Frontiers in public health · 2026
Social inequalities in rural oral health: social capital and SDOH according to the severity of dental caries in Peru.
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Salas-Huamani Juana Rosmeri, León-Manco Roberto Antonio, Del Castillo-López César, Barbosa Taís de Souza
Аннотация
OBJECTIVE: To evaluate the association between Social Determinants of Health (SDOH), Social Capital (SC), and dental caries experience according to severity in 12-year-old children from a rural Peruvian community.
METHODS: A cross-sectional study was conducted with 61 schoolchildren and their families in Pampacolca, Arequipa - Peru. DMFT index (decayed, missing, and filled teeth) was assessed via clinical examination (kappa = 0.90). SDOH and SC were evaluated through household interviews with parents, using a survey based on the National Census and the short version of the Adapted Social Capital Assessment Tool (SASCAT), respectively. Data were analyzed using Spearman's correlation and the coefficient of determination (R2).
RESULTS: The mean DMFT score was 5.25 ± 2.94. SDOH explained 3.99% of the variance in caries experience overall (p > 0.05). Significant associations were found when stratified by severity: in children with low severity (DMFT≤3), maternal education showed a significant correlation (r = -0.632, p = 0.007), explaining 39.9% of the variance. In children with high severity (DMFT≥5), limited access to health services was the most relevant factor (r = -0.605, p = 0.001), explaining 36.6% of the variance. Regarding social capital, only Cognitive SC showed a significant correlation (r = 0.494, p = 0.044), explaining 24.4% of the variance in the low-severity group.
CONCLUSION: The findings suggest that SDOH and specific dimensions of SC are associated with dental caries, with effects varying by disease severity. While limited access to health services was linked to greater caries experience in high-severity cases, higher maternal education and cognitive social capital appeared to be associated with lower caries experience in children with lower severity. These results highlight the importance of context-specific social interventions.
METHODS: A cross-sectional study was conducted with 61 schoolchildren and their families in Pampacolca, Arequipa - Peru. DMFT index (decayed, missing, and filled teeth) was assessed via clinical examination (kappa = 0.90). SDOH and SC were evaluated through household interviews with parents, using a survey based on the National Census and the short version of the Adapted Social Capital Assessment Tool (SASCAT), respectively. Data were analyzed using Spearman's correlation and the coefficient of determination (R2).
RESULTS: The mean DMFT score was 5.25 ± 2.94. SDOH explained 3.99% of the variance in caries experience overall (p > 0.05). Significant associations were found when stratified by severity: in children with low severity (DMFT≤3), maternal education showed a significant correlation (r = -0.632, p = 0.007), explaining 39.9% of the variance. In children with high severity (DMFT≥5), limited access to health services was the most relevant factor (r = -0.605, p = 0.001), explaining 36.6% of the variance. Regarding social capital, only Cognitive SC showed a significant correlation (r = 0.494, p = 0.044), explaining 24.4% of the variance in the low-severity group.
CONCLUSION: The findings suggest that SDOH and specific dimensions of SC are associated with dental caries, with effects varying by disease severity. While limited access to health services was linked to greater caries experience in high-severity cases, higher maternal education and cognitive social capital appeared to be associated with lower caries experience in children with lower severity. These results highlight the importance of context-specific social interventions.