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

Authors

Farid Najafi 1, Satar Rezaei 1, Mohammad Hajizadeh 2, Moslem Soofi 3, Yahya Salimi 3, Ali Kazemi Karyani 1, Shahin Soltani 1, Sina Ahmadi 4, Enayatollah Homaie Rad 5, Behzad Karami Matin 1, Yahya Pasdar 1, Behrooz Hamzeh 1, Mehdi Moradi Nazar 1, Ali Mohammadi 6, Hossein Poustchi 7, Nazgol Motamed-Gorji 7, Alireza Moslem 8, Ali Asghar Khaleghi 9, Mohammad Reza Fatthi 10, Javad Aghazadeh-Attari 11, Ali Ahmadi 12, Farhad Pourfarzi 13, Mohammad Hossein Somi 14, Mehrnoush Sohrab 15, Alireza Ansari-Moghadam 16, Farhad Edjtehadi 10, Ali Esmaeili 17, Farahnaz Joukar 18, Mohammad Hasan Lotfi 19, Teamur Aghamolaei 20, Saied Eslami 21, Seyed Hamid Reza Tabatabaee 22, Nader Saki 23, Ali Akbar Haghdost 24

  • 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.

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.

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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.

Metrics

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

Tags: Ali Ahmadi, Ali Akbar Haghdost, Ali Asghar Khaleghi, Ali Esmaeili, Ali Kazemi Karyani, Ali Mohammadi, Alireza Ansari-Moghadam, Alireza Moslem, Behrooz Hamzeh, Behzad Karami Matin, Enayatollah Homaie Rad, Farahnaz Joukar, Farhad Edjtehadi, Farhad Pourfarzi, Farid Najafi, Hossein Poustchi, Javad Aghazadeh-Attari, Mehdi Moradi Nazar, Mehrnoush Sohrab, Mohammad Hajizadeh, Mohammad Hasan Lotfi, Mohammad Hossein Somi, Mohammad Reza Fatthi, Moslem Soofi, Nader Saki, Nazgol Motamed-Gorji, Saied Eslami, Satar Rezaei, Seyed Hamid Reza Tabatabaee, Shahin Soltani, Sina Ahmadi, Teamur Aghamolaei, Yahya Pasdar, Yahya Salimi