title: Self-rated dental health and dental insurance: modification by household income.
abstract: BACKGROUND
  Previous studies have reported that socioeconomically disadvantaged Australians have poorer self-rated dental health (SRDH), are less likely to be insured for dental services and are less likely to have regular dental visits than their more advantaged counterparts. However, less is known about the associations between dental insurance and SRDH. The aim of this study was to examine the associations between SRDH and dental insurance status and to test if the relationship was modified by household income.
  
  
  METHODS
  A random sample of 3,000 adults aged 30-61 years was drawn from the Australian Electoral Roll and mailed a self-complete questionnaire. Analysis included dentate participants. Bivariate associations were assessed between SRDH and insurance stratified by household income group. A multiple variable model adjusting for covariates estimated prevalence ratios (PR) of having good to excellent SRDH and included an interaction term for insurance and household income group.
  
  
  RESULTS
  The response rate was 39.1% (n = 1,093). More than half (53.9%) of the participants were insured and 72.5% had good to excellent SRDH. SRDH was associated with age group, brushing frequency, insurance status and income group. Amongst participants in the $40,000- < $80,000 income group, the insured had a higher proportion reporting good to excellent SRDH (80.8%) than the uninsured (66.5%); however, there was little difference in SRDH by insurance status for those in the $120,000+ income group. After adjusting for covariates, there was a significant interaction (p < 0.05) between having insurance and income; there was an association between insurance and SRDH for adults in the $40,000- < $80,000 income group, but not for adults in higher income groups.
  
  
  CONCLUSIONS
  For lower socio-economic groups being insured was associated with better SRDH, but there was no association for those in the highest income group. Insurance coverage may have the potential to improve dental health for low income groups.
authors.affiliation: ARCPOH, School of Dentistry, University of Adelaide, 122 Frome Street, 5005 Adelaide, South Australia. dana.teusner@adelaide.edu.au.
authors.forename: Dana N
authors.initials: DN
authors.lastname: Teusner
authors.forename: Olga
authors.initials: O
authors.lastname: Anikeeva
authors.forename: David S
authors.initials: DS
authors.lastname: Brennan
mesh_terms: D000328:Adult; D000367:Age Factors; D001315:Australia / Q000453:epidemiology; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D019458:Insurance Coverage / Q000191:economics / Q000706:statistics & numerical data; D007347:Insurance, Dental / Q000191:economics / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009909:Oral Health / Q000191:economics* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014099:Toothbrushing / Q000191:economics / Q000706:statistics & numerical data