Social capital and self-rated oral health among young people

Factors associated with subjective oral health among older adults aged 65 and over living alone: the role of social capital

BACKGROUND

With the global increase in the number of older adults and single-person households, attention is increasingly being directed toward older adults living alone as a vulnerable population in public health. These individuals are particularly susceptible to deficiencies in social capital, one of the key social determinants of health. However, research on the relationship between social capital and oral health among older adults living alone remains limited. Therefore, this study aims to analyze the factors associated with oral health in this population, with a specific focus on social capital.

METHODS

This study analyzed data from the Korean Community Health Survey, 2023, focusing on 21,677 older adults aged 65 and over living alone. The dependent variable was subjective oral health level, while independent variables included social capital factors such as trust, reciprocity, social network, and social participation. Hierarchical logistic regression analysis was conducted to investigate the relationship between social capital and subjective oral health levels, with results presented as odds ratios and 95% confidence intervals.

RESULTS

Older adults aged 65 and over living alone were found to be particularly vulnerable to poor subjective oral health, especially those with older age, lower educational attainment, lower income levels, lack of economic activity, and residence in rural areas. Among the social capital variables, the analysis showed that individuals without reciprocity had 1.30 times higher odds of worse subjective oral health compared to those with reciprocity (OR = 1.30, 95% CI 1.18-1.42). Similarly, individuals without social participation had 1.31 times higher odds of worse subjective oral health compared to those with social participation (OR = 1.31, 95% CI 1.21-1.42).

CONCLUSIONS

Social capital is significantly associated with the subjective oral health levels of older adults aged 65 and over living alone. This emphasizes the importance of enhancing social capital to mitigate oral health inequalities among socially vulnerable older adults living alone.

Relationship among different levels of individual and community social capital with oral health related-quality of life among adolescents

AIM

To evaluate the relationship of different levels of social capital with oral health-related adolescents' quality of life (OHRQoL).

METHODS

This is a cross-sectional study nested in a cohort study started in 2010 with a sample of children 1 to 5 years old from Brazil. Individuals were followed after 10 years, data which was considered in this study (11 to 15 years old). OHRQoL was evaluated by the short version of CPQ11-14. Individual social capital (ISC) was assessed through the presence of individual social networks and social trust. Community social capital (CSC) was assessed through the presence of voluntary institutions, community cultural centers or residents' associations. For both ISC and CSC, the participants were classified as with high social capital (at least one source) or low social capital (absence of any source). Adjusted Poisson Regression analysis was performed to verify the interaction of different levels of social capital and OHRQoL. Results are present in Rate Ratio (RR) and 95 % confidence interval (95 % CI).

RESULTS

A total of 429 adolescents were evaluated. Adolescents with low CSC and low ISC presented CPQ11-14 scores 36 % higher (RR 1.36 95 %CI 1.15-1.62) than counterparts who presented higher social capital levels. The interaction among high and low levels of social capital was not associated with CPQ11-14 scores, indicating that no level stands out over the other.

CONCLUSION

Only the total absence of both levels of social capital negatively related with OHRQoL, indicating the importance of the presence of at least one source of social capital.

CLINICAL RELEVANCE

The findings show that social capital affects OHRQoL, a crucial psychosocial aspect considering the clinical practice.

Associations of Social Psychological Factors and OHRQoL in Periodontitis Patients: A Structural Equation Modeling Study

Background and Purpose

Periodontitis is the leading cause of tooth loss in adults worldwide. The functional loss, nutritional deficiencies, and psychological barriers it causes, as well as its impact on overall health and quality of life, are all significant. The prevalence of periodontal disease is high in China. Our study aimed to determine the intricate relationship between periodontal disease status, dental anxiety, self-rated oral health (SROH), self-efficacy for oral care, perceived social support, socioeconomic status (SES), and the oral health-related quality of life (OHRQoL) among periodontitis patients.

Methods

This cross-sectional study used purposive sampling to identify 247 patients with periodontitis who entered the First Affiliated Hospital of Bengbu Medical University between October 2022 and October 2023. 247 participants underwent a periodontal clinical examination combined with imaging, adhering to the "2018 world new classification of periodontal and peri⁃implant diseases and conditions". Participants also completed a detailed questionnaire in paper format, which included OHRQoL, sociodemographic details, dental anxiety, SROH, self-efficacy in oral care, perceived social support, and subjective SES.

Results

Dental anxiety, self-efficacy for oral care, and SROH all had a direct and significant effect on OHRQoL. OHRQoL was indirectly related to SROH mediated by dental anxiety and subjective SES, perceived social support and self-efficacy for oral care, respectively. SROH was directly related to subjective SES, and at the same time, they had a direct effect on dental anxiety. Furthermore, patient's age, gender, annual household income, and education level were significantly associated with the degree of periodontal disease.

Conclusion

OHRQoL and periodontal status was influenced by socio-demographics characteristics, dental anxiety, SROH, self-efficacy for oral care, perceived social support, subjective SES in periodontitis patients. These insights underscore the importance of adopting a holistic approach in the management and treatment of periodontal diseases.

Self-perceived quality of social roles, activities and relationships predicts incident gingivitis

OBJECTIVES

While physical health status is known to impact social functioning, a growing literature suggests that social well-being may affect oral health. This investigation evaluated whether self-perceived quality of social roles, activities and relationships (social well-being) influences gingival inflammation.

METHODS

Data were from the Population Assessment of Tobacco and Health Study, a nationally representative cohort of US adults, biennial waves 4 (2017) to 6 (2021). Social well-being was derived from the validated PROMIS Global-10 survey instrument, categorized for this longitudinal analysis as high, moderate or low. The main outcome was incident self-reported gum bleeding (dichotomous, proxy for gingivitis). Survey-weighted logistic regression modelling adjusted for overall health status, sociodemographic (e.g. age, sex, race/ethnicity), socioeconomic (e.g. income, education) and behavioural (e.g. tobacco, alcohol) confounders and was used to predict marginal mean gum bleeding incidence.

RESULTS

Cross-sectionally at wave 4 (N = 23 679), gum bleeding prevalence was higher along a stepwise gradient of decreasing satisfaction with social activities and relationships (extremely satisfied: 20.4%; not at all: 40.1%). Longitudinally, among participants who had never reported gum bleeding through wave 4 (N = 9695), marginal predicted new gum bleeding at wave 6 was greater with each category of lower wave 4-5 social well-being (high: 7.6%; moderate: 8.6%; low: 12.4%). Findings were robust to alternative model specifications. Results should be interpreted considering study limitations (e.g. potential unmeasured confounding; outcome by self-report).

CONCLUSIONS

Social functioning may affect physical health. Specifically, social roles, activities and relationships may influence inflammatory oral conditions, like gingivitis. Confirmatory research is warranted, along with policies and interventions that promote social well-being.

The role of health and health systems in promoting social capital, political participation and peace: A narrative review

High levels of violence and insecurity are highly detrimental for societies. United Nations Sustainable Development Goal 16 is advocating for peaceful, accountable and inclusive institutions as one powerful channel to foster global development. Investing in health and health policies can potentially contribute achieving these objectives. After providing a conceptual framework, this article reviews the existing literature on the evidence of the role of health and health systems in promoting social capital and trust, political engagement and participation, and peace that closely relate to the objectives of Sustainable Development Goal 16. We provide evidence of a systematically positive impact of better physical and mental health on social capital, and on political participation, both contributing to the sustainability of inclusive democratic institutions. We also document that health and health systems can help supporting peace, both via the reduction of social inequality and grievances, and by reducing the disruptive effects of epidemic shocks. Overall, the study provides evidence that health and health systems can generate co-benefits outside the health domain by promoting social capital, political participation and peace.

Psychosocial aspects associated with self-reported oral health in Brazilians older adults

OBJECTIVES

Oral health conditions can be determined by a series of factors that include psychosocial aspects. Therefore, this study aimed to investigate the association between psychosocial aspects and self-reported oral health in Brazilian older adults.

METHODS

The Brazilian Longitudinal Study of Ageing (ELSI-Brazil) baseline data was analysed to develop this cross-sectional study. The outcome was self-reported oral health, and the psychosocial aspects included neighbourhood trust, life satisfaction and depressive symptoms. The associations were determined through Poisson regression models, controlling for socioeconomic, demographic and behavioural characteristics.

RESULTS

A total of 9365 individuals with aged 50 years or over were included in this study. Individuals with good life satisfaction had 16% (PR: 0.84; 95% CI: 0.78-0.90) lower prevalence of having poor self-reported oral health. Individuals who have depressive symptoms and do not trust in the neighbourhood presented 17% (PR: 1.17; 95% CI: 1.09-1.25) and 12% (PR: 1.12; 95% CI: 1.04-1.21) higher prevalence of poor self-report oral health compared to those who did not show depressive symptoms and trust the neighbourhood.

CONCLUSION

Our findings suggest that positive psychosocial aspects are moderately associated with better self-reported oral health. Therefore, we suggest that psychological health and social interaction should be present in public health policy actions.

Associations of Attitudes and Practice Toward Oral Health, Socioeconomic Status, Self-Rated Oral Health, Subjective Oral Symptoms, and Oral Health-Related Quality of Life Among Residents in Eastern China: A Structural Equation Modeling Approach

Background and Purpose

The purpose of this study was to investigate the relationships among attitudes and practice about oral health, socioeconomic status, subjective oral symptoms, self-rated oral health, and oral health-related quality of life (OHRQoL) in a group of people from eastern China.

Methods

Between January 2021 to February 2022, 2502 (87.4%) of the 2863 participants completed an online questionnaire. OHRQoL, Socio-demographics characteristics, attitudes and practice toward oral health, self-rated oral health and subjective oral symptoms were all covered by the questionnaires. Based on the hypothetical model, structural equation modeling with the bootstrap method was used to examine the interactions and the strength of the correlations between the measured variables.

Results

The final model demonstrated acceptable data fit. Socioeconomic status (β = -0.051), attitudes (β = -0.100) and practice (β = -0.127) toward oral health, self-rated oral health (β = -0.493) and subjective oral symptoms (β = 0.294) were all significantly correlated with OHRQoL. Socioeconomic status was directly linked to attitudes (β = 0.046) and practice (β =0.070) about oral health, and attitudes play the role of intermediary between practice and socioeconomic status (β = 0.018). OHRQoL was indirectly linked with attitudes mediated by practice (β = -0.092), practice mediated by subjective oral symptoms (β = -0.107), subjective oral symptoms mediated by self-rated oral health (β = 0.031). OHRQoL was correlated with income, educational level, and socioeconomic status. Self-rated oral health was related to educational level and socioeconomic status.

Conclusion

In a sample of eastern China residents, OHRQoL was influenced by socioeconomic status, attitudes and practice toward oral health, subjective oral symptoms, and self-rated oral health.

Social support and oral health among working-age and older adults in the United States

OBJECTIVES

The purpose of this study was to examine the association of social support with untreated dental caries and severe tooth loss in adults in the United States.

METHODS

This cross-sectional study was conducted by analyzing data obtained from 5,447 individuals, 40 years of age and older, in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2008 who had both a complete dental examination and social support index measures. Sample characteristics, overall and by social support level, were examined through descriptive statistical analyses. Logistic regression analyses were performed to estimate the association of social support with untreated dental caries and severe tooth loss.

RESULTS

In this nationally representative sample (mean age 56.5 years) the prevalence of low social support was 27.5%. The prevalence of individuals with moderate-to-high social support increased with higher levels of educational attainment and income level. In fully adjusted models, relative to those who had moderate-high social support levels, individuals with low social support had 1.49 higher odds of untreated dental caries (95% CI, 1.17-1.90, p=0.002) and 1.23 higher odds of severe tooth loss (95% CI, 1.05-1.44, p=0.011).

CONCLUSIONS

Higher odds of untreated dental caries and severe tooth loss were found among U.S. adults with low levels of social support compared to those with moderate-to-high levels of social support. Additional studies are warranted to provide a more current perspective on the impact of social support on oral health so that programs may be developed and tailored to reach these populations.

Disentangling the complexities of modelling when high social capital contributes to indicating good health

The association between social capital and health is under continuous research. Based both on theoretical frameworks and previous empirical studies, the magnitude and sign of this association are ambiguous. Our main goal is to empirically investigate under which conditions is social capital relevant to obtain good or very good self-rated health, while acknowledging that different paths can lead to this outcome. The data used in this study come from the European Social Survey 2018 (47,423 observations for 29 European countries) and fuzzy-set qualitative comparative analysis was adopted. Our results show that neither the presence of social capital (as measured in this study - 'Generalised trust' and/or 'Informal social connections'), nor its absence, is a necessary condition for good or very good self-rated health. While not being necessary, there are contexts where social capital is relevant for health and, whenever it is present, it positively contributes to good or very good self-rated health. However, our results further suggest that social capital alone is not sufficient to be healthy. The relevance of social capital is contingent on the presence, or absence, of other conditions. What works for some individuals does not work for others. And for any given individual, rarely there is only one way to be healthy. Additionally, our findings suggest that the impact of belonging to a minority ethnic group on health might be stronger than what has been hitherto recognised.

Understanding the Link between Household Food Insecurity and Self-Rated Oral Health in Ghana

There is increasing scholarly attention on the role of food insecurity on the health of older adults in sub-Saharan Africa, including Ghana. Yet, we know very little about the association between food insecurity and self-rated oral health. To address this void in the literature, this study uses a representative survey of adults aged 60 or older from three regions in Ghana to examine whether respondents who experienced household food insecurity rated their oral health as poor compared to their counterparts who did not. We found that 34% of respondents rated their oral health as poor, while 7%, 21%, and 36% experienced mild, moderate, and severe food insecurity, respectively. Moreover, the results from the logistic regression analysis showed that older adults who experienced mild (OR = 1.66, p < 0.05), moderate (OR = 2.06, p < 0.01), and severe (OR = 2.71, p < 0.01) food insecurity were more likely to self-rate their oral health as poor, compared to those who did not experience any type of food insecurity. Based on these findings, we discuss several implications for policymakers and directions for future research.

Social Capital Promotes a Healthier Diet among Young Adults by Reducing Psychological Distress

Studies have revealed the links between social capital and diet. However, the mediating role of psychological distress in this relationship has been understudied. This study aims to identify direct and indirect relationships between social capital and adherence to the Mediterranean diet among Lithuanian young adults and identify the mediating role of psychological distress in this relationship. Data were collected from 1336 young adults, aged 18-36 years; 40.5% were males. MEDAS was used to measure adherence to a healthy diet. Social capital was measured by eight separate items in terms of family support, social support, social cohesion, social trust, communication, collaboration, participation, and distant communication. Kessler's six-item scale was used to assess psychological distress. Higher family support (β = 0.105), higher social participation (β = 0.294), and lower psychological distress (β = 0.073) directly predicted higher adherence to the Mediterranean diet. Social capital was indirectly related to adherence to the Mediterranean diet, with standardized effect sizes of 0.02-0.04, indicating small effect sizes. Thus, psychological distress mediates the relationship between social capital and a healthy diet. Given that social capital is related to psychological health and both directly and indirectly predicts healthy behavior in young adults, further longitudinal and experimental research is required to measure the effects of the intervention on incorporating, facilitating, encouraging, and implementing measures to strengthen the social connection between people and groups of people within the community, neighborhood, and organizations.

Factors associated with self-perceived oral health in different age groups

OBJECTIVES

To determine the factors associated with self-perceived oral health (SPOH) in different age groups.

METHODS

This cross-sectional study used probabilistic samples of adolescents, adults and older adults from São Paulo State, Brazil. SPOH was assessed using a global self-rating item. Hierarchical Poisson regression models were used to determine the estimated prevalence ratios (PRs) and 95% confidence intervals (CIs) for poor SPOH and demographic and socio-economic variables, social capital, dental attendance and clinical measures. The analyses for each age group were performed separately.

RESULTS

Data from 5314 adolescents, 5815 adults and 5556 older adults were analysed. Female adolescents and adults, non-White adults and older adults with a higher educational level had worse SPOH. Adolescents, adults and older adults with lower social capital showed higher rates of poor SPOH (PR = 1.58; 95% CI: 1.27-1.97, PR = 1.20; 95% CI: 1.10-1.31 and PR = 1.26; 95% CI: 1.06-1.49, respectively). Those whose reason for last dental attendance was treatment had worse SPOH, regardless of age group. Adolescents, adults and older adults with greater number of decayed teeth had worse SPOH (PR = 1.56; 95% CI: 1.37-1.77, PR = 1.30; 95% CI: 1.22-1.38, and PR = 1.29; 95% CI: 1.17-1.42, respectively). Adolescents and adults with more missing teeth presented higher rates of poor SPOH (PR = 1.23; 95% CI: 1.04-1.44 and PR = 1.09; 95% CI: 1.02-1.16, respectively). Older adults needing a dental prosthesis had worse SPOH (PR = 2.13; 95% CI: 1.88-2.41).

CONCLUSION

There are differences in the factors associated with SPOH between age groups, and these differences reflect social inequalities in health.

Social capital and oral health in children and adolescents: A systematic review and meta-analysis

OBJECTIVES

To systematically evaluate the association of individual and contextual social capital with oral health outcomes in children and adolescents.

METHODS

Electronic searches were performed in PubMed/Medline, Embase, Web of Science and Scopus databases for articles published from 1966 up to June 2021. Two calibrated reviewers screened and critically appraised the identified papers. Observational studies that evaluated the relationship of individual or/and contextual social capital or their proxies with oral health outcomes in children and adolescents using validated methods were included. Quality assessment was conducted using the Newcastle-Ottawa Scale. Data were extracted for narrative synthesis and meta-analysis followed by a meta-regression model. Meta-analysis using random effects method was used to estimate pooled prevalence ratio (PR) and 95% confidence intervals (CI).

RESULTS

Of the 3060 studies initially retrieved, 31 were included in the systematic review and 21 in the meta-analysis, totalling 81 241 individuals. The clinical outcomes included dental caries and gingival bleeding and subjective outcomes were oral health-related quality of life (OHRQoL) and self-rated oral health (SROH). Individuals with lower levels of individual social capital had a higher prevalence of poor clinical (PR 1.11; 95%CI 1.02-1.22) and subjective (PR 1.25; 95%CI 1.09-1.45) oral health conditions. The prevalence of worse clinical (PR 1.34; 95%CI 1.11-1.61) and subjective (PR 1.56; 95%CI 1.13-2.16) oral health outcomes were also associated with lower levels of contextual social capital. In general, the contextual level of social capital exerted more impact, and the subjective oral health outcomes were the more affected.

CONCLUSIONS

Contextual and individual social capital were positively related to oral health outcomes, such as dental caries, gingival bleeding, SROH and OHRQoL in children and adolescents.

Social capital and oral health promotion: Past, present, and future challenges

Social capital has been widely inserted in health discussions in recent decades. In this sense, social capital has become a popular term and has been highlighted as one of the main determinants of health in the conceptual framework of the social determinants of the World Health Organization. The concept of social capital focuses on the positive consequences of sociability and places these consequences in the broader discussion of capital. In this sense, social capital reflects the benefits that individuals and communities derive from having broad social networks or high levels of social trust. Despite controversies regarding its definition and numerous criticisms, a growing body of evidence suggests that high levels of social capital benefit oral health. This factor has also been recognized as a potential softener of the impact of oral conditions on oral health, through behavioural and psychosocial processes. Thus, efforts to reduce inequities in oral health preferably should be based on their origins and on their complex causal process, such as the social determinants. The future challenges in the area are specially related to the development of interventions and health promotion actions that aim to stimulate social capital, aiming to reduce the impact of social inequalities on oral health throughout the life course.

Trends in Self-Rated Oral Health and Its Associations with Oral Health Status and Oral Health Behaviors in Japanese University Students: A Cross-Sectional Study from 2011 to 2019

Self-rated oral health (SROH) is a valid, comprehensive indicator of oral health status. The purpose of this cross-sectional study was to analyze how oral health behaviors and clinical oral status were associated with SROH and how they had changed over the course of nine years in Japanese university students. Data were obtained from 17,996 students who underwent oral examinations and completed self-questionnaires from 2011 to 2019. Oral status was assessed using the decayed and filled teeth scores, bleeding on probing (BOP), probing pocket depth, the Oral Hygiene Index-Simplified (OHI-S), oral health behaviors, and related factors. SROH improved from 2011 to 2019. The logistic regression model showed that university students who were female and had a high daily frequency of tooth brushing, no BOP, no decayed teeth, no filled teeth, and a low OHI-S score and were significantly more likely to report very good, good, or fair SROH. An interaction effect was observed between survey year and regular dental check-ups (year × regular dental check-ups). The improvement trend in SROH might be associated with changes in oral health behaviors and oral health status.

The association between social capital indicators and psychological distress in Catalan adolescents

According to the WHO, globally, one in seven adolescents experiences a mental disorder, being in a detrimental situation toward educational achievement, social cohesion, future health and life chances. Calls to identify risk and resilience factors to develop effective preventive actions have been made. Following a systemic approach, we conducted a cross-sectional study on the relationship between social capital and psychological distress in a sample of Catalan adolescents in Barcelona, taking into account a range of other relevant aspects at different levels influencing mental health, including gender, age, migrant status, family background, lifestyle factors, body mass index, and self-rated health. Data were collected through validated questionnaires in December 2016 from 646 of 14- to 18-year-old adolescents from three public and private high schools in Barcelona (Spain). Data analysis included descriptive analysis, a correlational study and logistic regression to obtain the odds ratio for social capital indicators to be associated with psychological distress. Our results suggest that reporting higher levels of family support and higher levels of teacher-student trust reduce the likelihood of suffering psychological distress. Higher levels of neighborhood informal control were associated with mental health, but a possible detrimental effect cannot be ruled out. Being a girl, reporting low self-rated health or higher media use was also associated with higher likelihood of psychological distress. Current results may encourage interventions that focus on social capital as a means to reduce psychological distress and foster well-being in youth.

Sense of coherence moderates the relationship between social capital and oral health‑related quality of life in schoolchildren: a 10-year cohort study

Background

This study aimed to evaluate the moderating effect of sense of coherence (SOC) on the relationship between social capital and oral health-related quality of life (OHRQoL) among schoolchildren.

Methods

A cohort study was conducted in the city of Santa Maria, Brazil, involving children aged 1–5 years at baseline who were reassessed after 10 years in adolescence (11–15 years-old). Social capital was assessed at baseline and follow-up through social networks and social trust. Sense of coherence scale (SOC-13) and the short form of the Child Perceptions Questionnaire 11–14 (CPQ11–14) were measured at 10-years follow-up. Demographic and socioeconomic characteristics, and dental caries were also evaluated. Moderating effect of SOC on the relationship between social capital and OHRQoL was tested using multilevel adjusted Poisson regression analysis and simple slope test.

Results

From the 639 subjects assessed at baseline, 429 were reassessed at follow-up (cohort retention rate 67.1%). Moderate and high levels of SOC demonstrated a moderating effect on the relationship between social capital and OHRQoL. Among individuals who presented low social capital at baseline and follow-up, those who had high SOC reported, respectively, an impact 63% and 70% lower on OHRQoL when compared to those with low SOC. The greatest margin effect was observed in individuals with low social capital and low SOC at follow-up (24.25; p < 0.05).

Conclusion

Our findings suggest that SOC moderates the negative impact of low social capital on poor OHRQoL in schoolchildren.

Association between social capital and oral health among adults aged 50 years and over in China: a cross-sectional study

Background

Social capital has a potential effect in protecting oral health among population. However, no study has explored the association between social capital and oral health in the Chinese context. Due to the unique culture, political, social context in China, it is important to understand their association in the Chinese context. The study aims to investigate the association between cognitive and structural dimensions of social capital with edentulism among adults aged 50 years and over in China.

Method

The study used data from the WHO SAGE (Study on Global AGEing and Adult Health) wave 1 China component. Structural social capital was operationalized as social participation. Cognitive social capital was operationalized as perceived community trust and perceived community safety. Community-level social capital was measured by aggregating individual-level social capital into community level. Oral health was measured using a final marker of oral health status, self-reported edentulism. A 2-level multilevel logistic regression was used to evaluate the association between different dimensions of social capital and oral health.

Results

In total, 12,856 individuals were included in the study, the overall prevalence of edentulism was 9.1% (95% CI 8.3–10.0). Multilevel logistic analysis revealed that individual-level social capital and community-level social capital are independently associated with edentulism. Individuals with low structural social capital and living in areas with low structural social capital have, respectively, 1.54 (95% CI 1.18–2.01) and 2.14 (95% CI 1.47–3.12) times higher odds for edentulism, after adjustment for potential confounders (age, sex, marital status, residence locality, wealth, education level, chronic conditions) and a potential mediator(smoking).

Conclusions

Living in a community with lower structural social capital and individual with low structural social capital is associated with higher risk for edentulism among adults aged 50 years and over in China.

Possible association between oral health and sleep duration: A cross-sectional study based on the Korean National Health and Nutrition Examination Surveys from 2010 to 2015

This study was performed to investigate the association between oral health and sleep duration in South Korean subjects using 2010-2015 data from the Korean National Health and Nutrition Examination Survey (KNHANES).Cross-sectional data on 35,599 adults over the age of 19 years who completed KNHANES were analyzed. All participants reported subjective oral health status and their daily average sleep duration using a self-reported questionnaire. Sleep duration and oral health status were divided into 3 categories: ≤5, 6-8, ≥9 h/day and good, fair, poor, respectively.The overall prevalence of poor oral health status was 43.8%. Univariate analysis demonstrated that poor oral health status was significantly associated with age, smoking, alcohol, diabetes, education, income, depression, marital status, and sleep duration. After adjusting for covariates (age, sex, diabetes mellitus, hypertension, obesity, smoking, income, education, marital status), sleep durations of ≤5 hours (OR = 1.42; 95% CI, 1.26-1.60) and ≥9 hours (OR = 1.21; 95% CI, 1.04-1.40) were significantly associated with poor oral health, compared to a sleep duration of 6-8 hours. Short or long sleep duration was more likely to have an impact on the development of poor oral health status in men than in women. A significant relationship between sleep duration and oral health status was found in participants younger than 60 years.This is the first report that both short and long sleep durations are significantly associated with the development of poor oral health status. The effect of short or long sleep duration on poor oral health was more significant in younger subjects and in men.

Role of social support in the relationship between financial hardship and multimorbidity-a causal mediation analysis

BACKGROUND

Social disadvantage is a key determinant of multimorbidity. Pathways through which social disadvantage leads to multimorbidity are yet undefined. In this study, we first examined the causal effect of moving into financial hardship on multimorbidity among Australian adults, and then the role of social support as a mediator of the relationship between financial hardship and multimorbidity.

METHODS

Data were obtained from the Household, Income and Labour Dynamics in Australia (HILDA) Survey (2009-2013). We identified individuals who moved into financial hardship between 2010 and 2011 (n = 5775). Inverse probability treatment weighting with regression adjustment was used to examine the relationship between financial hardship and multimorbidity. Causal mediation analysis was applied to decompose the total effect of financial hardship on multimorbidity into the proportion attributable to social support and the proportion not occurring through measured pathways. We accounted for baseline covariates including age, sex, marital status, educational attainment, employment status, income, country of birth, multimorbidity and social support. Bootstrapping with 1000 replications was used to calculate 95% confidence intervals (CIs).

RESULTS

The risk of multimorbidity was higher in those with financial hardship by 19% [relative risk 1.19 (95% CI: 1.02-1.37) and absolute risk difference 0.036 (95% CI: 0.004-0.067)] than those without financial hardship. Social support accounted for 30% of the total effect of financial hardship on multimorbidity, risk difference 0.009 (95% CI: 0.003-0.018).

CONCLUSIONS

Financial hardship leads to increased risk of multimorbidity. Interventions directed at increasing social support among those in financial hardship may reduce their risk of multimorbidity.

Perceived social support and discrimination and oral health behaviors in adolescents

OBJECTIVES

The aims of this study were to examine the associations between perceived social support and oral health behaviors among adolescents and if this perception had a protective effect against the influence of perceived racial discrimination on oral health behaviors in this population.

MATERIAL AND METHODS

Participants of this cross-sectional study were adolescents aged 12-18 years recruited from University dental clinic. They completed a questionnaire comprising three sections: demographics (14 items), oral health behaviors (6 items), and validated Personal Resource Questionnaire (25 items). Perceived discrimination was evaluated by a question asking if the adolescent had ever experienced discrimination based on their race.

RESULTS

Of 252 participants, mean (SD) age of 14 (1.8) years, 60% were girls, 56% were self-identified as White, and 81% were born in Canada. Discrimination was reported by 21%. Frequency of toothbrushing and self-rated oral health were significantly associated with increased levels of perceived social support. Sugar consumption was significantly different for participants with and without perceived racial discrimination (p-value = 0.002). Perceived social support did not act as a buffer against perceived racial discrimination for sugar consumption (OR = 1.00; 95% CI: 0.98-1.01).

CONCLUSIONS

Adolescents' perceived social support affected some aspects of their oral health but did not moderate the influence of perceived racial discrimination.

Association of sense of coherence with oral health behaviors and gingival bleeding among adolescents

Context:

Adolescents experience many types of gingival and periodontal diseases, including gingivitis, localized or generalized aggressive periodontitis, and periodontal complications of various systemic diseases. The occurrence of periodontal diseases is not only related to biotic factors but may also be affected by nonbiotic factors such as oral health behaviors and practices. Various factors that influence an individual's health-related behaviors include a psychosocial construct named sense of coherence (SOC).

Aim:

The aim of this study is to investigate the association of SOC with oral health behaviors and gingival bleeding.

Settings and Design:

This was a cross-sectional, analytical study that was done in the school setting.

Materials and Methods:

A random sample of 850 adolescents was selected from nine schools of the Faridabad block of Faridabad district (Haryana) through the multistage cluster sampling technique. Methods of data collection included a combination of questionnaire administration and clinical examination. The questionnaire comprised sociodemographic variables, questions related to oral health behaviors, and Antonovsky's SOC scale. The questionnaire was interviewer administered.

Statistical Analysis:

Unadjusted and adjusted rate ratios of gingival units having bleeding on probing were estimated by Poisson regression multilevel analysis in Statistical Package for the Social Sciences (SPSS) software for Microsoft Office.

Results:

Adolescents whose mothers had studied <8 years (relative risk [RR] 1.26; 95% confidence interval [CI] 1.04–1.38), who were males (RR 1.198; 95% CI 1.01–1.29), low SOC (RR 15.93; 95% CI 13.06–19.35), and toothbrushing frequency of less than once a day (RR 1.43; 95% CI 1.21–1.67) and children with plaque index >1 (RR 2.765; 95% CI 2.12–3.25) presented with the higher number of gingival units having bleeding.

Conclusion:

SOC is associated with gingival bleeding through oral health behaviors.

A Multilevel Perspective on the Health Effect of Social Capital: Evidence for the Relative Importance of Individual Social Capital over Neighborhood Social Capital

Employing a multilevel perspective on the health effects of social capital, this study analyzes how individual and neighborhood differences in self-rated health in Ghent (Belgium), relate to individual and collective social mechanisms, when taking demographic and socioeconomic characteristics of individuals into account. This study estimates the health effects of social trust, informal social control and disorder at the neighborhood level and social support and network size at the individual level, using indicators indebted to both the normative and resource-based approaches to social capital. Instead of the mere aggregation of individual indicators of social capital, this study uses the key informant technique as a methodologically superior measurement of neighborhood social capital, which combined with a multilevel analysis strategy, allows to disentangle the health effects of individual and neighborhood social capital. The analysis highlights the health benefits of individual social capital, i.e., individual social support and network size. The study indicates that controlling for individual demographic and socioeconomic characteristics reduces the effect of the neighborhood-level counterparts and the neighborhood characteristics social trust and neighborhood disorder have significant, but small health effects. In its effects on self-rated health, social capital operates on the individual level, rather than the neighborhood level.

The Direct and Indirect Relationships of Environmental, Interpersonal and Personal Factors with High School Students Physical Activity: An Ecological Approach

BACKGROUND

Across countries, young people are not sufficiently physically active. The evidence confirms that beyond demographic and individual agents, individuals participate within their social and physical environment. The ecological model enables a search for the modifiable factors in specific populations, as it allows consideration of factors affecting individuals' lives on different levels, as well as considering the interplay of those factors. The aim of this study was to examine the complex interconnections among environmental, social capital and motivational factors at different levels, within an ecological model for high school students' moderate-to-vigorous physical activity during their leisure time.

METHODS

This cross-sectional population-based study included 1285 students from 14 to 18 years old, with a mean age of 16.14 ± 1.22. Physical activity, neighborhood physical activity recourses, neighborhood safety, social capital, physical activity motivation and sociodemographic factors were evaluated. Logistic regression, mediation and moderation analyses were performed predicting moderate-to-vigorous physical activity during leisure time.

RESULTS

In the final multivariate logistic regression model, greater social participation (OR 1.03 [1.01-1.05]), higher relative autonomy index (OR 1.11 [1.06-1.15]) and male gender (OR 1.71 [1.13-2.57]) directly predicted meeting MVPA recommendations. Any significant moderation effects (p > 0.05) of environmental characteristics were not found for the relationship between social capital, motivational factors and moderate-to-vigorous physical activity. The evidence of positive indirect mediation effects was found in all five models for social capital components as all CIs for its βs do not contain 0, though standardized effect sizes were between 0.02 and 0.07, indicating small effect sizes.

CONCLUSION

These findings provide support for the presence of some direct and indirect pathways from social capital to moderate-to-vigorous physical activity. Future intervention strategies should focus on strengthening physical activity motivation by encouraging the development of social network and social participation as well as family, neighborhood and school social capital within the framework of the ecological model.

Living with Family Is Directly Associated with Regular Dental Checkup and Indirectly Associated with Gingival Status among Japanese University Students: A 3-Year Cohort Study

Although some studies showed that lifestyle was associated with oral health behavior, few studies investigated the association between household type and oral health behavior. The aim of this prospective cohort study was to investigate the association between household type, oral health behavior, and periodontal status among Japanese university students. Data were obtained from 377 students who received oral examinations and self-questionnaires in 2016 and 2019. We assessed periodontal status using the percentage of bleeding on probing (%BOP), probing pocket depth, oral hygiene status, oral health behaviors, and related factors. We used structural equation modeling to determine the association between household type, oral health behaviors, gingivitis, and periodontitis. At follow-up, 252 students did not live with their families. The mean ± standard deviation of %BOP was 35.5 ± 24.7 at baseline and 32.1 ± 25.3 at follow-up. In the final model, students living with their families were significantly more likely to receive regular dental checkup than those living alone. Regular checkup affected the decrease in calculus. The decrease in calculus affected the decrease in %BOP over 3 years. Living with family was directly associated with regular dental checkups and indirectly contributed to gingival status among Japanese university students.

Association between Household Exposure to Secondhand Smoke and Dental Caries among Japanese Young Adults: A Cross-Sectional Study

The long-term effects of secondhand smoke (SHS) on dental caries among Japanese young adults remain unclear. The purpose of this cross-sectional study was to evaluate whether household exposure to SHS is associated with dental caries in permanent dentition among Japanese young adults. The study sample included 1905 first-year university students (age range: 18-19 years) who answered a questionnaire and participated in oral examinations. The degree of household exposure to SHS was categorized into four levels according to the SHS duration: no experience (-), past, current SHS < 10 years, and current SHS ≥ 10 years. Dental caries are expressed as the total number of decayed, missing, and filled teeth (DMFT) score. The relationships between SHS and dental caries were determined by logistic regression analysis. DMFT scores (median (25th percentile, 75th percentile)) were significantly higher in the current SHS ≥ 10 years (median: 1.0 (0.0, 3.0)) than in the SHS-(median: 0.0 (0.0, 2.0)); p = 0.001). DMFT ≥ 1 was significantly associated with SHS ≥ 10 years (adjusted odds ratio: 1.50, 95% confidence interval: 1.20-1.87, p < 0.001). Long-term exposure to SHS (≥10 years) was associated with dental caries in permanent dentition among Japanese young adults.

Connection between Social Capital and Sport Success of Young Tennis Players

Young athletes are influenced by different physical, psychological, and social factors. Social factors significantly impact a young athlete’s growth. Parents, coaches, and schools are important factors in young athletes’ sports careers. Achieving sport success without their support would be a real challenge. Social capital is a resource that comes from social relationships and social networks. It is a resource that impacts athletes and sports performance. The aim of this study was to determine the connection between social capital and competitive success in young tennis players. This research was conducted with participants of an ITF (International Tennis Federation) junior tournament in tennis. Research included 75 tournament players (N = 36 girls, age: 15.54 ± 1.29 years; N = 39 boys, age: 16.13 ± 0.98 years). Participants filled out a questionnaire which evaluated their social capital. Social capital predictors were significant predictors of sporting success (13.1% variance explained), which indicated that there is a moderate association between social capital indicators and sport success in young tennis players. Sports performance was higher with a higher degree of family and sports team social capital among girls. It was higher with a lower school social capital among boys. Intervention that leverages social capital might serve as an avenue for performance promotion in youth.

Effect of dental caries and socioeconomic status on social capital throughout adolescence: a 6-year follow-up

The aim of the study was to investigate the influence of clinical and socioeconomic factors on social capital throughout adolescence. A cohort study was performed in 2012 (T1) with a random sample of 1,134 12-year-old adolescents from Santa Maria, Brazil. Questions on socioeconomic factors (maternal education, household income, household crowding) were answered by the parents. Clinicians evaluated their dental caries (decayed, missing, and filled status of permanent teeth) and gingival bleeding (using the Community Periodontal Index). Contextual variables including the mean income of the neighborhood in which the school was located were used (T1). The adolescents were revaluated in 2018 (T2) and answered questions regarding social capital (social trust, social control, empowerment, neighborhood security, and political effectiveness). A path analysis was used to test the relationship between the predictor variables (T1) and social capital (T2). A total of 768 adolescents were reevaluated at a 6-year follow-up (cohort retention rate of 67.7%). Most of the adolescents were girls, with a low household income, about 40% had caries experience (T1), and about 64% had high social capital (T2). The highest neighborhood's mean income was related to a lower household income in T1 (p < 0.01), and this was directly related to a low social capital in T2 (p = 0.04). Furthermore, caries experience at T1 was directly associated with low social capital at T2 (p = 0.03). Socioeconomic factors were also related to caries experience. Individuals who lived in neighborhoods with greater inequality such as families with a low household income and those with untreated dental caries in early adolescence, had a low social capital after follow-up.

Social capital, social cohesion, and health of Syrian refugee working children living in informal tented settlements in Lebanon: A cross-sectional study

BACKGROUND

Since 2011, the protracted Syrian war has had tragic consequences on the lives of the Syrian people, threatening their stability, health, and well-being. The most vulnerable are children, who face interruption of schooling and child labor. This study explored the relationship between social capital and the physical health and emotional well-being of Syrian refugee working children in rural areas of Lebanon.

METHODS AND FINDINGS

In this cross-sectional study, we surveyed 4,090 Syrian refugee children working in the Bekaa Valley of Lebanon in 2017. Children (8-18 years) gave direct testimony on their living and social environment in face-to-face interviews. Logistic regressions assessed the association of social capital and social cohesion with the health and emotional well-being of Syrian refugee working children; specifically, poor self-rated health, reporting a health problem, engaging in risky health behavior, feeling lonely, feeling optimistic, and being satisfied with life. Of the 4,090 working children in the study, 11% reported poor health, 16% reported having a health problem, and 13% were engaged in risky behaviors. The majority (67.5%) reported feeling lonely, while around 53% were optimistic and 59% were satisfied with life. The study findings suggest that positive social capital constructs were associated with better health. Lower levels of social cohesion (e.g., not spending time with friends) were significantly associated with poor self-rated health, reporting a physical health problem, and feeling more lonely ([adjusted odds ratio (AOR), 2.4; CI 1.76-3.36, p < 0.001], [AOR, 1.9; CI 1.44-2.55, p < 0.001], and [AOR, 0.5; CI 0.38-0.76, p < 0.001], respectively). Higher levels of social support (e.g., having good social relations), family social capital (e.g., discussing personal issues with parents), and neighborhood attachment (e.g., having a close friend) were all significantly associated with being more optimistic ([AOR, 1.5; CI 1.2-1.75, p < 0.001], [AOR, 1.3; CI 1.11-1.52, p < 0.001], and [AOR, 1.9; CI 1.58-2.29, p < 0.001], respectively) and more satisfied with life ([AOR, 1.3; CI 1.01-1.54, p = 0.04], [AOR, 1.2; CI 1.01-1.4, p = 0.04], and [AOR, 1.3; CI 1.08-1.6, p = 0.006], respectively). The main limitations of this study were its cross-sectional design, as well as other design issues (using self-reported health measures, using a questionnaire that was not subject to a validation study, and giving equal weighting to all the components of the health and emotional well-being indicators).

CONCLUSIONS

This study highlights the association between social capital, social cohesion, and refugee working children's physical and emotional health. In spite of the poor living and working conditions that Syrian refugee children experience, having a close-knit network of family and friends was associated with better health. Interventions that consider social capital dimensions might contribute to improving the health of Syrian refugee children in informal tented settlements (ITSs).

Caries Increment and Salivary Microbiome during University Life: A Prospective Cohort Study

The purpose of this 3-year prospective cohort study was to explore the relationship between an increase in dental caries and oral microbiome among Japanese university students. We analyzed 487 students who volunteered to receive oral examinations and answer baseline (2013) and follow-up (2016) questionnaires. Of these students, salivary samples were randomly collected from 55 students at follow-up and analyzed using next-generation sequencing. Students were divided into two groups: increased group (Δdecayed, missing, and filled teeth (ΔDMFT) score increased during the 3-year period) and non-increased group (ΔDMFT did not increase). Thirteen phyla, 21 classes, 32 orders, 48 families, 72 genera, and 156 species were identified. Microbial diversity in the increased group (n = 14) was similar to that in the non-increased group (n = 41). Relative abundances of the family Prevotellaceae (p = 0.007) and genera Alloprevotella (p = 0.007) and Dialister (p = 0.039) were enriched in the increased group compared with the non-increased group. Some bacterial taxonomic clades were differentially present between the two groups. These results may contribute to the development of new dental caries prevention strategies, including the development of detection kits and enlightenment activities for these bacteria.

Influence of social capital on self-perception related to orthodontic treatment need

Aim: To evaluate the influence of social capital on self-perception related to orthodontic treatment need. Methods: A cross-sectional study was conducted with a sample of 578 11-16 years-old adolescents from a city in southern Brazil. Social capital was evaluated using the Social Capital Questionnaire for Adolescent Students (SCQ-AS). Index of Orthodontic Treatment Need (IOTN) assessed malocclusion and self-perception related to orthodontic treatment need. Sociodemographic aspects of adolescents were also evaluated. Individual analyses were performed, relating the study variables to the outcome, estimating the odds ratio with the respective confidence intervals of 95%. The variables with p<0.20 in the individual analyses were tested in the multiple logistic regression models, and those with p<0.10 remained in the model. Results: Social capital did not influence the self-perception related to orthodontic treatment need. Adolescents with high orthodontic needs were 5.35 (CI 95%: 2.68 to 10.65) times more likely to perceived orthodontic treatment need (p <0.05). Crowding and dental absence were associated with self-perception related to orthodontic treatment need (p <0.05). Conclusions: Social capital did not influence the self-perception related to orthodontic treatment need.

Immigrant Status, Resilience, and Perceived Oral Health Among Chinese Americans in Hawaii

OBJECTIVES

This study aims to examine the associations among immigrant status, resilience, and perceived oral health for Chinese American older adults in Hawaii.

METHOD

Data derived from 430 Chinese American adults aged 55 years and older residing in Honolulu, HI. We compared the self-rated oral health and oral health problems between U.S.-born Chinese Americans and foreign-born Chinese Americans by using ordered logistic regression and ordinary least squares regression models.

RESULTS

Findings suggest that immigrant status and lower levels of resilience are associated with poorer self-rated oral health and more oral health problems for Chinese American older adults in Hawaii. Resilience is more strongly associated with self-rated oral health for U.S.-born Chinese American than for foreign-born Chinese Americans, but this pattern was not evident for oral health problems.

DISCUSSION

Older Chinese American immigrants in Hawaii are disadvantaged in terms of their oral health. Understanding their susceptibilities may lead to targeted interventions.

Social capital and periodontal disease in Hispanic/Latino adults in the United States: Results from the Hispanic Community Health Study/Study of Latinos

AIMS

To examine the association of social capital with periodontal disease severity.

MATERIALS AND METHODS

We analysed data obtained from 3,994 men and women aged 18-74 years in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study (HCHS/SOL SCAS). From 2008 to 2011, dentists assessed periodontitis status with a full-mouth periodontal examination. Periodontitis was classified using standardized case definitions. Multivariable logistic regression estimated odds of moderate-severe periodontitis associated with two measures of social capital: structural support (Social Network Index) and functional support (Interpersonal Support Evaluation List).

RESULTS

For US-born participants, for each additional person in their social network, the adjusted odds of moderate-severe periodontitis was reduced 17% (OR = 0.83, 95% CI = 0.71, 0.96). However, no association was found between functional support and periodontal disease severity.

CONCLUSIONS

Greater structural social support was associated with a lower prevalence of moderate-severe periodontitis in US-born Hispanics/Latinos. These findings suggest that US-born Hispanics/Latinos with less social support represent a vulnerable segment of the population at high-risk group for periodontal disease.

Dental health status and oral health behaviours of patients with facial burn in Pakistan

Background

There is a limited understanding about the oral health of patients with facial burn, hence the aim was to describe the oral health status and the related risks factors.

Methods

This cross-sectional study had randomly and systematically recruited facial burn patients from the Burn Care Center, Pakistan Institute of Medical Sciences, Islamabad, from June of 2016 to July of 2017. Intraoral examination recorded the DMFT, CPI and OHI-S. Information on the socio-demographic status, self-perceived oral health, oral health behaviours were collected using a self-administered questionnaire and; the burn characteristics were obtained from the patients’ medical record. The t-test, ANOVA, SLR, and chi-square test were used to examine the relationship between oral health and each factor. A parameter was derived from the clinical indices using the principal component analysis and used in the multiple linear regression analysis to determine the important factors associated with oral health status.

Results

A total of 271 burn patients (69% female and 31% male) had participated in the study. All of the participants had caries with mean DMFT = 10.96 (95%CI: 10.67, 11.25). There were 59.0% (95%CI: 53.15, 64.93%) and 66.1% (95%CI: 60.38, 71.73%) of the participants who had periodontitis and poor oral hygiene respectively. About 79 and 80% of the participants rated their dental and periodontal status as poor. About 78% reported brushing once daily and 89% did not practice regular dental visit. The DMFT, CPI and OHI-S were associated with the burn characteristics and oral health behaviours (p < 0.05). Dental anxiety, cost and social issues were the most cited reasons for not utilising oral health services. Greater burn severity, the longer time elapsed since the burn incident, and dental anxiety were associated with poorer oral health status and; brushing twice or more and regular dental visit, with better status (p < 0.01).

Conclusion

Patients with oro-facial burn injury had a generally poor oral health and, the risks are greater in those with a more severe and wider area of injury, the longer time elapsed since the burn incident and dental anxiety; but a good oral hygiene practice and regular dental visits were protective against the risk.

The Relationship between Social Capital within Its Different Contexts and Adherence to a Mediterranean Diet Among Lithuanian Adolescents

The eating habits of adolescents are a serious current public health problem. Scientists call attention to the availability of social resources for enhancing healthy eating behavior. Social capital defines those resources as trust, reciprocity, social participation, integrity, and coherence, and they are supposed to help people achieve their life goals, in general, and health goals, in particular. Our aim is to investigate the relationship between social capital within its different contexts and adherence to a Mediterranean diet (MD) among Lithuanian adolescents. The nationally representative cross-sectional study included 1863 students (906 boys and 957 girls). The KIDMED index questionnaire (Mediterranean Diet Quality Index in children and adolescents) was used to evaluate the adherence to an MD. Family, neighborhood, and school contexts of social capital were assessed using six items indicating family support, neighborhood trust, social control, vertical trust, horizontal trust, and reciprocity at school. Covariates such as gender, physical activity, parental education, and body mass index were also included in the analysis. Descriptive results showed that only 14% of Lithuanian adolescents followed an MD. Linear regression analysis indicated that family support (β = 0.096) and trust in school teachers (β = 0.074) were related to better rates of adherence, especially regarding the consumption of fruits, vegetables, cereals, fish, and the use of olive oil as a main source of fat. More adolescents who perceived family support and trust in their teachers used these products regularly and were less likely to skip breakfast. These findings could be used as a base for further developing nutrition education programs aimed at enhancing support and trust among families and schoolteachers.

How different contexts of social capital are associated with self-rated health among Lithuanian high-school students

Background. Adolescents’ self-rated health is related to a number of sociodemographic and socio-economic factors, health-related behaviors, and their social environment. The impact of the latter is still not well explored. An adolescent’s social environment is represented by the social capital, i.e. social resources that they can access. The relationships between various contexts of social capital (family, neighborhood, peers, and school) and self-rated health among adolescents are still unclear.

Objective. This study aims to examine the relationships between various social capital contexts and self-rated health in Lithuanian adolescents.

Methods. The current cross-sectional study includes a nationally representative sample of 1863 adolescents (51.4% were girls) aged 14–18 years. The indicators of self-rated health as well as indicators of social capital in family, neighborhood, and school contexts were assessed. The results of the relationships between self-rated health and contexts of social capital were calculated controlling for the following covariates: physical activity, psychological distress, gender, body mass index, and family socioeconomic status.

Results. Results indicate that there are significant relationships between good self-rated health and a higher level of family support, neighborhood trust, and vertical school trust. In the final logistic regression model, while controlling for all covariates, a higher level of family support and neighborhood trust remain significant predictors of good self-rated health.

Conclusions. Family support and neighborhood trust are important correlates of self-rated health in adolescents.

The association of various social capital indicators and physical activity participation among Turkish adolescents

BACKGROUND

Physical activity participation (PAP) has been proven to improve health and promote optimal growth among adolescents. However, most adolescents do not meet the current physical activity (PA) recommendations in Turkey. The role of the social environment and social factors on PAP is being increasingly recognized. Although social capital (SC) indicators have been examined in high-income countries, there are few studies on developing countries. The aim of this study was to examine the relationship between SC indicators and PAP among Turkish adolescents.

METHODS

A survey was conducted among 19 high schools in 4 different cities in Turkey in 2016. A total of 506 female and 729 male high school students participated in this study. The dependent variable was overall PAP, which was measured using the short form of the International Physical Activity Questionnaire. The independent variables included self-perceived family, neighborhood, and school SC. Self-rated health and obesity status, measured by body mass index, were other study covariates in multiple binary logistic regression models. Chi-square tests were used to assess the differences between genders.

RESULTS

PAP levels were significantly different between males and females. A higher percentage of males reported PAP (77.4%) compared to females (51.0%). Among males, teacher-student interpersonal trust and informal social control were inversely associated with PAP, while high students interpersonal trust was positively associated with increased odds of PAP. For females, students interpersonal trust was inversely associated with PAP.

CONCLUSION

Various SC indicators are associated with PAP for males and females. These associations are different from findings of studies conducted in developed countries. Therefore, health-promotion interventions and policies should consider gender and different social agents on the social and cultural background to improve PAP among Turkish adolescents.

[Inequalities in dental care during the life course of young people: a cohort study]

The scope of this study was to investigate dental care from the life course perspective and its determinant factors among young people in the city of Sobral, State of Ceará, Brazil. A cohort study was conducted with waves in 2000, 2006 and 2012 with 482 young people aged between 17 and 21 years. Two outcomes were investigated: immediate dental care and the lack of dental care, based on the dental trajectory in relation to restorative treatment. Socioeconomic conditions and recourse to oral health services and actions in the three waves investigated were used as independent variables. It was found that low socioeconomic status throughout life presented itself as a risk factor for lack of dental care and the inverse effect was observed with immediate dental care. Participation in groups of teenagers was also related to dental care, as well as receiving information on oral health. This study revealed the presence of inequalities in dental care throughout the life course of the population assessed.

Association between disability and social capital among community-dwelling elderly

Objective

To assess the prevalence of disability and its association with social capital among community-dwelling elderly.

Methods

The study was based on 2nd Health Survey of Belo Horizonte Metropolitan Region - 2010, that included 1,995 community-dwelling elderly, randomly sampled. The exposure of interest was social capital, measured by confidence in neighborhood, perception of the physical environment, sense of cohesion in housing, and neighborhood perception of help. Socio-demographic variables, health conditions and use of health services were considered in the analysis with the purpose of adjustment.

Results

Approximately one third of participants (32.6%) were unable to at least one instrumental activity of daily living (IADL) and/or basic activity of daily living (ADL); the prevalence of disability in ADL/IADL was 18.1%, and only in IADL was 14.6%. Elderly with functional disabilities had higher odds of poor social capital, but only the sense of cohesion in housing neighborhood showed to be independently associated with functional disability (OR = 1.80; 95%CI 1.12 - 2.88).

Conclusions

Our results show the importance of social capital in research on associated factors of functional disability and indicate the need to implement public policies for social and environmental areas, since the needs of the elderly require measures beyond those typical of the health sector.

Correlation of Perceived Self-Rated Oral Health Status with Various Dental Health and Awareness Factors

Aims and Objectives:

Self-rated oral health is the key element that has a greater effect on quality of life and found to be authentic and logical to consider this as an indicator for overall oral health status. The aim was to investigate and identify the impact of various social and clinical factors on the perceived self-rated oral health status (PSR-OHS).

Materials and Methods:

A self-administered questionnaire was distributed 600 patients seeking information for age, gender, nationality, educational level, and their last dental visit followed by 15 questions related to social factors (patient self-rated oral health, patient-dentist communication, literacy level of the patient, and dental neglect) followed by estimating the clinical oral health status (decayed, missing, and filled teeth [DMFT] scores as per WHO norms).

Results:

The results were estimated by a single five-point-response-scale question dichotomized into poor and good self-rated oral health. The average mean age for participation in the study is 32.5 years and found to be highly significant (P < 0.01) with inverse relation indicating that younger patients give better PSR-OHS. There were no significant differences in PSR-OHS among other demographic factors. Patients visiting the dentist recently found to be confident about their PSR-OHS and are statistically significant. Pearson correlating scores of social factors and the DMFT scores most concerned in the present study have a significant relation with self-rated oral health status.

Conclusions:

PSR-OHS is governed by various dental health and awareness factors. It can be used as an important tool by a clinician to assess the clinical examination results which helps to achieve more effective time and patient management.

Effects of multi-dimensional social capital on mental health of children in poverty: An empirical study in Mainland China

Using the data of 1314 underprivileged children in Xiushui, China, this study adopted an ecological framework to explore how social capital embedded in family, peer, school, and community interplay and affect the mental health of poor children. Structural equation modeling was employed to verify the hypothesized model. The results demonstrated that higher levels of family, peer, and school social capital were all associated with better mental health outcomes of children in poverty. Moreover, family, peer, and school social capital fully mediated the effect of community social capital on children's mental health. Theoretical and practical implications were discussed.

The dark side of social capital: A systematic review of the negative health effects of social capital

There is a growing literature demonstrating the health benefits of social capital (defined as the resources accessed through social connections). However, social capital is also acknowledged to be a "double-edged" phenomenon, whose effects on health are not always positive. We sought to systematically review studies that have found a negative (i.e. harmful) association between social capital and health outcomes. Our objective was to classify the different types of negative effects, following a framework originally proposed by Portes (1998). We conducted a literature search in Pubmed, Embase and PsychInfo. We identified 3530 manuscripts. After detailed review, we included 44 articles in our systematic review. There are at least two negative consequences of social capital besides the classification proposed by Portes: behavioral contagion and cross-level interactions between social cohesion and individual characteristics. When leveraging the concept of social capital for health promotion interventions, researchers need to take account of these potential "downsides" for health outcomes.

Factors associated with good self-rated health in European adolescents: a population-based cross-sectional study

OBJECTIVES

The aim of the present study was to investigate self-reported health status and associated factors.

METHODS

In this cross-sectional study, the participants were 6501 adolescents (52% females) aged 14-19 years from three European countries: Croatia, Lithuania and Serbia. Self-rated health was assessed by using one item question: "How would you perceive your health?" The answers were arranged along a 5-point Likert-type scale: (1) very poor, (2) poor, (3) fair, (4) good and (5) excellent. The outcome was binarized as "good" (fair, good and excellent) and "poor" health (very poor and poor). Potential factors associated with self-rated health included demographic (age, gender, socioeconomic status and body-mass index), social (social capital) and lifestyle (physical activity and psychological distress) variables.

RESULTS

In both univariate and multivariate models, being older, being a boy, having higher level of family, neighbourhood and school social capital, participating in moderate-to-vigorous physical activity more frequently and having low psychological distress were associated with good self-rated health.

CONCLUSIONS

Our findings suggest strong associations between social and lifestyle factors and self-rated health. Other explanatory variables will require future research.

Social Determinants of Pediatric Oral Health

Social determinants of health are defined as conditions in which people are born and live and the role these conditions play on health outcomes. Research indicates that risk factors and their interactions are far more complex than originally thought. This article outlines social determinant constructs and their role in understanding oral health promotion. Due to the complex interactions, oral health must be promoted using a multilevel chronic disease model or common risk factor approach. An understanding of social determinants is particularly important for the pediatric population because optimum oral health and general health in adulthood are heavily influenced by childhood.

Associations among oral health-related quality of life, subjective symptoms, clinical status, and self-rated oral health in Japanese university students: a cross-sectional study

BACKGROUND

The present study aimed to elucidate the associations among self-rated oral health, clinical oral health status, oral health behaviors, subjective oral symptoms, and oral health-related quality of life (OHRQoL) in a group of Japanese university students.

METHODS

Of 2051 participants, 2027 (98.83%) students received an optional oral examination and answered a questionnaire including items regarding age, sex, self-rated oral health, oral health behaviors, subjective oral symptoms, and OHRQoL [The Oral Health Impact Profile (OHIP)-14]. On oral examination, the decayed, missing, and filled teeth (DMFT) score, Community Periodontal Index (CPI), the percentage of teeth showing bleeding on probing (%BOP), and malocclusion were recorded. Structural equation modelling (SEM) analysis was used to test associations.

RESULTS

The mean score (± SD) of OHIP-14 was 1.92 ± 5.47. In the SEM analysis, the final model showed that self-rated oral health, oral pain, malocclusion, and the DMFT score were directly associated with the OHRQoL, and subjective symptoms of temporomandibular disorders (TMD) and recurrent aphthous stomatitis were both directly and indirectly associated (p < 0.05). CPI, %BOP, and oral health behaviors were excluded from the final model.

CONCLUSIONS

OHRQoL was associated with self-related oral health, subjective symptoms of TMD, oral pain and stomatitis, DMFT, and malocclusion in this group of Japanese university students.

Social capital and physical activity among Croatian high school students

OBJECTIVE

To examine factors associated with regular physical activity in Croatian adolescents.

STUDY DESIGN

A cross-sectional survey among high school students was carried out in the 2013/14 school year.

METHOD

A survey was conducted among 33 high schools in Zagreb City, Croatia. Participants were students aged 17-18 years. The dependent variables were regular moderate to vigorous physical activity (MVPA) and overall physical activity measured by the short version of International Physical Activity Questionnaire and defined as 60 min or more of daily physical activity. The independent variables included family, neighborhood, and high school social capital. Other study covariates included: socio-economic status, self-rated health, psychological distress and nutritional status. The associations between physical activity and social capital variables were assessed separately for boys and girls through multiple logistic regression and inverse probability weighting in order to correct for missing data bias.

RESULTS

A total of 1689 boys and 1739 girls responded to the survey. A higher percentage of boys reported performing regular vigorous and moderate physical activity (59.4%) and overall physical activity (83.4%), comparing with the girls (35.4% and 70%, respectively). For boys, high family social capital and high informal social control were associated with increased odds of regular MVPA (1.49, 95%CI: 1.18 - 1.90 and 1.26, 95%CI: 1.02 - 1.56, respectively), compared to those with low social capital. For girls, high informal social control was associated with regular overall physical activity (OR 1.38, 95% CI: 1.09 - 1.76).

CONCLUSION

High social capital is associated with regular MVPA in boys and regular overall activity in girls. Intervention and policies that leverage community social capital might serve as an avenue for promotion of physical activity in youth.

Association between Knowledge about Comprehensive Food Education and Increase in Dental Caries in Japanese University Students: A Prospective Cohort Study

In Japan, comprehensive food education (shokuiku) programs are carried out with the aim of improving dietary practices and thereby reducing the incidence of lifestyle-related diseases, including dental caries. The purpose of this prospective cohort study was to investigate the association between knowledge about shokuiku and the increase in dental caries among Japanese university students who had attended a shokuiku program while in junior/senior high school. A total of 562 students volunteered to undergo oral examinations over a three-year follow-up period, during which the number of cases of dental caries were recorded. Additional information was collected using a questionnaire survey regarding knowledge about shokuiku, dietary habits, and oral health behaviors. In logistic regression analysis, males who lacked knowledge about shokuiku had significantly higher odds for dental caries than those who did not (odds ratio (OR), 2.00; 95% confidence interval (CI), 1.12-3.58; p = 0.019). On the other hand, among females, those who frequently consumed sugar-sweetened soft drinks had significantly higher odds for dental caries than those who did not (OR, 1.89; 95% CI, 1.05-3.42; p = 0.035). These results suggest that having no knowledge about shokuiku is associated with a risk of increase in dental caries in Japanese male university students.

Social position, social ties and adult's oral health: 13 year cohort study

OBJECTIVES

This study explored different pathways by which social position and social ties influence adult's oral health over a 13-year period.

METHODS

A cohort investigation (Pro-Saúde Study) was conducted of non-faculty civil servants at a university in Rio de Janeiro, Brazil (N=1613). Baseline data collected in 1999 included age, social position, social ties, and access to dental care. Psychological factors and smoking were assessed in 2001, whereas tooth loss and self-rated oral health (SROH) were collected in 2012. A hypothesised model exploring different direct and indirect pathways was developed and tested using structural equation modelling.

RESULTS

The model was a good fit to the data and accounted for 40% and 27% of the variance in tooth loss and SROH, respectively. A greater social position was linked to more social ties (β=0.31), health insurance (β=0.48), low psychological distress (β=0.07), less smoking (β=-0.21), more regular dental visiting (β=0.30), less tooth loss (β=-0.44) and better SROH (β=-0.25) over time. Social position (β=0.0005) and social ties (β=-0.0015) were linked indirectly with psychological distress, smoking and tooth loss. Social position was linked indirectly with social ties, psychological distress and SROH (β=-0.0071).

CONCLUSIONS

Poor social position and weak social ties were important predictors for tooth loss and poor SROH in adults over the 13-year period. Direct and indirect pathways via psychological factors and smoking on the aforementioned relationships were identified, suggesting different areas of intervention to promote adults' oral health.

CLINICAL SIGNIFICANCE

Adult's oral health is influenced by social conditions through direct and indirect pathways, including via psychological factors and smoking.

The Role of School Social Environment on Dental Caries Experience in 8- to 12-Year-Old Brazilian Children: A Multilevel Analysis

Aim: Although children spend most of their time involved in activities related to school, few studies have focused on the association between school social environment and oral health. This cross-sectional study assessed individual and school-related social environment correlates of dental caries in Brazilian schoolchildren aged 8-12 years. Methods: A sample of children from 20 private and public schools (n = 1,211) was selected. Socio-economic data were collected from parents, and data regarding children characteristics were collected from children using a questionnaire. Dental examinations were performed to assess the presence of dental plaque: dental caries experience (DMFT ≥1) and dental caries severity (mean dmf-t/DMF-T). The social school environment was assessed by a questionnaire administered to school coordinators. Multilevel Poisson regression was used to investigate the association between school social environment and dental caries prevalence and experience. Results: The dental caries prevalence was 32.4% (95% confidence interval: 29.7-35.2) and the mean dmf-t/DMF-T was 1.84 (standard deviation: 2.2). Multilevel models showed that the mean dmf-t/DMF-T and DMFT ≥1 were associated with lower maternal schooling and higher levels of dental plaque. For contextual variables, schools offering after-hours sports activities were associated with a lower prevalence of dental caries and a lower mean of dmf-t/DMF-T, while the occurrence of violence and theft episodes was positively associated with dental caries. Conclusions: The school social environment has an influence on dental caries in children. The results suggest that strategies focused on the promotion of healthier environments should be stimulated to reduce inequalities in dental caries.

The Association between Participation of Adolescents in Community Groups and Dental Caries in a Deprived Area in Brazil

There is limited evidence concerning the role of social networks on the oral health of adolescents. This study assessed the association between the participation of adolescents in community groups and dental caries. A cross-sectional household-based study was carried out involving 200 subjects aged 15-19 years living in a deprived area in the state of Amazon, Brazil. Dental caries was assessed through dental examinations using the DMFT index conducted by a single examiner who was previously calibrated. Four dental caries outcomes were investigated, including caries experience (DMFT score), current caries (number of current decayed teeth), missing teeth due to caries, and the care index (ratio between number of filled teeth and DMFT score). Details of participation of adolescents in community groups, demographic and socioeconomic data and information on dental visiting were obtained through individual interviews. All caries measures were significantly higher in adolescents who did not participate in community groups compared to their counterparts. Multivariate Poisson regression showed that participation of adolescents in community groups was independently associated with all dental caries outcomes. After adjusting for confounders, participation in community groups was statistically associated with lower DMFT score (ratio of mean, RM: 0.33, 95% CI: 0.24-0.46), fewer decayed teeth (RM: 0.23, 95% CI: 0.11-0.47), fewer missing teeth (RM: 0.28, 95% CI: 0.17-0.47), and higher care index (RM: 1.69, 95% CI: 1.24-2.29) than those who did not participate. Participation of adolescents in community activities was related to lower levels of dental caries.