서울시 노인의 구강통증 여부 및 치과서비스이용의 사회적 결정요인에 대한 다수준분석
Social determinants of oral pain and dental service utilization among the elderly Seoul residents: a multilevel study
Objectives: Oral health has been understudied in Korea, compared to physical or mental health. Oral health is particularly important for quality life for elderly population, since oral problems can cause nutritional deficiency which will results in adverse health outcomes. Dental service utilization is another important component for quality life, since its limitation can aggravate oral problems. This study examines social risk factors of oral health problems and dental services utilization among the elderly Seoul residents aged 65 and up.Methods: Based on the 2005 Seoul Citizens' Health Interview Survey that includes a representative sample of Seoul residents, we excluded a subset of data set comprised of 1,465 elderly respondents for this study. We examined two dependent variables related with oral health: ① perceived oral pain; ② dental service utilization, focusing on the impact of individual and area level social characteristics. Multilevel analysis techniques are applied for parameter estimates, using the HLM version 6.02 statistical software.Results: There are area variances in oral pain and dental service utilization status across 25 KUs, and area-level contextual characteristics partly explain the variance, particularly for the dental service utilization. Individual disadvantages in socioeconomic status are substantially associated with disadvantaged dental and service utilization status. Area disadvantages in socioeconomic status have notable effect only for the dental service utilizations. Area social capital does not have anything to do with both dental outcome variables in Seoul.Conclusion: Individual's SES is a strong predictor of both dental outcomes of this study, while area level SES and social capital partly affect the dental service utilization only. More policy and academic attention should be paid to the dental status and need of disadvantaged urban elderly dwellers.
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