Socio-economic inequalities in the use of dental care in urban and rural areas in Poland

Introduction. The issue of inequalities in the use of health services and health inequalities between urban and rural dwellers is a subject of numerous scientific reports, but similar publications on dental health are scarce. Objective. The aim of this study is to assess the correlations between the use or non-use of dental services and the classical socio-economic factors (SES) in urban and rural groups in a representative population of Poland. Materials and method. The analysis consisted in desk research based on a questionnaire survey conducted by the Central Statistical Office of Poland on 12,532 individuals (urban areas - 6411, rural areas - 6121) in 2013. The chi-squared test, multivariate and univariate logistic regression models were applied. Results. There were major differences in the use of dental services depending on income level, education and source of income among rural and urban populations, as well as differences between these populations. Urban dwellers had 1.34 times greater odds of using dental services than rural ones (95% CI: 1.20-1.51). In the case of the highest income group, the odds were 3.26 (95% CI 2.21-4.83) times greater in cities and 2.07 (95% CI 1.51-2.85) times greater in villages than the odds in the lowest income group. In the highest education group, the odds were 1.58 (95% CI 1.17-2.13) times greater in urban areas and 2.08 (95% CI 1.48-2.91) times greater in rural areas than the odds in the lowest education group. Conclusions. There are considerable inequalities in the use of dental services, yet the differences in non-use, despite such a need, are less evident. This could imply that health disparities arise not only from economic constraints and unavailability of health care, but also from health attitudes and behaviours.