目的:通过:(i)表征从出生到成年的社会流动模式,以及(ii)评估其对SPOH的影响来确定社会流动对自我感知口腔健康(SPOH)的影响英国成年人。
方法:1970年英国队列研究的次要数据分析。数据是在出生时以及5、10、16、26、30、34、38、42和46岁时收集的。从出生到16岁的父母SC表示社会阶层(SC),从26岁到42岁的SC表示。在46岁时,使用一个问题测量了SPOH。性,种族,国家和居住区被列为潜在的混杂因素。潜在类别生长分析(LCGA)用于确定暴露于非手动SC随时间变化的轨迹,而不是预先确定的类别。
结果:LCGA确定了四种社会流动模式:稳定高,稳定低,向上移动和向下移动;SC变化的时间在16到26年之间。共有9657名参与者参加。在粗略的模型中,稳定高位的赔率较低(OR:0.67,95%CI:0.59-0.76),而向下移动和稳定的低SPOH的几率(OR:1.36,95%CI:1.15-1.61和OR:1.57,95%CI:1.40-1.77)高于向上移动。这些结果在完全调整的模型中得到了证实;女性和生活在农村地区也与不良SPOH的较低几率相关(OR:0.64,95%CI:0.59-0.71和OR:0.90,95CI:0.80-1.00)。
结论:社会流动性显著影响英国成年人的SPOH。非手动SC比手动SC具有更好的SPOH。与向上流动相比,向下流动的个人更频繁地报告不良的SPOH,证明当前SC对口腔健康的影响比早年SC稍大。
OBJECTIVE: To determine the effect of social mobility on self-perceived oral health (SPOH) by: (i)characterizing patterns of social mobility from birth to adulthood and (ii)assessing their influence on SPOH among British adults.
METHODS: A secondary data analysis of the 1970 British Cohort Study. Data were collected at birth and at 5, 10, 16, 26, 30, 34, 38, 42 and 46 years of age. Social class (SC) was indicated by parental SC from birth to age 16 and own SC from ages 26 to 42. At age 46, SPOH was measured using a single question. Sex, ethnicity, country and residence area were included as potential confounders. Latent class growth analysis (LCGA) was used to identify trajectories of exposure to non-manual SC over time, instead of predetermined categories.
RESULTS: LCGA identified four social mobility patterns: stable high, stable low, upwardly mobile and downwardly mobile; the time for the change in SC happening between 16 and 26 years. A total of 9657 participants were included. In the crude model, stable high had lower odds (OR: 0.67, 95% CI: 0.59-0.76), while downward mobility and stable low had higher odds (OR: 1.36, 95% CI: 1.15-1.61 and OR: 1.57, 95% CI: 1.40-1.77) of poor SPOH than upward mobility. These results were corroborated in the fully adjusted model; being female and living in rural areas was also associated with lower odds (OR: 0.64, 95% CI: 0.59-0.71 and OR: 0.90, 95%CI: 0.80-1.00) of poor SPOH.
CONCLUSIONS: Social mobility significantly affects SPOH in British adults. Those in non-manual SC have better SPOH than those in manual SC. When compared to upward mobility, downwardly mobile individuals report bad SPOH more frequently, evidencing that current SC influences oral health in a slightly greater measure than early years SC.