A cross-national comparison of income gradients in oral health quality of life in four welfare states: application of the Korpi and Palme typology.

Hdl Handle:
http://hdl.handle.net/10147/124037
Title:
A cross-national comparison of income gradients in oral health quality of life in four welfare states: application of the Korpi and Palme typology.
Authors:
Sanders, A E; Slade, G D; John, M T; Steele, J G; Suominen-Taipale, A L; Lahti, S; Nuttall, N M; Allen, P Finbarr
Affiliation:
The University of North Carolina at Chapel Hill, North Carolina, NC 27599, USA. anne_saunders@dentistry.unc.edu
Citation:
A cross-national comparison of income gradients in oral health quality of life in four welfare states: application of the Korpi and Palme typology. 2009, 63 (7):569-74 J Epidemiol Community Health
Journal:
Journal of epidemiology and community health
Issue Date:
Jul-2009
URI:
http://hdl.handle.net/10147/124037
DOI:
10.1136/jech.2008.083238
PubMed ID:
19351621
Abstract:
The extent to which welfare states may influence health outcomes has not been explored. It was hypothesised that policies which target the poor are associated with greater income inequality in oral health quality of life than those that provide earnings-related benefits to all citizens.; Data were from nationally representative surveys in the UK (n = 4064), Finland (n = 5078), Germany (n = 1454) and Australia (n = 2292) conducted from 1998 to 2002. The typology of Korpi and Palme classifies these countries into four different welfare states. In each survey, subjects completed the Oral Health Impact Profile (OHIP-14) questionnaire, which evaluates the adverse consequence of dental conditions on quality of life. For each country, survey estimation commands were used to create linear regression models that estimated the slope of the gradient between four quartiles of income and OHIP-14 severity scores. Parameter estimates for income gradients were contrasted across countries using Wald chi(2) tests specifying a critical p value of 0.008, equivalent to a Bonferroni correction of p<0.05 for the six pairwise tests.; Statistically significant income gradients in OHIP-14 severity scores were found in all countries except Germany. A global test confirmed significant cross-national differences in the magnitude of income gradients. In Australia, where a flat rate of benefits targeted the poor, the mean OHIP-14 severity score reduced by 1.7 units (95% CI -2.15 to -1.34) with each increasing quartile of household income, a significantly steeper gradient than in other countries.; The coverage and generosity of welfare state benefits appear to influence levels of inequality in population oral health quality of life.
Item Type:
Article
Language:
en
MeSH:
Adult; Attitude to Health; Australia; Female; Finland; Germany; Great Britain; Health Status Disparities; Humans; Income; Male; Middle Aged; Oral Health; Poverty; Quality of Life; Social Welfare; State Medicine
ISSN:
1470-2738

Full metadata record

DC FieldValue Language
dc.contributor.authorSanders, A Een
dc.contributor.authorSlade, G Den
dc.contributor.authorJohn, M Ten
dc.contributor.authorSteele, J Gen
dc.contributor.authorSuominen-Taipale, A Len
dc.contributor.authorLahti, Sen
dc.contributor.authorNuttall, N Men
dc.contributor.authorAllen, P Finbarren
dc.date.accessioned2011-03-09T14:29:18Z-
dc.date.available2011-03-09T14:29:18Z-
dc.date.issued2009-07-
dc.identifier.citationA cross-national comparison of income gradients in oral health quality of life in four welfare states: application of the Korpi and Palme typology. 2009, 63 (7):569-74 J Epidemiol Community Healthen
dc.identifier.issn1470-2738-
dc.identifier.pmid19351621-
dc.identifier.doi10.1136/jech.2008.083238-
dc.identifier.urihttp://hdl.handle.net/10147/124037-
dc.description.abstractThe extent to which welfare states may influence health outcomes has not been explored. It was hypothesised that policies which target the poor are associated with greater income inequality in oral health quality of life than those that provide earnings-related benefits to all citizens.-
dc.description.abstractData were from nationally representative surveys in the UK (n = 4064), Finland (n = 5078), Germany (n = 1454) and Australia (n = 2292) conducted from 1998 to 2002. The typology of Korpi and Palme classifies these countries into four different welfare states. In each survey, subjects completed the Oral Health Impact Profile (OHIP-14) questionnaire, which evaluates the adverse consequence of dental conditions on quality of life. For each country, survey estimation commands were used to create linear regression models that estimated the slope of the gradient between four quartiles of income and OHIP-14 severity scores. Parameter estimates for income gradients were contrasted across countries using Wald chi(2) tests specifying a critical p value of 0.008, equivalent to a Bonferroni correction of p<0.05 for the six pairwise tests.-
dc.description.abstractStatistically significant income gradients in OHIP-14 severity scores were found in all countries except Germany. A global test confirmed significant cross-national differences in the magnitude of income gradients. In Australia, where a flat rate of benefits targeted the poor, the mean OHIP-14 severity score reduced by 1.7 units (95% CI -2.15 to -1.34) with each increasing quartile of household income, a significantly steeper gradient than in other countries.-
dc.description.abstractThe coverage and generosity of welfare state benefits appear to influence levels of inequality in population oral health quality of life.-
dc.language.isoenen
dc.subject.meshAdult-
dc.subject.meshAttitude to Health-
dc.subject.meshAustralia-
dc.subject.meshFemale-
dc.subject.meshFinland-
dc.subject.meshGermany-
dc.subject.meshGreat Britain-
dc.subject.meshHealth Status Disparities-
dc.subject.meshHumans-
dc.subject.meshIncome-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshOral Health-
dc.subject.meshPoverty-
dc.subject.meshQuality of Life-
dc.subject.meshSocial Welfare-
dc.subject.meshState Medicine-
dc.titleA cross-national comparison of income gradients in oral health quality of life in four welfare states: application of the Korpi and Palme typology.en
dc.typeArticleen
dc.contributor.departmentThe University of North Carolina at Chapel Hill, North Carolina, NC 27599, USA. anne_saunders@dentistry.unc.eduen
dc.identifier.journalJournal of epidemiology and community healthen
dc.description.provinceMunster-

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