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La adversidad social está causalmente relacionada con la multimorbilidad, incluidas las afecciones orales
A O Esemezie1,2, D J Lizotte2,3, G Tsakos4
1Dentistry, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
Journal of dental research
|September 6, 2025
Resumen
La adversidad social, incluido el bajo capital económico y social, aumenta causalmente el riesgo de desarrollar afecciones orales (OC) y multimorbilidad, incluidas las afecciones orales (MIOC) en adultos mayores. Estos efectos fueron más pronunciados en individuos de mediana edad.
Área de la Ciencia:
- Determinantes sociales de la salud
- Epidemiología de la salud bucal
- Gerontología e Investigación del Envejecimiento
Sus antecedentes:
- La teoría de la causa fundamental sugiere que los factores sociales influyen en la enfermedad, pero la causalidad directa para la salud bucal sigue sin estar clara.
- La adversidad social, que abarca el bajo capital económico y social, está relacionada con diversas enfermedades, incluidas las afecciones orales y sistémicas.
- La comprensión de las vías causales desde la adversidad social hasta las afecciones orales y la multimorbilidad es crucial para las intervenciones de salud pública.
Objetivo del estudio:
- Estimar el efecto causal de la adversidad social en el desarrollo de enfermedades orales (CO).
- Evaluar el efecto causal de la adversidad social en la multimorbilidad, incluidas las afecciones orales (MIOC).
- Examinar si estos efectos causales varían según la edad o el sexo en adultos de mediana edad y mayores.
Principales métodos:
- Análisis de dos olas (2011, 2018) de la cohorte del Estudio Longitudinal Canadiense sobre el Envejecimiento (CLSA).
- La adversidad social definida por los bajos ingresos y el capital social (participación de la comunidad, relaciones sociales).
- Modelos estructurales marginales logísticos con ponderación de probabilidad inversa utilizados para estimar las probabilidades causales (OR) para el desarrollo de OC y MIOC.
Principales resultados:
- La adversidad social aumentó significativamente las probabilidades de desarrollar OC (OR = 1,9) y MIOC (OR = 1,7) durante un período de 7 años.
- Los efectos causales de la adversidad social fueron más fuertes en el subgrupo de mediana edad.
- Se observó un aumento similar de las probabilidades de OC y MIOC tanto en hombres como en mujeres que experimentaban adversidad social.
Conclusiones:
- El capital social y económico está causalmente relacionado con el desarrollo de las condiciones orales y la multimorbilidad en las poblaciones que envejecen.
- Las intervenciones dirigidas a las condiciones sociales y de vida son esenciales para promover un envejecimiento saludable y reducir las disparidades en materia de salud.
- Los resultados subrayan la importancia de abordar los factores socioeconómicos en las estrategias generales de salud bucal y sistémica.
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