June 2018

Volume 35, Issue 2

Social gradient in intermediary determinants of oral health at school level in Finland

Authors: Jaakko Anttila Mimmi Tolvanen Rami Kankaanpää Satu Lahti
doi: 10.1922/CDH_4127Anttila07


Objective: An adapted framework for oral health inequalities suggests that structural determinants cause oral health inequalities through socio-economic position (SEP) and intermediary determinants. We applied this framework to examine whether there is a social gradient in the intermediary determinants at the school level, even when adjusted for school size, geographical location and teaching language. Basic research design: Cross-sectional survey. Methods: This study combined data from two independent studies focusing on Finnish upper comprehensive schools (N=970): the School Health Promotion study (SHPS) and the School Sweet Selling survey (SSSS). All schools that took part in the SSSS and whose pupils answered the SHPS were included in the analysis (n=360, response rate=37%). From the questions of the SHPS and the SSSS suitable for the theoretical framework, attitudes and access to intoxicants, school health services, school environment, home environment, the school’s oral health-related actions and the pupil’s own behaviour were selected as the intermediary determinants and as the factors determining the school-level SEP. The social gradient in the intermediary determinants of oral health was investigated with Pearson’s and Spearman’s correlation coefficients between those and the school-level SEP. In the multivariable analysis, the General Linear Model with manual backward elimination was used. Results: A social gradient was observed in the intermediary determinants ‘home environment’ and ‘the pupils’ tooth brushing frequency’ and an inverse social gradient in ‘attitudes and access to intoxicants’ and ‘school health services’. Conclusions: Social gradient between schools could increase Finnish adolescents’ oral health inequalities. Key words: Diet, Health promotion, Inequalities, Oral health behaviour, Schools, Socio-economic factors


Other articles in this issue

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The Brussels statement on the future needs for caries epidemiology and surveillance in Europe 66-66 Download
Readying community water fluoridation advocates through training, surveillance, and empowerment 67-70 Download
Challenges associated with implementation of a school-based tooth-brushing and fluoride varnish programme in a diverse and transient urban population 71-74 Download
Social gradient in intermediary determinants of oral health at school level in Finland 75-80 Download
Community-based nutrition intervention to promote oral health and restore healthy body weight in refugee children: A scoping review 81-88 Download
Child, caregiver, and family factors associated with child dental utilization among Mexican migrant families in California 89-94 Download
Factors associated with Brazilian adolescents’ satisfaction with oral health 95-101 Download
Chronic Intra Oral Pain and Depressive Symptoms in Japanese Community-Dwelling Elderly: A Longitudinal Study 102-108 Download
Use and misuse of mixed methods in population oral health research: A scoping review 109-118 Download
Adaptation and validation of a Nepali version of the Child-Oral Impacts on Daily Performances Index (C-OIDP) 119-126 Download


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