Socioeconomic disadvantage across the life-course and oral health in older age: findings from a longitudinal study of older British men

• Published in: Journal of public health (Oxford, England) England), 2018-12, Vol.40 (4), p.e423-e430
• Main Authors: Ramsay, Sheena E., Papachristou, Efstathios, Watt, Richard G., Lennon, Lucy T., Papacosta, A. Olia, Whincup, Peter H., Wannamethee, S. Goya
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Aged, 80 and over; Humans; Likelihood Functions; Longitudinal Studies; Male; Oral Health - economics; Oral Health - statistics & numerical data; Original; Periodontal Diseases - epidemiology; Periodontal Diseases - etiology; Socioeconomic Factors; Tooth Loss - epidemiology; Tooth Loss - etiology; United Kingdom - epidemiology; Vulnerable Populations - statistics & numerical data; Wider determinants (online only)
• ISSN: 1741-3842; 1741-3850
• DOI: 10.1093/pubmed/fdy068

The influence of life-course socioeconomic disadvantage on oral health at older ages is not well-established. We examined the influence of socioeconomic factors in childhood, middle-age and older age on oral health at older ages, and tested conceptual life-course models (sensitive period, accumulation of risk, social mobility) to determine which best described observed associations. A representative cohort of British men aged 71-92 in 2010-12 included socioeconomic factors in childhood, middle-age and older age. Oral health assessment at 71-92 years (n = 1622) included tooth count, periodontal disease and self-rated oral health (excellent/good, fair/poor) (n = 2147). Life-course models (adjusted for age and town of residence) were compared with a saturated model using Likelihood-ratio tests. Socioeconomic disadvantage in childhood, middle-age and older age was associated with complete tooth loss at 71-92 years-age and town adjusted odds ratios (95% CI) were 1.39 (1.02-1.90), 2.26 (1.70-3.01), 1.83 (1.35-2.49), respectively. Socioeconomic disadvantage in childhood and middle-age was associated with poor self-rated oral health; adjusted odds ratios (95% CI) were 1.48 (1.19-1.85) and 1.45 (1.18-1.78), respectively. A sensitive period for socioeconomic disadvantage in middle-age provided the best model fit for tooth loss, while accumulation of risk model was the strongest for poor self-rated oral health. None of the life-course models were significant for periodontal disease measures. Socioeconomic disadvantage in middle-age has a particularly strong influence on tooth loss in older age. Poor self-rated oral health in older age is influenced by socioeconomic disadvantage across the life-course. Addressing socioeconomic factors in middle and older ages are likely to be important for better oral health in later life.