The association between area level socio-economic position and oral health-related quality of life in the South African adult population

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.