Journal of Public Health Advance Access originally published online on June 27, 2008
Journal of Public Health 2008 30(4):472-478; doi:10.1093/pubmed/fdn047
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Neighbourhood deprivation and dental service use: a cross-sectional analysis of older people in England
I. A. Lang, Trainee Specialist in Public Health and Honorary Research Fellow1,2
S. J. Gibbs, Consultant in Public Health2
N. Steel, Clinical Senior Lecturer3
D. Melzer, Professor of Epidemiology and Public Health1,2
1 Epidemiology and Public Health Group, Peninsula Medical School, Exeter EX2 5DW, UK
2 Public Health Directorate, Devon Primary Care Trust, Exeter EX1 1PQ, UK
3 School of Medicine, Health Policy and Practice, University of East Anglia, Norwich NR4 7TJ, UK
Address correspondence to Iain A. Lang, E-mail: iain.lang{at}pms.ac.uk
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Abstract |
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Background Appropriate dental care is an important part of maintaining good oral health. We examined the relationship between socioeconomic status, neighbourhood deprivation levels and older people's dental service use.
Methods We used logistic regression analysis to assess the relationship between self-reported dental service use and neighbourhood deprivation, adjusting for individual socioeconomic and health factors, in individuals aged 65+ in the 2005 Health Survey for England (n = 4240).
Results Among dentulous respondents, 69.9% reported attending for regular check-ups, 6.2% occasional check-ups, 18.4% only saw a dentist when in trouble and 5.6% never went to a dentist. In our adjusted model age, sex, region, education level, occupational social class, self-reported health and smoking status, but not degree of urbanization, were associated with use of dental services. Following adjustment for these other factors those living in the most deprived 20% of neighbourhoods, compared with those in the least deprived, had a relative risk ratio of 2.25 (95% confidence interval 1.59–3.17) of using dental services only when symptomatic, rather than going for regular or occasional check-ups. When alternative outcomes of reporting having recently seen a doctor or been a hospital inpatient were assessed these deprivation-related patterns in service use were not evident.
Conclusion Levels of neighbourhood deprivation are associated with the use of dental services by older people. Action is needed to ensure older people in deprived communities access appropriate and comprehensive dental services.
Keywords: dentistry, oral health, older people, health services, socioeconomic status