Structural determinants explain caries differences among preschool children in Chile's Metropolitan Region

Area of Science:

• Public Health
• Pediatric Dentistry
• Social Epidemiology

Background:

• Social Determinants of Health (SDH) are crucial factors influencing health outcomes, including oral health.
• Understanding the association between SDH and caries in preschool children is vital for targeted interventions.

Purpose of the Study:

• To estimate the association between structural and intermediate Social Determinants of Health (SDH) and caries indicators in preschool children in Chile's Metropolitan Region.

Main Methods:

• A multilevel cross-sectional study involving 2,275 children aged 1-6 years in Chile's Metropolitan Region (2014-2015).
• Data collected at district, school, and child levels, analyzing Community Human Development Index (CHDI), urban/rural location, school type, caregiver education, and family income.
• Caries assessed using dmft-index and prevalence of untreated caries; Poisson multilevel regression models were employed.

Main Results:

• Significant disparities in untreated caries prevalence were observed across districts based on social advantage, ranging from 17.1% in high CHDI districts to 53.9% in disadvantaged districts.
• Increased family income was associated with a decreased probability of untreated caries (PR=0.9).
• Rural children exhibited higher untreated caries prevalence (PR=3.0) and dmft-index (7.3) compared to urban children (4.4). Caregiver's secondary education was linked to higher caries prevalence (PR=1.3).

Conclusions:

• Strong associations exist between structural Social Determinants of Health and caries indicators in Chilean preschool children.
• Notable differences in caries prevalence were found between districts, highlighting socioeconomic disparities.
• Rurality and caregiver's educational level emerged as the most consistent predictors of caries in this population.