Inequalities by sex on remaining teeth in adults: A decomposition analysis

Author:

Borgeat Marjorie12ORCID,Espinoza Iris234ORCID,Navarro Karina5ORCID,Carvajal Claudia6ORCID,Carvajal Paola47ORCID

Affiliation:

1. Interdisciplinary Center for Health Studies, Faculty of Dentistry University of Valparaíso Valparaíso Chile

2. Interuniversity Center for Healthy Aging Chile

3. Department of Oral Pathology and Medicine, Faculty of Dentistry University of Chile Santiago Chile

4. Center for Epidemiology and Surveillance of Oral Diseases (CESOD) Santiago Chile

5. Department of Sociology, Faculty of Social Sciences University of Chile Santiago Chile

6. Department of Oral Health, Division of Prevention and Control of Diseases, Ministry of Health Santiago Chile

7. Department of Conservative Dentistry, Faculty of Dentistry University of Chile Santiago Chile

Abstract

AbstractObjectiveTo identify which social determinants of health explain the gap in the remaining teeth between men and women.MethodsA secondary analysis of data from the Chilean National Health Survey (CNHS) 2016–2017 was performed on the number of remaining teeth in adults. The explanatory variables were organized into structural and intermediate social determinants of health according to the WHO framework. The contribution of both groups and the contribution of each individual explanatory variable to the remaining teeth gap was estimated using the Blinder‐Oaxaca decomposition analysis.ResultsThe predicted average number of remaining teeth for men was 23.4 and 21.0 for women, thus a mean difference of 2.4 teeth. 49.8% of the inequality between men and women was due to the different distribution (endowments) of the predictors in the model. Among them, structural determinants of health, namely education level (15.8%) and employment status (17.8%), contributed the most. Intermediate determinants had no relevant contribution to explain the gap.ConclusionsResults revealed that the difference in the mean number of remaining teeth between men and women was mainly explained by two structural determinants: education level and employment status. The lack of explanatory power of intermediate determinants and the large explanatory power of structural determinants means that tackling oral health inequity in Chile requires strong political commitment. The role of intersectoral and intersectional public policies to address gender inequalities in oral health in Chile is discussed.

Publisher

Wiley

Subject

Public Health, Environmental and Occupational Health,General Dentistry

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