral health related consciousness and behaviors. Methods: We used data from the third 2006 Korea National Oral Health Survey(KNOHS) and a total of 3,457 subjects aged over 18 years were analyzed. The dependent variable was periodontal conditions which is devided into dichotomy, that is, health and ill-health, using the Community Periodontal Index(CPI) in KNOHS. Socioeconomic status(SES) were measured by educational attainment, income and residential area. Age, gender, oral health consciousness(self-assessed oral health status, concern about oral health and self-perceived dental treatment needs and behaviors(brushing, use of dental floss and dental visits) were adjusted in binary logistic regression analysis. Results and Conclusion: The results show that oral health consciousness and behaviors do not mediate the relationship between SES and periodontal health and there might be limitations to attenuate socioeconomic disparities in oral health only by changing of either oral health consciousness or(and) behaviors. Our findings suggest that more definite oral health policies and dental health education among adults with lower education will need in order to improve oral health.

Keywords

References

  1. 김명희. 한국사회의 건강형평성 실태. 한국건강형평성학회 창립세미나 서울: 한국, 2003.
  2. 김영준. 전남대학교 교직원들의 치주상태 및 자각증상에 대한 조사. 대한구강보건학회지 1995;19(1):123-140.
  3. 김혜영. 사회경제적 수준과 구강진료필요도의 연관성에 대한 건강행위, 구강진료이용도의 영향 평가. 대한구강보건학회지 2006;30(1):85-94.
  4. 보건복지가족부. 2003․2004년 국민의료비 추계 및 국민보건계정구축. 서울: 보건복지가족부, 2006b.
  5. 보건복지가족부. 2006년 국민구강건강실태조사. 서울: 보건복지가족부, 2006a.
  6. 송근배, 최연희, 홍석진, 김진범. 한국 성인들의 사회경제적 요인 및 구강보건의식행태에 따른 치아우식증 실태분석. 대한구강보건학회지 2003;27(2):319-328.
  7. 이미숙. 한국 성인의 건강불평등. 한국 사회학회 2005;39(6):183-209.
  8. 이원영. 성인 구강건강수준의 사회경제적 불평등에서 일부 구강건강관련 행태 요인의 역할. 한국보건교육건강증진학회지 2009;26(1):129-140.
  9. 정세환. 국민건강영양조사 제 3기(2005) 심층분석: 건강면접 및 보건의식 부문. 서울: 질병관리본부, 한국보건사회연구원, 2007;157-179.
  10. 조남억. 한국성인의 사회경제적 요인 및 구강보건의식행태에 따른 FUCTIONING TEETH Index와 T-HEALTH Index의 분석 연구[석사학위논문], 서울: 연세대학교 대학원, 2005.
  11. 한경순,김윤신,강제경,황윤숙,한동헌,배광학. 수도권지역 성인에서 흡연과 치주상태의 관련성. 대한구강보건학회지 2008; 32(2):250-260.
  12. 한국건강형평성학회. 건강 형평성 측정 방법론. 파주: 한울 아카데미, 2008;19-260.
  13. Daly B, Watt RG, Batchelor P, Treasure ET. Essential Dental Public Health. UK: Oxford, 2005:21-32.
  14. Davidson PN, Whitehead M. Inequalities in health: the Black Report and the Health Divide. 2nd ed. London: Penguim Books, 1992.
  15. Gilbert GH, Duncan RP, Heft MW, Dolan TA, Vogel WB. Oral disadvantage among dentate adults. Community Dent Oral Epidemiol 1997;25:301-313. https://doi.org/10.1111/j.1600-0528.1997.tb00944.x
  16. Heft MW., Gregg H. Gilbert, Brent J. Shelton and R. Paul Duncan. Relationship of dental status, sociodemographic status, and oral symptoms to perceived need for dental care. Community Dent Oral Epidemiol 2003;31:351-60. https://doi.org/10.1034/j.1600-0528.2003.00014.x
  17. Locker D, Gibson B. The concept of positive health: a review and commentary on its application in oral health research. Community Dent Oral Epidemiol 2006;34(3):161-173. https://doi.org/10.1111/j.1600-0528.2006.00263.x
  18. Locker D, Miller Y. Evaluation of subjective oral health status indicators. J. Public Health Dent 1994;54:167-176. https://doi.org/10.1111/j.1752-7325.1994.tb01209.x
  19. 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
  20. Lopez R, Fernandez O, Baelum V. Social gradients in periodontal diseases among adolescents. Communuty Dent Oral Epidemiol 2006;34:184-196. https://doi.org/10.1111/j.1600-0528.2006.00271.x
  21. Newton JT, Bower EJ. The social determinants of oral health: new approaches to conceptualizing and researching complex casual networks. Community Dent Oral Epidemiol 2005;33:25-34. https://doi.org/10.1111/j.1600-0528.2004.00190.x
  22. Petersen PE. The World Oral Health Report 2003: continuous improvement of oral health in the 21st centry-the approach of the WHO Global Oral Health Programme. Community Dent Oral Epidemiol 2003;31(1):3-23. https://doi.org/10.1046/j..2003.com122.x
  23. Primary Dental Care Services in England and Wales. Audit Commission 2002. National Health Report. Northampton: Belmont Press, 2002.
  24. Reisine ST, Poster W. Socioeconomic status and selected behavioral determinants as risk factors for dental caries. J Dent Edu 2001;65(10):1009-1016.
  25. Sabbah, Georgios T, Sheiham A, Watt RG. The role of health-related behaviors in the socioeconomic disparties in oral health. Soc Sci Med 2009;68:298-303. https://doi.org/10.1016/j.socscimed.2008.10.030
  26. Sanders AE, Slade GD, Turrell G, John Spencer A, Marcenes W. The shape of the socioeconomic-oral health gradient: implications for theoretical explanations. Community Dent Oral Epidemiol 2006a;34:310-319. https://doi.org/10.1111/j.1600-0528.2006.00286.x
  27. Sanders AE, Spencer AJ, Slade GD. Evaluating the role of dental behaviour in oral health inequalities. Community Dent Oral Epidemiol 2006b;34:71-79. https://doi.org/10.1111/j.1600-0528.2006.00261.x
  28. Sheiham A, Nicolau B. Evaluation of social and psychological factors in periodontal disease. Periodontology 2000, 2005;39:118-131. https://doi.org/10.1111/j.1600-0757.2005.00115.x
  29. 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
  30. Sisson KL. Theoretical explanations for social inequalities in oral health. Community Dent Oral Epidemiol 2007;35:81-88. https://doi.org/10.1111/j.1600-0528.2007.00354.x
  31. Wamala S, Merlo J, Boström G. Inequity in access to dental care services explains current socioeconomic disparties in oral health: The Swedish National Surveys of Public Health 2004-2005. J Epidemiol Community Health 2006;60:1027-1033. https://doi.org/10.1136/jech.2006.046896
  32. Watt RG, Sheiham A. Inequalities in oral health: a review of the evidence and recommendations for action. Br Dent J 1999;187:6-12.
  33. Zhu L, Petersen PD, Wang HY, Bian JY, Zhang BX . Oral health knowledge, attitudes and behaviour of adults in China. Int Dent J 2005;55:231-241. https://doi.org/10.1111/j.1875-595X.2005.tb00321.x