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Social Inequalities in Use of Preventive Dental and Medical Services among Adults in European Countries

Author

Listed:
  • Shiho Kino

    (Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, University of Boston, Boston, MA 02115, USA)

  • Eduardo Bernabé

    (Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London SE5 9RS, UK)

  • Wael Sabbah

    (Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London SE5 9RS, UK)

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’ 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.

Suggested Citation

  • Shiho Kino & Eduardo Bernabé & Wael Sabbah, 2019. "Social Inequalities in Use of Preventive Dental and Medical Services among Adults in European Countries," IJERPH, MDPI, vol. 16(23), pages 1-9, November.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:23:p:4642-:d:289694
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    References listed on IDEAS

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    1. Patrick Bodenmann & Bernard Favrat & Hans Wolff & Idris Guessous & Francesco Panese & Lilli Herzig & Thomas Bischoff & Alejandra Casillas & Thomas Golano & Paul Vaucher, 2014. "Screening Primary-Care Patients Forgoing Health Care for Economic Reasons," PLOS ONE, Public Library of Science, vol. 9(4), pages 1-9, April.
    2. Joanna M Davies & Katherine E Sleeman & Javiera Leniz & Rebecca Wilson & Irene J Higginson & Julia Verne & Matthew Maddocks & Fliss E M Murtagh, 2019. "Socioeconomic position and use of healthcare in the last year of life: A systematic review and meta-analysis," PLOS Medicine, Public Library of Science, vol. 16(4), pages 1-23, April.
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    Cited by:

    1. Yuko Inoue & Yoshihiro Shimazaki & Akiko Oshiro & Takashi Zaitsu & Michiko Furuta & Yuichi Ando & Hideo Miyazaki & Masaki Kambara & Kakuhiro Fukai & Jun Aida, 2021. "Multilevel Analysis of the Association of Dental-Hygienist-Related Factors on Regular Dental Check-Up Behavior," IJERPH, MDPI, vol. 18(6), pages 1-10, March.

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