Municipal Inequalities in the Prevalence of Caries-Free Children Aged 2, 4, and 6 Years in Santiago, Chile: An Ecological Study
DOI:
https://doi.org/10.15517/183d0f08Keywords:
Dental caries; Health inequalities; Social determinants of health; Oral health; Primary teeth; Child; Risk factors; Ecological study.Abstract
To analyze municipal inequalities in the prevalence of caries-free children among 2-, 4-, and 6-year-old children treated in the eastern sector of Santiago, Chile, during 2024, and to evaluate the presence of social inequalities according to municipal socioeconomic position. An ecological study based on monthly statistical records (REM) from the Chilean Ministry of Health. Data from 6,951 children aged 2, 4, and 6 years who entered dental care at primary health care centers in the eastern sector were analyzed. The prevalence of caries-free children was estimated as the proportion of children with a dmft index of 0, by municipality and age group. Territorial inequalities were assessed using absolute and relative differences, and the relative variation index. The social gradient was analyzed using the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII), considering the Social Priority Index as the socioeconomic position variable. A statistical significance level of p<0.05 was used. The analyses were performed using Stata 19.5. The overall prevalence of children with no caries experience was 62.9%. By age, prevalence was 87.6% at 2 years, 49.6% at 4 years, and 50.3% at 6 years. The absolute differences between communes reached 25.3 percentage points at 2 years and exceeded 50 percentage points at 4 and 6 years. The relative difference indicated that the commune with the highest prevalence had approximately twice the prevalence of the commune with the lowest (PR=2.02). Inequalities were more pronounced at older ages. No statistically significant socioeconomic gradient was observed according to SII and RII. The prevalence of children without caries experience decreases with age, and territorial gaps widen in later stages. The absence of a statistically significant social gradient should be interpreted with caution, considering the limitations of the study design and the context analyzed.
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