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首页> 外文期刊>International Journal of Environmental Research and Public Health >Health Insurance, Socio-Economic Position and Racial Disparities in Preventive Dental Visits in South Africa
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Health Insurance, Socio-Economic Position and Racial Disparities in Preventive Dental Visits in South Africa

机译：南非预防性牙科访问中的健康保​​险，社会经济地位和种族差异

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This study sought to determine the contributions of socio-economic position and health insurance enrollment in explaining racial disparities in preventive dental visits (PDVs) among South Africans. Data on the dentate adult population participating in the last South African Demographic and Health Survey conducted during 2003–2004 (n = 6,312) was used. Main outcome measure: Reporting making routine yearly PDVs as a preventive measure. Education, material wealth index and nutritional status indicated socio-economic position. Multi-level logistic regression analysis was conducted to determine the predictors of PDVs. A variant of Blinder-Oaxaca decomposition analysis was also conducted. Health insurance coverage was most common among Whites (70%) and least common among black Africans (10.1%) in South Africa. Similarly, a yearly PDV was most frequently reported by Whites (27.8%) and least frequently reported among black Africans (3.1%). Lower education and lower material wealth were associated with lower odds of making PDVs. There was significant interaction between location (urban/rural) and education (p = 0.010). The racial and socio-economic differences in PDVs observed in urban areas were not observed in rural areas. In the general dentate population, having health insurance significantly increased the odds of making PDVs (OR = 4.32; 3.04–6.14) and accounted for 40.3% of the Whiteon-White gap in the probability of making PDVs. Overall, socio-economic position and health insurance enrollments together accounted for 55.9% (95% CI = 44.9–67.8) of the Whiteon-White gap in PDVs. Interventions directed at improving both socio-economic position and insurance coverage of non-White South Africans are likely to significantly reduce racial disparities in PDVs.
机译：这项研究试图确定社会经济地位和健康保险人数对解释南非人预防性牙科就诊（PDV）中的种族差异的贡献。使用了参与2003-2004年间进行的上一次南非人口与健康调查的齿状成年人的数据（n = 6,312）。主要结果指标：报告制定年度例行PDV作为预防措施。受教育程度，物质财富指数和营养状况表明其社会经济地位。进行多级逻辑回归分析以确定PDV的预测因子。还进行了Blinder-Oaxaca分解分析的变体。在南非，白人的健康保险覆盖率最高（70％），而黑人非洲人的健康保险覆盖率最低（10.1％）。同样，白人每年报告PDV的频率最高（27.8％），而黑人非洲人的报告频率最低（3.1％）。较低的教育程度和较低的物质财富与制作PDV的几率降低有关。地理位置（城市/农村）与教育之间存在显着的相互作用（p = 0.010）。在城市地区观察到的PDV的种族和社会经济差异在农村地区没有观察到。在普通牙齿人群中，拥有健康保险会大大增加制作PDV的几率（OR = 4.32; 3.04-6.14），占制作PDV可能性的白人/非白人差距的40.3％。总体而言，社会经济地位和健康保险入学率合计占PDV中白人/非白人差距的55.9％（95％CI = 44.9-67.8）。旨在改善非白人南非人的社会经济地位和保险覆盖面的干预措施可能会大大减少PDV中的种族差异。

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