The authors declare that they have no competing interests.
FG: carried out data analysis and contributed to manuscript writing. GE and SO: provided data from Sweden and revised manuscript writing. SAL: contributed to data analysis and revised manuscript writing. ANÅ: conceived of the study in Norway, supervised data analysis and contributed to manuscript writing. All authors have read and approved the final manuscript.
A life course perspective recognizes influences of socially patterned exposures on oral health across the life span. This study assessed the influence of early and later life social conditions on tooth loss and oral impacts on daily performances (OIDP) of people aged 65 and 70 years. Whether social inequalities in oral health changed after the usual age of retirement was also examined. In accordance with “the latent effect life course model”, it was hypothesized that adverse early-life social conditions increase the risk of subsequent tooth loss and impaired OIDP, independent of later-life social conditions.
Data were obtained from two cohorts studies conducted in Sweden and Norway. The 2007 and 2012 waves of the surveys were used for the present study. Early-life social conditions were measured in terms of gender, education and country of birth, and later-life social conditions were assessed by working status, marital status and size of social network. Logistic regression and Generalized Estimating Equations (GEE) were used to analyse the data. Inverse probability weighting (IPW) was used to adjust estimates for missing responses and loss to follow-up.
Early-life social conditions contributed to tooth loss and OIDP in each survey year and both countries independent of later-life social conditions. Lower education correlated positively with tooth loss, but did not influence OIDP. Foreign country of birth correlated positively with oral impacts in Sweden only. Later-life social conditions were the strongest predictors of tooth loss and OIDP across survey years and countries. GEE revealed significant interactions between social network and survey year, and between marital status and survey year on tooth loss.
The results confirmed the latent effect life course model in that early and later life social conditions had independent effects on tooth loss and OIDP among the elderly in Norway and Sweden. Between age 65 and 70, inequalities in tooth loss related to marital status declined, and inequalities related to social network increased.
United Nations. World Population Ageing: 1950–2050. New York: United Nations; 2002.
Adulyanon S, Sheiham A. Oral Impacts on Daily Performances. In: Slade GD, editor. Measuring Oral Health and Quality of Life. Chapel Hill: University of North Carolina, Dental Ecology; 1997.
Ostberg AL, Andersson P, Hakeberg M. Cross-cultural adaptation and validation of the Oral Iimpacts on Daily Performances (OIDP) in Swedish. Swed Dent J. 2008;32(4):187–95. PubMed
Ferrera M. The ‘Southern Model’ of welfare in social Europe. J Eur Soc Policy. 1996;6(1):17–37. CrossRef
Arnek M. Skäl till att gå i pension eller inte. Pensionsmyndigheten; 2012. http://secure.pensionsmyndigheten.se/SkalAttGaIPensionEllerInte.html
Bråthen M, Bakken F. Arbeid eller pensjon? En studie av hvilke faktorer som påvirker seniorers beslutning om å fortsette i jobb. Oslo: NAV; 2013.
Herd P. Do functional health inequalities decrease in old age?: Educational status and functional decline among the 1931–1941 birth cohort. Res Aging. 2006;28(3):375–92. CrossRef
Sanders AE, Slade GD, John MT, Steele JG, Suominen-Taipale AL, Lahti S, et al. A cross-national comparison of income gradients in oral health quality of life in four welfare states: application of the Korpi and Palme typology. J Epidemiol Community Health. 2009;63(7):569–74. CrossRefPubMedPubMedCentral
Tsakos G, Marcenes W, Sheiham A. Cross-cultural differences in oral impacts on daily performance between Greek and British older adults. Community Dent Health. 2001;18(4):209–13. PubMed
SSB, Folkemengden, 1. January 2014. [ https://www.ssb.no/befolkning/statistikker/folkemengde]
- Inequality in oral health related to early and later life social conditions: a study of elderly in Norway and Sweden
Stein Atle Lie
Anne Nordrehaug Åstrøm
- BioMed Central
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