Socioeconomic and psychosocial associations with oral health impact and general health

Abstract

Background: There is debate whether both subjective and objective measures of socioeconomic status (SES) are needed to predict health, and whether these factors are explained by psychosocial characteristics. The aims were to investigate the association of socioeconomic and psychosocial variables with oral health impact and general health utility.

Methods: A random sample of 45- to 54-year-olds from Adelaide, South Australia, was surveyed by self-complete questionnaire in 2004-2005. Oral health impact was assessed using OHIP-14 and general health utility by EQ-5D. SES was determined using objective (income, education) and subjective (McArthur scale) measures. Psychosocial variables comprised social support, health self-efficacy, well-being, coping and affectivity.

Results: Data were collected from 879 participants (response rate = 43.8%). Both objective and subjective socioeconomic status measures were associated with OHIP and EQ-5D scores. Higher income and subjective social status were both associated (P < 0.05) with less oral health impact (β = -0.28 and β = -0.73, respectively) and better general health utility (both with β = 0.01, respectively). Psychosocial variables accounted for a relatively large percentage of variance in OHIP (20.7%) and EQ-5D (21.9%) scores.

Conclusions: For both oral health impact and general health utility, objective SES was significant in the presence of subjective SES. Psychosocial variables had important independent associations with both oral and general health.

Keywords: oral health; psychosocial; quality of life; socioeconomic status; subjective social status.