Social capital: theory, evidence, and implications for oral health

Rouxel, Patrick; Heilmann, Anja; Aida, Jun; Tsakos, Georgios; Watt, Richard G.

doi:10.1111/cdoe.12141

Cited by 91 publications

(188 citation statements)

References 71 publications

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“…Religiosity has also been associated with preventive pattern of dental attendance and the adoption of oral health‐related behaviour . Religious practice as social network at individual level can explain two domains associated to the concept of social capital: cognitive (perceived interpersonal trust, norms, and reciprocity) and structural (civic participation, socializing, and networking) . Several plausible pathways link social capital to health outcomes.…”

Section: Discussionmentioning

confidence: 99%

Pathways of socioeconomic inequalities in gingival bleeding among adolescents

Sfreddo

Moreira

Celeste

et al. 2018

Comm Dent Oral Epid

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Objectives To explore the pathways through which the socioeconomic inequalities may influence gingival bleeding in adolescents, assessing the direct and indirect effects of material and psychosocial variables. Methods This cohort study followed a multistage, random sample of 1134 12‐year‐old adolescents from 20 public schools of Santa Maria, a city in southern Brazil. The percentage of teeth with gingival bleeding was recorded according to the Community Periodontal Index criteria (scored as healthy or bleeding) at baseline and at 2‐year follow‐up. Biological (dental plaque, caries, and dental crowding), material (socioeconomic position [SEP] operationalized as family income and parents’ education), psychosocial (parents’ religiosity, self‐rated health, and happiness) and behavioural (use of dental service by adolescents) factors were collected at baseline. Structural equation modelling (SEM) was guided by the adapted Commission on the Social Determinants of Health model linking material, psychosocial, biological, and behaviour variables to health. The SEM was employed to estimate standardized direct, indirect, and total effects of material and psychosocial factors on gingival bleeding at follow‐up. Results A total of 770 14‐year‐old adolescents were reassessed (follow‐up rate of 68%). The lower SEP at baseline had a higher direct effect (standard coefficient [SC] = −0.17, P < 0.01) than a mediated effect on percentage of teeth with gingival bleeding at 2‐year follow‐up. The lower indirect effect (SC = −0.06, P < 0.01) from SEP to gingival bleeding at follow‐up ran through biological factors—dental plaque (baseline and follow‐up) and gingival bleeding at baseline. The lower religiosity of the parents as a psychosocial aspect had only a small direct effect (SC = −0.10, P = 0.03) on gingival bleeding at follow‐up. Conclusions Material factors such as SEP contributed most to explanations on inequalities in adolescents’ periodontal health because of their higher direct effect and additional shared (indirect) effect (through biological factors) on gingival bleeding. Religious practice as a psychosocial factor only explained part of percentage of teeth with gingival bleeding at follow‐up.

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Section: Discussionmentioning

confidence: 99%

Pathways of socioeconomic inequalities in gingival bleeding among adolescents

Sfreddo

Moreira

Celeste

et al. 2018

Comm Dent Oral Epid

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“…Behavioural pathways that link SC to worse health outcomes have been linked with an unsupportive social environment that is strongly related to social influence from friends or community, who are more likely to influence short-term choices, such as appearance and interests [Rouxel et al, 2015]. Schools failing to offer health promotion activities and a healthy environment can contribute to the development of children with stress, resulting in unhealthy behaviours.…”

Section: Discussionmentioning

confidence: 99%

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

Fernandez¹,

Goettems²,

Ardenghi

et al. 2015

Caries Res

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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.

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“…Differences in definitions of concepts might exist according to levels. For instance, there is a lack of consensus on the meaning and definition of social capital . Lack of clarity on the definition makes the operationalization of social capital in epidemiological investigations challenging.…”

Section: Methodological Aspects Relevant To Application Of Multilevelmentioning

confidence: 99%

Investigating societal determinants of oral health—Opportunities and challenges in multilevel studies

Singh

Harford

Peres

2018

Comm Dent Oral Epid

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The high prevalence of oral diseases and the persistent nature of socioeconomic inequalities in oral health outcomes across societies presents a significant challenge for public health globally. A debate exists in epidemiology on the merits of investigating population variations in health and its determinants over studying individual health and its individual risk factors. The choice of analytical unit for health outcomes at the population level has policy implications and consequences for the causal understanding of population-level variations in health/disease. There is a lack of discussion in oral epidemiology on the relevance of studying population variations in oral health. Evidence on the role of societal factors in shaping variations in oral health at both the individual level and the population level is also mounting. Multilevel studies are increasingly applied in social epidemiology to address hypotheses generated at different levels of social organization, but the opportunities offered by multilevel approaches are less applied for studying determinants of oral health at the societal level. Multilevel studies are complex as they aim to examine hypotheses generated at multiple levels of social organization and require attention to a range of theoretical and methodological aspects from the stage of design to analysis and interpretation. This discussion study aimed to highlight the value in studying population variations in oral health. It discusses the opportunities provided by multilevel approaches to study societal determinants of oral health. Finally, it reviews the key methodological aspects related to operationalizing multilevel studies of societal determinants of oral health.

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Social capital: theory, evidence, and implications for oral health

Cited by 91 publications

References 71 publications

Pathways of socioeconomic inequalities in gingival bleeding among adolescents

Pathways of socioeconomic inequalities in gingival bleeding among adolescents

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

Investigating societal determinants of oral health—Opportunities and challenges in multilevel studies

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