Exploring the Link Between Social Capital and Edentulism in Low- and Middle-Income Countries

Abstract

Objectives: Although social capital (SC) has received growing attention in public health, no research has yet compared how SC and oral health are associated in diverse contexts. This cross-sectional study aims to examine the association of community and individual-level SC with edentulism among adults aged 50 and above in five low- and middle-income countries (LMICs).

Materials and methods: Data are from SAGE-wave 1 (2007-2010), including 27,676 participants aged 50 years or older from China (N = 12,830), Ghana (N = 4261), India (N = 6040), Mexico (N = 1327), and South Africa (N = 3218). The primary outcome was self-reported edentulism. Cognitive and structural SC were used to measure SC at the individual and community levels. The association between SC dimensions and oral health was investigated using a two-level multilevel logistic regression.

Results: Multilevel analysis revealed that low individual and community structural SC are independently associated with edentulism in China (OR 1.43; CI 1.08-1.89 and OR 1.95; CI 1.32-2.90, respectively). In South Africa, low individual cognitive SC was negatively associated with edentulism (OR 0.48; CI 0.24-0.98), while low individual structural SC was positively associated with edentulism (OR 2.34; CI 1.16-4.74). In Ghana, only participants living in middle community structural SC had higher odds of being edentulous after adjustment for all potential confounders (OR 1.78; CI 0.71-2.96). In Mexico and India, no association was found between any dimensions of SC and oral health.

Conclusion: The dimensions of SC and its relationship to edentulism differed across the five LMICs. Our study highlights the importance of considering contextual factors when analyzing the relationship between SC and oral health. Further research is required to understand how SC influences oral health in LMICs.

Keywords: aging; edentulism; oral health; social capital.

Figure 1

Components of social capital.

Figure 2

Forest plot illustrating associations between social capital and edentulism through multilevel logistic regression (Model 4). The y‐axis displays the explanatory variables influencing edentulism, while the x‐axis shows the adjusted odds ratios (aOR), with high social capital as the reference. SC, social capital.