Pathways that explain racial differences on edentulism among older adults: 2019 Brazil National Health Survey.

This study aimed to evaluate the pathways that explain the association between race/skin color and edentulism in elderly Brazilians. This was a cross-sectional study using data from participants aged 60 years or older from the 2019 Brazilian National Health Survey, a nationally representative population-based sample. Data were obtained by a structured interview and participants were classified as edentulous if they reported having lost all natural teeth. Information on race, socioeconomic level, behavioral aspects, psychosocial aspects, and access to dental care was collected by interviewers using a questionnaire. The pathways between race/skin color and edentulism were analyzed using structural equation modeling. The final sample of the study included 22,357 participants. Most participants were white (51.5%; 95% confidence interval [CI]: 50.3-52.6), and 36.8% (95%CI: 35.7-37.9) were edentulous. Race/skin color was indirectly associated with edentulism via enabling factors. These findings suggest that socioeconomic inequalities are key in explaining racial inequalities in edentulism among Brazilian older adults.

[1]  I. Schneider,et al.  Racial inequities in tooth loss among older Brazilian adults: A decomposition analysis. , 2020, Community dentistry and oral epidemiology.

[2]  Eun Sug Park,et al.  Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019 , 2020, Lancet.

[3]  Giseli Nogueira Damacena,et al.  Pesquisa Nacional de Saúde 2019: histórico, métodos e perspectivas , 2020, Epidemiologia e Serviços de Saúde.

[4]  P. Raina,et al.  Self-reported oral health at baseline of the Canadian Longitudinal Study on Aging. , 2019, Community dentistry and oral epidemiology.

[5]  David R. Williams,et al.  Understanding how discrimination can affect health , 2019, Health services research.

[6]  L. H. Tôrres,et al.  Oral health of the Latin American elders: What we know and what we should do—Position paper of the Latin American Oral Geriatric Group of the International Association for Dental Research , 2018, Gerodontology.

[7]  R. K. Celeste,et al.  Racial Inequalities in Oral Health , 2018, Journal of dental research.

[8]  R. K. Celeste,et al.  Discrimination, gender and self‐reported aesthetic problems among Brazilian Adults , 2018, Community dentistry and oral epidemiology.

[9]  M. Glickman,et al.  Dental Care in an Equal Access System Valuing Equity: Are There Racial Disparities? , 2016, Medical care.

[10]  M. Richter,et al.  Explaining socioeconomic inequalities in self-rated health: a systematic review of the relative contribution of material, psychosocial and behavioural factors , 2016, Journal of Epidemiology & Community Health.

[11]  D. Malta,et al.  Self-reported oral health in the Brazilian adult population: results of the 2013 National Health Survey. , 2016, Ciencia & saude coletiva.

[12]  Ademar Arthur Chioro dos Reis,et al.  Smoking Trends among Brazilian population - National Household Survey, 2008 and the National Health Survey, 2013. , 2015, Revista brasileira de epidemiologia = Brazilian journal of epidemiology.

[13]  B. Emmanuelli,et al.  Racial Differences in Oral Health-Related Quality of Life: A Multilevel Analysis in Brazilian Children. , 2015, Brazilian dental journal.

[14]  J. Hilgert,et al.  Association between underweight and overweight/obesity with oral health among independently living Brazilian elderly. , 2013, Nutrition.

[15]  R. Oppermann,et al.  Oral health status in elders from South Brazil: a population-based study. , 2012, Gerodontology.

[16]  B. Chakraborty,et al.  Tooth loss and dental caries in community-dwelling older adults in northern Manhattan. , 2012, Gerodontology.

[17]  P. Góes,et al.  [Race and the use of dental health services by the elderly]. , 2012, Ciencia & saude coletiva.

[18]  Bei Wu,et al.  Oral health among white, black, and Mexican-American elders: an examination of edentulism and dental caries. , 2011, Journal of public health dentistry.

[19]  David R Williams,et al.  Race, socioeconomic status, and health: Complexities, ongoing challenges, and research opportunities , 2010, Annals of the New York Academy of Sciences.

[20]  Luisa Farah Schwartzman.  Does Money Whiten? Intergenerational Changes in Racial Classification in Brazil , 2007 .

[21]  P. Tramini,et al.  Tooth loss and associated factors in long-term institutionalised elderly patients. , 2007, Gerodontology.

[22]  J. Hilgert,et al.  Correlates of partial tooth loss and edentulism in the Brazilian elderly. , 2007, Community dentistry and oral epidemiology.

[23]  W. Marcenes,et al.  The shape of the socioeconomic-oral health gradient: implications for theoretical explanations. , 2006, Community dentistry and oral epidemiology.

[24]  D. Locker,et al.  What do older adults' global self-ratings of oral health measure? , 2007, Journal of public health dentistry.

[25]  M. Metzler,et al.  Socioeconomic status in health research: one size does not fit all. , 2005, JAMA.

[26]  D. Eadie,et al.  "It's as if you're locked in": qualitative explanations for area effects on smoking in disadvantaged communities. , 2001, Health & place.

[27]  N. Krieger.  A glossary for social epidemiology , 2001, Journal of epidemiology and community health.

[28]  E. Bonilla-Silva,et al.  RETHINKING RACISM: TOWARD A STRUCTURAL INTERPRETATION * , 1997 .

[29]  R. Andersen,et al.  Ethnicity, Aging, and Oral Health Outcomes: A Conceptual Framework , 1997, Advances in dental research.