9 research outputs found
The association between area level socio-economic position and oral health-related quality of life in the South African adult population
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 and reporting previous
dental visits. 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.DHE
The role of socio-economic position on satisfaction with oral health services among South African adults : a structural equation model
OBJECTIVE : To investigate how differences in socio-economic
position (SEP) influence satisfaction with dental
services among South Africans.
METHODS : Data collected from a nationally representative
sample of the South African population ≥16 years old
(n=3,112) included socio-demographics, health insurance
enrolment, past-year dental visit and facility type (public or
private), satisfaction and reason(s) for dissatisfaction with
the dental services received. Using structural equation
modelling, a pathway to satisfaction with dental services
was tested using a number of model fit statistics.
RESULT : Of the 15.1% (n=540) who had visited a dentist in
the past-year, 54.1% (n=312) were satisfied with the services
received. Reasons for dissatisfaction included long
waiting time (33.1%), painful procedure (13%) and rude
staff (10.4%). Being of higher SEP was associated with reporting
using private facility. Those who visited public facilities
were more likely to have encountered a long waiting
time, which in turn was associated with being more likely
to report treatment as having been painful and reporting
dissatisfaction. Long waiting times had the greatest direct
effect on dental service dissatisfaction (β = -0.31).
CONCLUSION : Improving waiting time is likely to be the major
factor to help reduce socio-economic disparities in the
quality of dental services experienced by South Africans.http://www.sada.co.zaam2017Dental Management Science
Oral health and subjective psychological well-being among South African adults : findings from a national household survey
OBJECTIVE : To determine the association between oral health and socioeconomic status with subjective psychological well-being.
METHODS : An interviewer-administered questionnaire was conducted during 2011 on a nationally representative sample of South African adults >16 years (n=2,971) who reported on socio-demographic data, past dental visit patterns, number of remaining teeth and oral and general health status. Subjective well-being was computed as the sum of scores obtained from participants' estimates of level of happiness (scale 0-6) and rating of level of satisfaction with life (scale 0-4). Analyses included t-tests and multivariable-adjusted Poisson regression.
RESULTS : The average score on a scale of 0-10 for subjective well-being was 6.31 (95%CI=6.17-6.44), which decreased with age, but increased with level of education and frequency of dental visits. Even after controlling for socioeconomic status, those who rated their oral health as good were more likely to report a higher subjective well-being (Prevalence Rate ratio (PRR) =1.14; 95% CI=1.03-1.27). Those who reported visiting a dentist at least every 6 months reported higher subjective well-being (PRR=1.10; 1.04-1.16.
CONCLUSIONS : Good oral health is independently associated with greater subjective well-being. This highlights the need to prioritise oral health promotion as an integral part of promoting general health and improving the quality of life of South Africans.http://www.sada.co.zaam201
Social gradient in the cost of oral pain and related dental service utilisation among South African adults
Background: Oral pain affects people's daily activities and quality of life. The burden of oral pain may vary across
socio-economic positions. Currently, little is known about the social gradient in the cost of oral pain among South
Africans. This study therefore assessed the social gradient in the cost of oral pain and the related dental service
utilisation pattern among South African adults.
Methods: Data were obtained from a nationally representative cross-sectional survey of South African adults
?16 year-old (n = 2651) as part of the South African Social Attitudes Survey conducted by the South African Human
Sciences Research Council. The survey included demographic data, individual-level socio-economic position (SEP),
self-reported oral health status, past six months' oral pain experience and cost. The area-level SEP was obtained
from the 2010 General Household Survey (n = 25,653 households) and the 2010/2011Quarterly Labour Force Survey
conducted in South Africa. The composite indices used for individual-level SEP (? = 0.76) and area-level SEP (? = 0.
88) were divided into tertiles. Data analysis was done using t-tests and ANOVA. Significance was set at p < 0.05.
Results: The prevalence of oral pain among the adult South Africans was 19.4 % (95 % CI = 17.2-21.9). The most
commonly reported form of oral pain was 'toothache' (78.9 %). The majority of the wealthiest participants sought
care from private dental clinics (64.7 %), or from public dental clinics (19.7 %), while the poorest tended to visit a
public dental clinic (45 %) or nurse/general medical practitioner (17.4 %). In the poorest areas, 21 % responded to
pain by 'doing nothing'. The individual expenditure for oral pain showed a social gradient from an average of
ZAR61.44 spent by those of lowest SEP to ZAR433.83 by the wealthiest (national average ZAR170.92). Average time
lost from school/work was two days over the six-month period, but days lost was highest for those living in middle
class neighbourhoods (3.41), while those from the richest neighbourhood had lost significantly fewer days from oral
pain (0.64).
Conclusions: There is a significant social gradient in the burden of oral pain. Improved access to dental care,
possibly through carefully planned universal National Health Insurance (NHI), may reduce oral health disparities in
South Africa.Scopus 201
Prevalence and socio-economic disparities in fissure sealant placement among adolescents in the Limpopo Province, South Africa
OBJECTIVES: This study investigated socio-economic factors
associated with the placement of fissure sealants in a population
of South African adolescents.
METHOD: The study participants were high school students aged
12 to layers who provided baseline data during 2005 in a tobaccouse
prevention trial, and consented to oral examination (n=1103).
Information was obtained using a self-administered survey
questionnaire, including demographic data, data on oral health
behaviour, the employment status of parents/guardians, and
the family structure of the household and on health insurance
enrolment. The main outcome measure was the presence of
a fissure sealant on any tooth, recorded using the WHO oral
examination protocol. Data were analysed using chi-square
statistics and multiple logistic regression analysis (p<0.05).
RESULTS: Overall, only 3.5% (n=37) of the study participants had a
fissure sealant, and only 31.3% (n=345) had ever made a dental
visit. Those who had attended seeking mostly preventive care
were significantly more likely to have a fissure sealant than those
who had visited mostly when they were in pain (14.2% vs. 2.9%;
p<0.001). In the multi-variable adjusted analysis, those reporting
to have parents who are both employed (OR = 2.76; 2.26 – 3.38),
and reporting regular preventive dental visits (OR = 3.55; 2.28 –
5.58) were positively associated with receiving fissure sealant,
while those who self-identified as black (OR = 0.04; 0.01 – 0.13),
were significantly less likely to present with a fissure sealant as
compared with other ethnicity/race groups.
CONCLUSIONS: Higher socio-economic status and regular access to
preventive care were significantly associated with the placement
of fissure sealants in the studied population.http://www.sada.co.z
Socio-economic inequities in dental caries experience of 12-year-old South Africans : policy implications for prevention
Please refer to abstract in articl
Health Insurance, Socio-Economic Position and Racial Disparities in Preventive Dental Visits in South Africa
This study sought to determine the contributions of socio-economic position and health insurance enrollment in explaining racial disparities in preventive dental visits (PDVs) among South Africans. Data on the dentate adult population participating in the last South African Demographic and Health Survey conducted during 2003–2004 (n = 6,312) was used. Main outcome measure: Reporting making routine yearly PDVs as a preventive measure. Education, material wealth index and nutritional status indicated socio-economic position. Multi-level logistic regression analysis was conducted to determine the predictors of PDVs. A variant of Blinder-Oaxaca decomposition analysis was also conducted. Health insurance coverage was most common among Whites (70%) and least common among black Africans (10.1%) in South Africa. Similarly, a yearly PDV was most frequently reported by Whites (27.8%) and least frequently reported among black Africans (3.1%). Lower education and lower material wealth were associated with lower odds of making PDVs. There was significant interaction between location (urban/rural) and education (p = 0.010). The racial and socio-economic differences in PDVs observed in urban areas were not observed in rural areas. In the general dentate population, having health insurance significantly increased the odds of making PDVs (OR = 4.32; 3.04–6.14) and accounted for 40.3% of the White/non-White gap in the probability of making PDVs. Overall, socio-economic position and health insurance enrollments together accounted for 55.9% (95% CI = 44.9–67.8) of the White/non-White gap in PDVs. Interventions directed at improving both socio-economic position and insurance coverage of non-White South Africans are likely to significantly reduce racial disparities in PDVs