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Social Inequalities in Use of Preventive Dental and Medical Services among Adults in European Countries
[journal article]
Abstract 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... view more
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.... view less
Keywords
socioeconomic factors; health; determinants; inequality; social inequality; prevention; health care delivery system; Europe; adult; tooth disease; dentistry; health care; preventive medical examination
Classification
Medicine, Social Medicine
Health Policy
Free Keywords
social determinants of health; healthcare disparities; preventive health services; ZA4977: Eurobarometer 72.3: Public Health Attitudes, Behavior, and Prevention (Oct 2009)
Document language
English
Publication Year
2019
Page/Pages
p. 1-9
Journal
International Journal of Environmental Research and Public Health, 16 (2019) 23
Issue topic
Oral Health Inequalities in the World
DOI
https://doi.org/10.3390/ijerph16234642
ISSN
1660-4601
Status
Published Version; peer reviewed