Abstract:
OBJECTIVE : To investigate the association between arealevel
socio-economic position (SEP) and oral health-related
quality of life (OHRQoL).
METHODS : Data collected from a nationally representative
sample of the South African population ≥16 years old
(n=3,003) included demographics, individual-level SEP
measures and self-reported oral health status. OHRQoL was
measured using the Oral Health Impact Profile-14 (OHIP-14).
The General Household Survey (n=25,653 households) and
Quarterly Labour Force Surveys (n~30,000 households/
quarter) were used to determine area-level SEP. Data analysis
included a random-effect negative binomial regression
model and Blinder-Oaxaca decomposition analysis.
RESULTS : Area-level deprivation was associated with more
negative oral impacts, independent of an individual’s SEP.
Other significant predictors of oral impacts included having
experienced oral pain (ß=1.15) and reporting previous
dental visits (ß=0.69). Area differences in dental attendance
contributed the most (37.5%) to the observed gap
in OHRQoL, explained by differences in area-level SEP,
whereas individual-level SEP contributed the least (18.8%).
In the more affluent areas, satisfaction with life in general
and individuals’ SEP were significantly positively associated
with OHRQoL.
CONCLUSION : To reduce inequalities in OHRQoL, proportionate
development of socio-economic conditions should
be prioritised, particularly there appears to be a need for
greater access to oral health services by disadvantaged
people in affluent areas.
