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

Abstract 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.

摘要：本研究旨在解析巴西老年人群种族/肤色与无牙症之间关联的作用路径。本研究为横断面研究（cross-sectional study），数据取自2019年巴西全国健康调查中60岁及以上的参与者，该调查采用全国代表性人群抽样方案。研究数据通过结构化访谈采集，若参与者自述已脱落全部天然恒牙，则将其归类为无牙症患者。研究人员通过调查问卷收集了种族、社会经济水平、行为特征、心理社会特征以及牙科就诊可及性等相关信息。采用结构方程模型（structural equation modeling）分析种族/肤色与无牙症之间的关联路径。本研究最终纳入22357名参与者，其中多数为白人（51.5%；95%置信区间[CI]：50.3~52.6），36.8%的参与者患有无牙症（95%置信区间[CI]：35.7~37.9）。结果显示，种族/肤色可通过促成因素间接与无牙症产生关联。本研究提示，社会经济不平等是解释巴西老年人群无牙症种族差异的关键因素。