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Inequalities in oral health among adolescents in Gangneung, South Korea.

ABSTRACT: BACKGROUND:This study aims to evaluate inequality in oral health among adolescents and to explain the mechanisms of such inequalities in Gangneung, South Korea. METHODS:One thousand two hundred sixty-seven students in their first year from four vocational and three general schools participated in the baseline survey of 2011, and 84.7% of them were surveyed again in 2013. Oral examinations by the same dentist and a self-administered questionnaire were repeated during both waves. Outcome measure for oral health was the existence of untreated dental caries (DT). As socioeconomic position (SEP) indicators, school type (general vs. vocational), father's and mother's education, perceived economic status, and Family Affluence Scale (FAS) were measured. Variables measuring oral health related behaviours included tooth brushing frequency, frequency of eating snacks and drinking sodas, smoking, and annual visits to dental clinics. Chi-square tests and panel logistic regression were adopted to examine the associations between dental caries and SEP indicators by STATA version 15.1. RESULTS:Having a less educated father and attending a vocational school were significant predictors for untreated caries after controlling for SEP indicators. However, students from general schools, higher SEP by father's education, perceived economic status, or FAS, or having non-smoking experience or annual visits to dental clinics were more likely to stay caries-free. CONCLUSIONS:There were socioeconomic inequalities in oral health on an adolescent panel. Given that oral health status during adolescents can persist throughout the course of a person's life, intervention to tackle such inequalities and school environments are required.

SUBMITTER: Jung SH

PROVIDER: S-EPMC5921975 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundSouth Africa is one of the most 'unequal' societies in the world. Despite apartheid ending more than 20 years ago, material inequalities remain interwoven with ethnic/racial inequalities. There is limited research on the prevalence/predictors of common mental disorders (CMD) among young people. Adolescence is a unique time-point during which intervention may lead to improved mental health and reduced social problems later. The study objective was to assess mental health disparities in a representative sample of adolescents growing up in South Africa.MethodsCross-sectional associations of race/ethnicity and material disadvantage with CMD and Post Traumatic Stress Disorder (PTSD) were assessed in a stratified random sample representative of school-attendees, aged 14-15 years, in a large metropolitan area of Cape Town. Validated instruments assessed mental disorders; these included: Harvard Trauma Questionnaire (PTSD); Short Moods and Feelings Questionnaire (depression); Zung self-rated anxiety scale (anxiety). Self-ascribed ethnicity was determined using procedures similar to the South African census and previous national surveys.ResultsResponse rate was 88% (1034 of 1169 individuals). Adolescents experienced a high prevalence of depression (41%), anxiety (16%) and PTSD (21%). A gradient between material disadvantage and CMD/ PTSD was evident across all ethnic/racial groups. Respondents self-identifying as 'black' or 'coloured' were disadvantaged across most indicators. After adjusting for confounders, relative to white children, relative risk (RR) of CMD in black children was 2.27 (95% CI:1.24, 4.15) and for PTSD was RR: 2.21 (95% CI:1.73, 2.83). Relative risk of CMD was elevated in children self-identifying as 'coloured' (RR: 1.73, 95% CI:1.11, 2.70). Putative mediators (violence, racially motivated bullying, social support, self-esteem) partially accounted for differences in CMD and fully for PTSD.ConclusionsAdolescent mental health inequalities in Cape Town are associated with material disadvantage and self-identification with historically disadvantaged groups.

Project description:OBJECTIVES:Although adolescence is a sensitive developmental period in oral health, the social equalization hypothesis that suggests health inequalities attenuate in adolescence has not been examined. This study analyses whether the socioeconomic gap and ethnic disadvantage in oral health among children aged 5 reduces among adolescents aged 15. METHODS:Data from the cross-sectional Children's Dental Health Survey 2013 were analysed, comprising of 8541 children aged 5, 8, 12 and 15 attending schools in England, Wales and Northern Ireland. Oral health indicators included decayed and filled teeth, plaque, gingivitis and periodontal health. Ethnicity was measured using the 2011 UK census ethnic categories. Socioeconomic position was measured by family, school and residential deprivation. Negative binomial and probit regression models estimated the levels of oral health by ethnicity and socioeconomic position, adjusted for demographic and tooth characteristics. RESULTS:The predicted rate of decayed teeth for White British/Irish children aged 5 was 1.54 (95%CI 1.30-1.77). In contrast, the predicted rate for Indian and Pakistani children was about 2-2.5 times higher. At age 15, ethnic differences had reduced considerably. Family deprivation was associated with higher levels of tooth decay among younger children but not among adolescents aged 15. The influence of residential deprivation on the rate of tooth decay and filled teeth was similar among younger and older children. Moreover, inequalities in poor periodontal health by residential deprivation was significantly greater among 15-year-old children compared to younger children. CONCLUSIONS:This study found some evidence of smaller ethnic and family socioeconomic differences in oral health among British adolescents compared to younger children. However, substantial differences in oral health by residential deprivation remain among adolescents. Community levels of deprivation may be particularly important for the health of adolescents.

Project description:PurposeThe aims of this study were to (a) describe gender inequalities in physical activity (PA) among adolescents from Global South countries, and (b) investigate the relationship between gender inequalities in PA and contextual factors, such as geographic region, human development index, gender inequality index, and unemployment rates.MethodsWe analyzed cross-sectional data from the Global School-Based Student Health Survey conducted in Global South countries between 2010 and 2020 among 13- to 17-year-old adolescents. Country-context variables were retrieved from secondary data sources (World Health Organization, World Bank, and Human Development Reports). PA was assessed by a self-administered questionnaire querying the number of days in the past week in which participants were physically active for a total of at least 60 min. PA absolute gender inequalities were evaluated by the differences in the prevalence between boys and girls, 95% confidence intervals (95%CIs) were estimated using the bootstrap method. Relative inequalities were obtained through Poisson regression. Meta-analyses with random effects were used to calculate pooled estimates of absolute and relative inequalities.ResultsBased on 64 Global South countries/surveys, the prevalence of PA was 6.7 percentage points (p.p.) higher in boys than in girls, ranging from 0.5 p.p. in Afghanistan to 15.6 p.p. in Laos (I2= 85.1%). The pooled ratio for all countries showed that boys presented a PA prevalence 1.58 times higher than girls (95%CI: 1.47-1.70) on average. The highest absolute and relative inequalities were observed in high income countries. Countries with higher Human Development Index rankings and lower Gender Inequality Index rankings also presented greater gender differences.ConclusionGiven that girls are overall less active than boys across the globe, the findings of this study reinforce that macro- and micro-level changes should be actively sought if we aim to increase population levels of PA in adolescents and promote equity in PA.

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Inequalities in oral health among adolescents in Gangneung, South Korea.

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