Explaining Socioeconomic Oral Checkup Inequalities.
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Background: As with many behavioral health aspects, there are clear socioeconomic inequalities in oral health and oral checkup regularity. This study aimed to assess the influence of material and psychosocial factors as mediators in the explanation of socioeconomic inequalities in relation to oral checkup regularity among Dutch adults. Methods: Survey data from subjects (25 – 75 years) that participated in the fifth wave follow up of the GLOBE study (N = 2577) was used for this study. Binary logistic regression models were created to demonstrate the association between socioeconomic status (educational level) and oral checkup regularity. It was studied whether material factors (financial difficulties) and psychosocial factors (psychological distress, social support, and social network size) functioned as mediating factors in this association. Odds ratios (OR) were obtained and compared to draw conclusions. Results: Lower socioeconomic status is associated with lower oral checkup regularity. This relationship functions as a gradient: people with lower educational backgrounds were less likely to perform regular oral checkups. Furthermore, financial difficulties, psychological distress, social network size and number of close family members functioned as mediators. Conclusions: The results indicate that financial difficulties, psychological distress, social support, and number of close family members play a role in the explanation of socioeconomic differences in oral checkup behavior. However, there are notable differences in the degree of influence and the effect of the mediators on different educational groups. This study calls on professionals to be aware of risk-factors for non-regular oral checkups and provides a solution for reform of the Dutch healthcare system. We suggest a removal of the financial barrier for oral checkups to reduce the socioeconomic inequalities in oral checkup regularity and oral health.