Decomposing socioeconomic inequality in dental caries in Iran: cross-sectional results from the PERSIAN cohort study

  1. Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
  2. School of Health Administration, Faculty of Health, Dalhousie University, Halifax, Canada.
  3. 3ocial Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
  4. Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
  5. Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran.
  6. Department of Health Information Technology, Paramedical School, Kermanshah University of Medical Sciences, Kermanshah, Iran.
  7. Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
  8. Department of Anesthesiology, Sabzevar University of Medical Sciences, Sabzevar, Iran.
  9. Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran.
  10. Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
  11. Social determinants of Health Research Center, Urmia Jundishapur University of Medical Sciences, Urmia, Iran.
  12. Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.
  13. Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
  14. Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
  15. Diabetes Research cente, Mazandaran University of Medical Sciences, Sari, Iran.
  16. Health Promotion Research Center, Zahedan Jundishapur University of Medical Sciences, Zahedan, Iran.
  17. Department of Cardiology, Medical school, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
  18. Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.
  19. Shahid Sadoghi University of Medical Sciences, Yazd, Iran.
  20. Department of Public Health, School of Public Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
  21. Pharmaceutical Research Center, Pharmaceutical Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
  22. Research Center for Health Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
  23. Hearing Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
  24. Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
bmj open

Abstract

Background: The current study aimed to measure and decompose socioeconomic-related inequalities in DMFT (decayed, missing, and filled teeth) index among adults in Iran.

Methods: The study data were extracted from the adult component of Prospective Epidemiological Research Studies in IrAN (PERSIAN) from 17 centers in 14 different provinces of Iran. DMFT score was used as a measure of dental caries among adults in Iran. The concentration curve and relative concentration index (RC) was used to quantify and decompose socioeconomic-related inequalities in DMFT.

Results: A total of 128,813 adults aged 35 and older were included in the study. The mean (Standard Deviation [SD]) score of D, M, F and DMFT of the adults was 3.3 (4.6), 12.6 (10.5), 2.1 (3.4) and 18.0 (9.5), respectively. The findings suggested that DMFT was mainly concentrated among the socioeconomically disadvantaged adults (RC = – 0.064; 95% confidence interval [CI), – 0.066 to – 0.063). Socioeconomic status, being male, older age and being a widow or divorced were identified as the main factors contributing to the concentration of DMFT among the worse-off adults.

Conclusions: It is recommended to focus on the dental caries status of socioeconomically disadvantaged groups in order to reduce socioeconomic-related inequality in oral health among Iranian adults. Reducing socioeconomic-related inequalities in dental caries should be accompanied by appropriate health promotion policies that focus actions on the fundamental socioeconomic causes of dental disease.

Keywords: Concentration index; Decomposition; Dental caries; Iran; Socioeconomic status.

How to Cite

Najafi F, Rezaei S, Hajizadeh M, Soofi M, Salimi Y, Kazemi Karyani A, Soltani S, Ahmadi S, Homaie Rad E, Karami Matin B, Pasdar Y, Hamzeh B, Nazar MM, Mohammadi A, Poustchi H, Motamed-Gorji N, Moslem A, Khaleghi AA, Fatthi MR, Aghazadeh-Attari J, Ahmadi A, Pourfarzi F, Somi MH, Sohrab M, Ansari-Moghadam A, Edjtehadi F, Esmaeili A, Joukar F, Lotfi MH, Aghamolaei T, Eslami S, Tabatabaee SHR, Saki N, Haghdost AA. Decomposing socioeconomic inequality in dental caries in Iran: cross-sectional results from the PERSIAN cohort study. Arch Public Health. 2020 Aug 18;78:75. doi: 10.1186/s13690-020-00457-4. PMID: 32832079; PMCID: PMC7436972.