Social gradients in oral and general health among adolescents in Northern Norway. A cross-sectional and longitudinal cohort study.

Abstract

Aim: To explore the social gradients in self-perceived oral and general health, caries experience and body mass index (BMI) in a Norwegian adolescent population. Methods: The data was retrieved from a population-based cohort study Fit Futures, which included all first-year high-school students aged 15-19 years, in two municipalities in Troms County, Northern Norway, in 2010-2011 (not including the summer months). Over 90% of the invited participants attended. All the data, except caries experience, BMI and 25(OH)D serum, was collected through the questionnaire. Analyzed sample consisted of 384 girls and 324 boys, with a participation rate of 63%. Multivariable binary logistic regression analysis stratified by gender was used to investigate the association between socioeconomic position indicators (mother’s education, parents’ employment and child’s school program) and outcomes. All models were adjusted for age, country of birth, household with adults, and a combined health variable, which included history of chronic diseases, alcohol consumption, smoking, use of snuff, physical activity, sugar and other unhealthy diet, vitamin D level, oral hygiene, self-esteem, mental health and sleep. Results: Girls attending vocational school program (vs program for specialization in general studies) had more than two times higher odds for being overweight/obese (OR 2.27, 95%CI 1.05-4.91) and for having higher than average DMFT score (OR 2.54, 95%CI 1.30-4.97). Moreover, these girls had more than two and a half times higher odds to perceive their general and oral health at baseline as less good (OR 2.79, 95% CI 1.27-6.12, and OR 2.54, 95%CI 1.30-4.96, respectively). Comparing to boys who attended the program for specialization in general studies, boys in vocational school program had more than three times higher odds to perceive their oral health at baseline as less good (OR 3.39, 95%CI 1.54-7.46), while boys in sports and physical education program had far lower odds to perceive their general health at FF2 as less good (OR 0.11, 95% CI 0.01-0.89). Furthermore, boys having mother with lower education (high school or less and college less than 4 year vs college 4 year or more) had more than three times higher odds to be overweight/obese (OR 3.06, 95% CI 1.05-8.92 and OR 3.59, 95% CI 1.17-11.02, respectively), but lower odds to perceive their general health FF2 as less good (OR 0.37, 95% CI 0.15-0.92 and OR 0.31, 95% CI 0.10-0.94, respectively). Conclusions: The data indicates social gradients among adolescent for general and oral health in Troms, Northern Norway.