Socioeconomic inequalities in toothbrushing behaviours in young children: a children's lifestyle survey in a representative population of A city, Okinawa prefecture, Japan.
We have less understanding of which socioeconomic status (SES) indicators may be reflective of latent socioeconomic inequalities in toothbrushing behaviours, especially finishing-toothbrushing by parents in young children. The aim of this study was to reveal the socioeconomic inequalities in children's toothbrushing and finishing-toothbrushing by parents and if it varies by SES indicators.
We used data from 'Survey on Children's Life' conducted by A city of Okinawa Prefecture, Japan. The multiple imputed data of 902 (boys, 453) included self-reported children's toothbrushing behaviour and finishing-toothbrushing by parents in three-to six-year-old children. SES was assessed using self-reported household income and parental educational attainment. Absolute and relative inequalities in toothbrushing behaviours were quantified using the slope index of inequality (SII) and relative index of inequality (RII), respectively.
There were significant absolute and relative inequalities of children's toothbrushing for household income (SII and RII were 0.241 and 2.73, respectively), of finishing-toothbrushing by parents for household income (SII and RII were 0.133 and 3.28, respectively), and educational attainment (SII and RII were 0.166 and 5.55, respectively). The same inequality trends were observed after adjusting for covariates (child's age and sex, family structure, breakfast and dinner frequency, and sleep duration).
Socioeconomic inequalities in children's toothbrushing and finishing-toothbrushing by parents varied according to SES indicators.
Kyan A
，Takakura M
，Kamiya Y
，Kinjo N
，Nakasone T
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Trajectory of social inequalities in the treatment of dental caries among preschool children in Japan.
The longitudinal trend of dental health inequalities among preschool children has not been described. In this study, we aimed to measure the trajectory of both relative and absolute inequalities in caries treatment among preschool children in Japan.
We used data from the Longitudinal Survey of Babies in the 21st Century (LSB21), which is an ongoing national representative longitudinal study. The target population was families residing in Japan with newborn baby/babies born between 10 January and 17 January or 10 July and 17 July 2001. Data regarding caries treatment history and socioeconomic status (SES) were collected using a self-reported questionnaire. SES was assessed on the basis of the parents' educational attainment. In total, 35 260 children were followed from 2.5 to 5.5 years through annual surveys. To evaluate absolute and relative inequalities, we calculated the slope index of inequality (SII) and relative index of inequality (RII), respectively.
The rate of caries treatment at the age of 2.5 years was <10% for all SES groups; this increased to more than 30% at 5.5 years of age. Children with lower SES received more frequent caries treatment, and both absolute and relative social inequalities were statistically significant. SII showed a significant increase throughout the follow-up period, with values of 4.13% (95% confidence interval [CI], 3.16; 5.09) and 15.50% (95% CI, 13.68; 17.32) at 2.5 and 5.5 years of age, respectively. In contrast, RII decreased with an increase in the treatment rate for all groups, with values of 1.83 (95% CI, 1.59; 2.11) and 1.53 (95% CI, 1.46; 1.61) at 2.5 and 5.5 years of age, respectively.
Our results suggest that the rate of caries treatment is higher for preschool children with lower SES in Japan, with significant widening of absolute inequalities along with the growth of the children.
Aida J
，Matsuyama Y
，Tabuchi T
，Komazaki Y
，Tsuboya T
，Kato T
，Osaka K
，Fujiwara T
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Socio-economic inequalities in health among older adults in China.
This study aimed to explore socio-economic inequalities in the health status of older people in China using the most recent data available.
This was a cross-sectional study.
Data for this study were obtained from the 2018 China Health and Retirement Longitudinal Study, which included 9831 subjects aged 60 years and older. We assessed differences in the prevalence of self-reported health, functional limitations, and chronic conditions by education level and household income level, and then estimated the Slope of Inequality Index (SII) and the Relative Inequality Index (RII) - indexes of the relative magnitude of socio-economic inequalities in health.
We found inequalities in all dimensions of health (self-assessed health status, reported chronic conditions, and physical functional limitations) at the household income level. Physical functional limitations, particularly the ability to perform instrumental activities of daily living, produced greater inequality than other domains, with an adjusted SII of 0.495 (95% CI, 0.467-0.524) and an adjusted RII of 2.129 (95% CI, 1.604-2.653). ADL limitations (adjusted SII, 0.524, 95% CI, 0.473-0.575, adjusted RII, 1.527, 95% CI, 1.027-2.027) and self-measured health (adjusted SII, 0.523, 95% CI, 0.258-0.789, adjusted RII, 1.531, 95% CI, 0.551-2.512) were also clearly different. Inequalities were also found across all health domains in terms of educational attainment. Consistent with inequalities in household income, inequalities were greatest for limitations in the ability to perform instrumental activities of daily living (adjusted SII, 0.581, 95% CI, 0.424-0.739, adjusted RII, 3.699, 95% CI, 3.642-3.757). Relative inequalities in limitations in activities of daily living (adjusted SII, 0.676, 95% CI, 0.560-0.792, adjusted RII, 2.587, 95% CI, 2.392-2.784) and self-rated health (poor/very poor) (adjusted SII, 0.647, 95% CI, 0.617-0.677, adjusted RII, 2.406, 95% CI, 2.224-2.587) were also higher.
Our study shows significant socio-economic differences in the areas of self-rated health, functional limitations, and reported chronic diseases, particularly in the area of IADL limitations. These inequalities need to be explicitly addressed and vulnerable subgroups should be targeted to reduce the socio-economic disparities.
Shang XT
，Wei ZH
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