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Social Inequalities in Use of Preventive Dental and Medical Services among Adults in European Countries

This study examined inequalities in dental check-ups and medical screenings using subjective and objective socioeconomic indicators. Data from 23,464 adults, aged 20 years old and over, who participated in a multi-national survey across Europe (Eurobarometer 72.3) were analysed. Participants’ socioe...

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Detalles Bibliográficos
Autores principales: Kino, Shiho, Bernabé, Eduardo, Sabbah, Wael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6926506/
https://www.ncbi.nlm.nih.gov/pubmed/31766584
http://dx.doi.org/10.3390/ijerph16234642
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author Kino, Shiho
Bernabé, Eduardo
Sabbah, Wael
author_facet Kino, Shiho
Bernabé, Eduardo
Sabbah, Wael
author_sort Kino, Shiho
collection PubMed
description This study examined inequalities in dental check-ups and medical screenings using subjective and objective socioeconomic indicators. Data from 23,464 adults, aged 20 years old and over, who participated in a multi-national survey across Europe (Eurobarometer 72.3) were analysed. Participants’ socioeconomic position (SEP) was measured by education, difficulty in paying bills and subjective social status. Use of preventive services was measured by attendance for dental check-ups, cancer and cardiovascular screenings in the past 12 months. Socioeconomic inequalities were assessed in two-level logistic regression (adults nested within countries), adjusting for demographic factors and type of healthcare system. There were apparent social inequalities in using all three preventive services. However, only dental check-ups showed consistent and significant inequalities across all socioeconomic indicators with those in the bottom groups in education (odds ratio: 0.51; 95% confidence interval: 0.46–0.55), difficulty in paying bills (OR: 0.64; 95% CI: 0.59–0.72) and subjective social status (OR: 0.63; 95% CI: 0.57–0.69) having lower odds of reporting dental check-ups in the past 12 months than those in the top groups. Cancer screening was not associated with difficulty in paying bills whereas cardiovascular disease screening was not associated with education and subjective social status. Despite the availability of universal health coverage, there were clear social gradients in using preventive services particularly across education and subjective social status groups. The stronger and more consistent gradients observed in dental check-ups compared to cancer and cardiovascular screening could be attributed to difference in the level of coverage of dental and medical services in Europe.
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spelling pubmed-69265062019-12-24 Social Inequalities in Use of Preventive Dental and Medical Services among Adults in European Countries Kino, Shiho Bernabé, Eduardo Sabbah, Wael Int J Environ Res Public Health Article This study examined inequalities in dental check-ups and medical screenings using subjective and objective socioeconomic indicators. Data from 23,464 adults, aged 20 years old and over, who participated in a multi-national survey across Europe (Eurobarometer 72.3) were analysed. Participants’ socioeconomic position (SEP) was measured by education, difficulty in paying bills and subjective social status. Use of preventive services was measured by attendance for dental check-ups, cancer and cardiovascular screenings in the past 12 months. Socioeconomic inequalities were assessed in two-level logistic regression (adults nested within countries), adjusting for demographic factors and type of healthcare system. There were apparent social inequalities in using all three preventive services. However, only dental check-ups showed consistent and significant inequalities across all socioeconomic indicators with those in the bottom groups in education (odds ratio: 0.51; 95% confidence interval: 0.46–0.55), difficulty in paying bills (OR: 0.64; 95% CI: 0.59–0.72) and subjective social status (OR: 0.63; 95% CI: 0.57–0.69) having lower odds of reporting dental check-ups in the past 12 months than those in the top groups. Cancer screening was not associated with difficulty in paying bills whereas cardiovascular disease screening was not associated with education and subjective social status. Despite the availability of universal health coverage, there were clear social gradients in using preventive services particularly across education and subjective social status groups. The stronger and more consistent gradients observed in dental check-ups compared to cancer and cardiovascular screening could be attributed to difference in the level of coverage of dental and medical services in Europe. MDPI 2019-11-22 2019-12 /pmc/articles/PMC6926506/ /pubmed/31766584 http://dx.doi.org/10.3390/ijerph16234642 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kino, Shiho
Bernabé, Eduardo
Sabbah, Wael
Social Inequalities in Use of Preventive Dental and Medical Services among Adults in European Countries
title Social Inequalities in Use of Preventive Dental and Medical Services among Adults in European Countries
title_full Social Inequalities in Use of Preventive Dental and Medical Services among Adults in European Countries
title_fullStr Social Inequalities in Use of Preventive Dental and Medical Services among Adults in European Countries
title_full_unstemmed Social Inequalities in Use of Preventive Dental and Medical Services among Adults in European Countries
title_short Social Inequalities in Use of Preventive Dental and Medical Services among Adults in European Countries
title_sort social inequalities in use of preventive dental and medical services among adults in european countries
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6926506/
https://www.ncbi.nlm.nih.gov/pubmed/31766584
http://dx.doi.org/10.3390/ijerph16234642
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