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

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

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: Socioeconomic status, Dental caries, Concentration index, Decomposition, Iran

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.