A cross-national comparison of income gradients in oral health quality of life in four welfare states: application of the Korpi and Palme typology
Background: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.Me...
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| Veröffentlicht in: | Journal of epidemiology and community health (1979) 2009-07, Vol.63 (7), p.569-574 |
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| container_title | Journal of epidemiology and community health (1979) |
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| creator | Sanders, A E Slade, G D John, M T Steele, J G Suominen-Taipale, A L Lahti, S Nuttall, N M Allen, P Finbarr |
| description | Background: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.Methods: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 χ2 tests specifying a critical p value of 0.008, equivalent to a Bonferroni correction of p |
| doi_str_mv | 10.1136/jech.2008.083238 |
| format | Article |
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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.Methods: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 χ2 tests specifying a critical p value of 0.008, equivalent to a Bonferroni correction of p<0.05 for the six pairwise tests.Results: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.Conclusion:The coverage and generosity of welfare state benefits appear to influence levels of inequality in population oral health quality of life.</description><identifier>ISSN: 0143-005X</identifier><identifier>EISSN: 1470-2738</identifier><identifier>DOI: 10.1136/jech.2008.083238</identifier><identifier>PMID: 19351621</identifier><identifier>CODEN: JECHDR</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd</publisher><subject>Adult ; Attitude to Health ; Australia - epidemiology ; Biological and medical sciences ; Classification ; Community health ; Countries ; Data collection ; Dental care ; Economic benefits ; Facial bones, jaws, teeth, parodontium: diseases, semeiology ; Female ; Finland - epidemiology ; Flat rates ; General aspects ; Germany - epidemiology ; Health disparities ; Health outcomes ; Health Status Disparities ; Household income ; Humans ; Income ; Income inequality ; Low income groups ; Male ; Medical sciences ; Middle Aged ; Miscellaneous ; Non tumoral diseases ; Oral Health ; Otorhinolaryngology. Stomatology ; Population ; Poverty - economics ; Public health ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Quality of Life ; Questionnaires ; Research reports ; Social Welfare - economics ; Socioeconomic factors ; Socioeconomics ; State Medicine - economics ; Studies ; United Kingdom - epidemiology ; Welfare state</subject><ispartof>Journal of epidemiology and community health (1979), 2009-07, Vol.63 (7), p.569-574</ispartof><rights>2009 BMJ Publishing Group</rights><rights>Copyright © 2009 BMJ Publishing Group</rights><rights>2009 INIST-CNRS</rights><rights>Copyright: 2009 2009 BMJ Publishing Group</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b615t-153e977a28a61349de3d75aeaf7fa8356972107edde35b9213d49f45075e119f3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jech.bmj.com/content/63/7/569.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttps://jech.bmj.com/content/63/7/569.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,230,314,776,780,799,881,3182,23551,27903,27904,57995,58228,77346,77377</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21567485$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19351621$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sanders, A E</creatorcontrib><creatorcontrib>Slade, G D</creatorcontrib><creatorcontrib>John, M T</creatorcontrib><creatorcontrib>Steele, J G</creatorcontrib><creatorcontrib>Suominen-Taipale, A L</creatorcontrib><creatorcontrib>Lahti, S</creatorcontrib><creatorcontrib>Nuttall, N M</creatorcontrib><creatorcontrib>Allen, P Finbarr</creatorcontrib><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</title><title>Journal of epidemiology and community health (1979)</title><addtitle>J Epidemiol Community Health</addtitle><description>Background: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.Methods: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 χ2 tests specifying a critical p value of 0.008, equivalent to a Bonferroni correction of p<0.05 for the six pairwise tests.Results: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.Conclusion:The coverage and generosity of welfare state benefits appear to influence levels of inequality in population oral health quality of life.</description><subject>Adult</subject><subject>Attitude to Health</subject><subject>Australia - epidemiology</subject><subject>Biological and medical sciences</subject><subject>Classification</subject><subject>Community health</subject><subject>Countries</subject><subject>Data collection</subject><subject>Dental care</subject><subject>Economic benefits</subject><subject>Facial bones, jaws, teeth, parodontium: diseases, semeiology</subject><subject>Female</subject><subject>Finland - epidemiology</subject><subject>Flat rates</subject><subject>General aspects</subject><subject>Germany - epidemiology</subject><subject>Health disparities</subject><subject>Health outcomes</subject><subject>Health Status Disparities</subject><subject>Household income</subject><subject>Humans</subject><subject>Income</subject><subject>Income inequality</subject><subject>Low income groups</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Non tumoral diseases</subject><subject>Oral Health</subject><subject>Otorhinolaryngology. Stomatology</subject><subject>Population</subject><subject>Poverty - economics</subject><subject>Public health</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Quality of Life</subject><subject>Questionnaires</subject><subject>Research reports</subject><subject>Social Welfare - economics</subject><subject>Socioeconomic factors</subject><subject>Socioeconomics</subject><subject>State Medicine - economics</subject><subject>Studies</subject><subject>United Kingdom - epidemiology</subject><subject>Welfare state</subject><issn>0143-005X</issn><issn>1470-2738</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqFkUtvEzEUhUcIRNPCng3IEkIs0AQ_xuMZFkhVRAqiPIQAdWfdzNiJU2c8tZ1C_ga_GE8nSoENKz_O53N978myRwRPCWHly7VqVlOKcTXFFaOsupNNSCFwTgWr7mYTTAqWY8wvjrLjENY4bQWt72dHpGaclJRMsl-nqPEuhLyDaFwHFjVu04M3wXXIaWS6dFZo6aE1qoshXSDnE7ZSYOMKXW3BmrgbUGu0GmTtth79UFaDVyhEiCq8QtD31jQ3NQY2rhR673xvEHQt-gw21Yi73lm33D3I7mmwQT3cryfZt_mbr7O3-fmns3ez0_N8URIec8KZqoUAWkFJWFG3irWCgwItNFSMl7WgBAvVJoEvakpYW9S64FhwRUit2Un2evTtt4uNapvUXmpM9t5swO-kAyP_Vjqzkkt3LZkokkmdDJ7vDby72qoQ5caERlkLnXLbIAVjlDKOcSKf_kOu05DStIMkQtS0pDUtEoVH6iYRr_ThLwTLIW855C2HvOWYd3ry5M8ebh_sA07Asz0AoQGrPXSNCQeOEl6KouKJezxy6xCdv9XxMETMkp6PuglR_Tzo4C9lKZjg8uP3mbwo5x_YGZnLL4l_MfKLzfr_bfwGLrXb8A</recordid><startdate>20090701</startdate><enddate>20090701</enddate><creator>Sanders, A E</creator><creator>Slade, G D</creator><creator>John, M T</creator><creator>Steele, J G</creator><creator>Suominen-Taipale, A L</creator><creator>Lahti, S</creator><creator>Nuttall, N M</creator><creator>Allen, P Finbarr</creator><general>BMJ Publishing Group Ltd</general><general>BMJ Publishing Group</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20090701</creationdate><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</title><author>Sanders, A E ; Slade, G D ; John, M T ; Steele, J G ; Suominen-Taipale, A L ; Lahti, S ; Nuttall, N M ; Allen, P Finbarr</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b615t-153e977a28a61349de3d75aeaf7fa8356972107edde35b9213d49f45075e119f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adult</topic><topic>Attitude to Health</topic><topic>Australia - epidemiology</topic><topic>Biological and medical sciences</topic><topic>Classification</topic><topic>Community health</topic><topic>Countries</topic><topic>Data collection</topic><topic>Dental care</topic><topic>Economic benefits</topic><topic>Facial bones, jaws, teeth, parodontium: diseases, semeiology</topic><topic>Female</topic><topic>Finland - epidemiology</topic><topic>Flat rates</topic><topic>General aspects</topic><topic>Germany - epidemiology</topic><topic>Health disparities</topic><topic>Health outcomes</topic><topic>Health Status Disparities</topic><topic>Household income</topic><topic>Humans</topic><topic>Income</topic><topic>Income inequality</topic><topic>Low income groups</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Non tumoral diseases</topic><topic>Oral Health</topic><topic>Otorhinolaryngology. Stomatology</topic><topic>Population</topic><topic>Poverty - economics</topic><topic>Public health</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Quality of Life</topic><topic>Questionnaires</topic><topic>Research reports</topic><topic>Social Welfare - economics</topic><topic>Socioeconomic factors</topic><topic>Socioeconomics</topic><topic>State Medicine - economics</topic><topic>Studies</topic><topic>United Kingdom - epidemiology</topic><topic>Welfare state</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sanders, A E</creatorcontrib><creatorcontrib>Slade, G D</creatorcontrib><creatorcontrib>John, M T</creatorcontrib><creatorcontrib>Steele, J G</creatorcontrib><creatorcontrib>Suominen-Taipale, A L</creatorcontrib><creatorcontrib>Lahti, S</creatorcontrib><creatorcontrib>Nuttall, N M</creatorcontrib><creatorcontrib>Allen, P Finbarr</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of epidemiology and community health (1979)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sanders, A E</au><au>Slade, G D</au><au>John, M T</au><au>Steele, J G</au><au>Suominen-Taipale, A L</au><au>Lahti, S</au><au>Nuttall, N M</au><au>Allen, P Finbarr</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A cross-national comparison of income gradients in oral health quality of life in four welfare states: application of the Korpi and Palme typology</atitle><jtitle>Journal of epidemiology and community health (1979)</jtitle><addtitle>J Epidemiol Community Health</addtitle><date>2009-07-01</date><risdate>2009</risdate><volume>63</volume><issue>7</issue><spage>569</spage><epage>574</epage><pages>569-574</pages><issn>0143-005X</issn><eissn>1470-2738</eissn><coden>JECHDR</coden><abstract>Background: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.Methods: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 χ2 tests specifying a critical p value of 0.008, equivalent to a Bonferroni correction of p<0.05 for the six pairwise tests.Results: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.Conclusion:The coverage and generosity of welfare state benefits appear to influence levels of inequality in population oral health quality of life.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd</pub><pmid>19351621</pmid><doi>10.1136/jech.2008.083238</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Attitude to Health Australia - epidemiology Biological and medical sciences Classification Community health Countries Data collection Dental care Economic benefits Facial bones, jaws, teeth, parodontium: diseases, semeiology Female Finland - epidemiology Flat rates General aspects Germany - epidemiology Health disparities Health outcomes Health Status Disparities Household income Humans Income Income inequality Low income groups Male Medical sciences Middle Aged Miscellaneous Non tumoral diseases Oral Health Otorhinolaryngology. Stomatology Population Poverty - economics Public health Public health. Hygiene Public health. Hygiene-occupational medicine Quality of Life Questionnaires Research reports Social Welfare - economics Socioeconomic factors Socioeconomics State Medicine - economics Studies United Kingdom - epidemiology Welfare state |
| 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 |
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