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Investigating social inequalities in older adults’ dentition and the role of dental service use in 14 European countries

Author

Listed:
  • Jing Shen

    (Newcastle University)

  • Stefan Listl

    (Radboud University
    Heidelberg University)

Abstract

Background Oral disease, despite being largely preventable, remains the most common chronic disease worldwide and has a significant negative impact on quality of life, particularly among older adults. Objective This study is the first to comprehensively and at a large scale (14 European countries) measure the social inequalities in the number of natural teeth (an informative oral health marker) in the over 50-year-old population and to investigate the extent to which such inequalities are attributable to dental service use. Methods Using Wave 5 of the Survey of Health, Ageing and Retirement in Europe, which included internationally harmonized information on over 50,000 individuals across 14 European countries, we calculated Gini and Concentration indices (CI) as well as the decompositions of CIs by socioeconomic factors. Results Sweden consistently performed the best with the lowest inequalities as measured by Gini (0.1078), CI by income (0.0392), CI by education (0.0407), and CI by wealth (0.0296). No country performed the worst in all inequality measures. However, unexpectedly, some wealthier countries (e.g., the Netherlands and Denmark) had higher degrees of inequalities than less-wealthy countries (e.g., Estonia and Slovenia). Decomposition analysis showed that income, education, and wealth contributed substantially to the inequalities, and dental service use was an important contributor even after controlling for income and wealth. Conclusions The study highlighted the importance of comprehensively investigating oral health inequalities. The results are informative to policymakers to derive country-specific health policy recommendations to reduce oral health inequalities in the older population and also have implications for oral health improvement of the future generations.

Suggested Citation

  • Jing Shen & Stefan Listl, 2018. "Investigating social inequalities in older adults’ dentition and the role of dental service use in 14 European countries," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(1), pages 45-57, January.
  • Handle: RePEc:spr:eujhec:v:19:y:2018:i:1:d:10.1007_s10198-016-0866-2
    DOI: 10.1007/s10198-016-0866-2
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    References listed on IDEAS

    as
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    2. Aida, Jun & Kondo, Katsunori & Kondo, Naoki & Watt, Richard G. & Sheiham, Aubrey & Tsakos, Georgios, 2011. "Income inequality, social capital and self-rated health and dental status in older Japanese," Social Science & Medicine, Elsevier, vol. 73(10), pages 1561-1568.
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    4. Tsakos, G. & Demakakos, P. & Breeze, E. & Watt, R.G., 2011. "Social gradients in oral health in older adults: Findings from the english longitudinal survey of aging," American Journal of Public Health, American Public Health Association, vol. 101(10), pages 1892-1899.
    5. Atkinson, Anthony B., 1970. "On the measurement of inequality," Journal of Economic Theory, Elsevier, vol. 2(3), pages 244-263, September.
    6. Erreygers, Guido, 2009. "Correcting the Concentration Index," Journal of Health Economics, Elsevier, vol. 28(2), pages 504-515, March.
    7. Kakwani, Nanak & Wagstaff, Adam & van Doorslaer, Eddy, 1997. "Socioeconomic inequalities in health: Measurement, computation, and statistical inference," Journal of Econometrics, Elsevier, vol. 77(1), pages 87-103, March.
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    Cited by:

    1. Chen, Fengming & Wakabayashi, Midori & Yuda, Michio, 2024. "The impact of retirement on health: Empirical evidence from the change in public pensionable age in Japan," The Journal of the Economics of Ageing, Elsevier, vol. 28(C).
    2. Domenica Matranga & Laura Maniscalco, 2022. "Inequality in Healthcare Utilization in Italy: How Important Are Barriers to Access?," IJERPH, MDPI, vol. 19(3), pages 1-14, February.

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    More about this item

    Keywords

    Oral health inequality; Dentition; Dental service use; Gini; Concentration index; Decomposition; Survey of Health; Ageing and Retirement in Europe (SHARE);
    All these keywords.

    JEL classification:

    • D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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