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Do welfare regimes matter for oral health? A multilevel analysis of European countries

Guarnizo-Herreño, CC; Watt, RG; Stafford, M; Sheiham, A; Tsakos, G; (2017) Do welfare regimes matter for oral health? A multilevel analysis of European countries. Health & Place , 46 pp. 65-72. 10.1016/j.healthplace.2017.05.004. Green open access

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Abstract

While the role of political factors on population health has recently received increasing attention, relatively little is known in that respect for oral health. We aimed to assess the influence of welfare state regimes on the variation in adult oral health between European countries, building on the existing literature by using a multilevel approach. Our analysis also explored how the oral health of people with different socioeconomic position was influenced by living in five different welfare state regimes. We analysed data from the Eurobarometer survey 2009. The main outcome was no functional dentition, defined as having fewer than 20 natural teeth. Age, gender, marital status, education and occupational social class were the individual-level explanatory variables, while welfare regimes, GDP per capita and GDP annual growth were the country-level variables. Multilevel logistic regression models were fitted with individuals nested within countries. Results revealed that country-level characteristics accounted for 8.1% of the variation in oral health. Adults in all welfare regimes were more likely to have poorer oral health than their counterparts in the Scandinavian regime, with those in Eastern countries being 6.94 (95% CI: 3.62-12.67) times as likely to lack a functional dentition as adults in Scandinavian countries. The variation at country-level reduced significantly when welfare regimes were introduced into the model (from 0.57 to 0.16; 72% reduction), indicating that welfare regime explained much of the variation in the outcome among European countries. Finally, adults with less education and lower occupational level were more likely to have no functional dentition, especially in the Eastern and Bismarckian welfare regimes.

Type: Article
Title: Do welfare regimes matter for oral health? A multilevel analysis of European countries
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.healthplace.2017.05.004
Publisher version: http://dx.doi.org/10.1016/j.healthplace.2017.05.00...
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Europe, Multilevel, Oral health, Welfare state regime
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: https://discovery.ucl.ac.uk/id/eprint/1556887
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