Socio-economic inequality in reported dental self-care behaviour among Iranian households: A national pooled study
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Updated: Oct 5, 2025

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Published on: February 2, 2020
Ali Kazemi-Karyani1, Jafar Yahyavi Dizaj2, Maryam Khoramrooz3
1Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Background:
Setting out effective prevention strategies in dental diseases needs recognition related factors of the prevention behaviours and targeting the most disadvantaged groups in the term of dental hygiene. This study aimed to investigate socio-economic inequality in the dental self-care status (DSS) of Iranian households and decompose the measured inequality into its contributors.
Method:
In this cross-sectional study, pooled data were extracted from Households Income and Expenditure Surveys (HIESs) conducted in Iran from 2012 to 2017. The index of socio-economic status (SES) for each household was constructed using principal components analysis (PCA). We used Wagstaff normalized concentration index as a measure of socio-economic inequality in dental self-care. Decomposition analysis was applied to determine the main factors contributed to the measured inequality.
Results:
The prevalence of dental self-care in the whole population was 40.56%. The total concentration index was 0.271 (CI: 0.266, 0.275). The results of decomposition analysis for the measured inequality showed that SES, was the highest positive contributors (90.19%) followed by sex of household's head (12.15%), place of residence (11.79%) and education level of household's head (11.71%). Furthermore, the province of residence had the highest negative contribution (-11.37) to the inequality.
Conclusion:
The findings of this study showed that a huge portion of the observed inequality was explained by SES that might give us a policy recommendation: There is room for improving dental health and reducing inequality in dental self-care by paying more attention to SES-disadvantaged households.
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