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Individual- and City-Level Socioeconomic Factors and Tooth Loss among Elderly People: A Cross-Level Multilevel Analysis

Author

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  • Mario Vianna Vettore

    (School of Dentistry, Federal University of Minas Gerais, Belo Horizonte 31270-901, Brazil
    Academic Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield S10 2TA, UK)

  • Janete M. Rebelo Vieira

    (School of Dentistry, Federal University of Amazonas, Manaus 69000-000, Brazil)

  • José F. F. Gomes

    (School of Dentistry, Federal University of Amazonas, Manaus 69000-000, Brazil)

  • Nara M. O. Martins

    (School of Dentistry, Federal University of Amazonas, Manaus 69000-000, Brazil)

  • Yan N. L. Freitas

    (School of Dentistry, Federal University of Amazonas, Manaus 69000-000, Brazil)

  • Gabriela de A. Lamarca

    (School of Dentistry, Federal University of Minas Gerais, Belo Horizonte 31270-901, Brazil)

  • Maria A. B. Rebelo

    (School of Dentistry, Federal University of Amazonas, Manaus 69000-000, Brazil)

Abstract

This study aimed to test the association of contextual and individual socioeconomic status with tooth loss among Brazilian elderly people aged 65–74 years. Data from 5435 elderly participants from the Brazilian National Oral Health Survey (2010) were linked to city-level data for 27 state capitals and the Federal District. Tooth loss was clinically assessed according to the number of missing natural teeth. Contextual social variables included Human Development Index income (HDI-income) and HDI-education. Individual socioeconomic measures were monthly family income and years of schooling. Covariates included sex, skin colour, number of residents per room and number of goods. Multilevel Negative Binomial regression models were used to estimate rate ratios (RR) and 95% confidence intervals between contextual and individual variables and tooth loss. Contextual and individual income and education measures were consistently associated with tooth loss. Elderly people living in cities with low HDI-income and low HDI-education were respectively 21% and 33% more likely to present tooth loss. Cross-level interaction suggested that the relationship of lower income and lower schooling with tooth loss is different across levels of city-level income and city-level education inequality, respectively. Public policies aiming to reduce the income and education gaps and preventive dental interventions are imperative to tackle tooth loss among elderly people.

Suggested Citation

  • Mario Vianna Vettore & Janete M. Rebelo Vieira & José F. F. Gomes & Nara M. O. Martins & Yan N. L. Freitas & Gabriela de A. Lamarca & Maria A. B. Rebelo, 2020. "Individual- and City-Level Socioeconomic Factors and Tooth Loss among Elderly People: A Cross-Level Multilevel Analysis," IJERPH, MDPI, vol. 17(7), pages 1-11, March.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:7:p:2345-:d:339045
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    References listed on IDEAS

    as
    1. Jung-Ha Lee & Seung-Kyoo Yi & Se-Yeon Kim & Ji-Soo Kim & Han-Na Kim & Seung-Hwa Jeong & Jin-Bom Kim, 2019. "Factors Related to the Number of Existing Teeth among Korean Adults Aged 55–79 Years," IJERPH, MDPI, vol. 16(20), pages 1-11, October.
    2. Matsuo, G. & Rozier, R.G. & Kranz, A.M., 2015. "Dental caries: Racial and ethnic disparities among North Carolina kindergarten students," American Journal of Public Health, American Public Health Association, vol. 105(12), pages 2503-2509.
    3. Loliza L F H Chalub & Carolina C Martins & Raquel C Ferreira & Andréa M D Vargas, 2016. "Functional Dentition in Brazilian Adults: An Investigation of Social Determinants of Health (SDH) Using a Multilevel Approach," PLOS ONE, Public Library of Science, vol. 11(2), pages 1-18, February.
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