Ethnicity, Social Support and Oral Health Among English Individuals

Objective: To determine whether social support explains ethnic inequalities in oral health among English individuals. Methods: Data from 42704 individuals across seven ethnic groups in the Health Survey for England (1999-2002 and 2005) were analysed. Oral health was indicated by self-reports of edentulousness and toothache. Social support was indicated by marital status and a 7-item scale on perceived social support. Confounder-adjusted regression models were fitted to evaluate ethnic inequalities in measures of social support and oral health (before and after adjustment for social support). Results: Overall, 10.4% of individuals were edentulous and 21.7% of dentate individuals had toothache in the past 6 months. Indian (Odd Ratio: 0.50, 95% Confidence Interval: 0.32-0.78), Pakistani (0.50, 95%CI: 0.30-0.84), Bangladeshi (0.29, 95%CI: 0.17-0.47) and Chinese (0.42, 95%CI: 0.25-0.71) individuals were less likely to be edentulous than white British individuals. Among dentate participants, Irish (1.21, 95%CI: 1.06-1.38) and black Caribbean individuals (1.37, 95%CI: 1.181.58) were more likely whereas Chinese individuals (0.78, 95%CI: 0.63-0.97) were less likely to experience toothache than white British individuals. These inequalities were marginally attenuated after adjustment for marital status and perceived social support. Lack of social support was associated with being edentulousness and having toothache whereas marital status was associated with edentulousness only. Conclusion: The findings did not support the mediating role of social support in the association between ethnicity and oral health. However, perceived lack of social support was inversely associated with worse oral health independent of participants' sociodemographic factors.