title: The impact of the economic crisis on unmet dental care needs in Spain.
abstract: OBJECTIVE
  To analyse the impact that the economic crisis and the evolution of socioeconomic inequality before (2007) and during (2011) the current crisis have had on unmet dental care needs in Spain.
  
  
  METHODS
  The Living Conditions Surveys from the years 2007 and 2011 were used, including 44 138 adults aged under 65 years. A descriptive and stratified analysis was carried out along with the calculation of the concentration index and a multivariate logistic regression jointly and separately by gender. The dependent variable was unmet dental care needs and the independent variables were income, employment status, gender, age, education and chronic disease. A dummy variable was created for the year of survey completion as a proxy measure for the economic crisis. The SPSS V.20 software was used.
  
  
  RESULTS
  During the period under analysis, the unmet needs for dental services increased (from 6.2% to 7.2%) along with the concentration index (from -0.1412 to -0.189). The main correlations with unmet needs were: unemployment (OR=1.46), lower income (OR=2.44 for the income quintile) and the year 2011 with respect to 2007 (OR 1.13). For women, the OR is greater according to income level (2.44 compared with 1.77 in men) and the year 2011 (1.21 compared with 1.06), while for men unemployment had a greater effect (OR=1.52 compared with 1.46).
  
  
  CONCLUSIONS
  There has been an increase in unmet dental care needs as well as in the social gradient for service access. The most vulnerable groups are those with less purchasing power and the unemployed. The economic crisis has also increased this unmet need.
authors: GS Córdoba Sur. Servicio Andaluz de Salud, Córdoba, Spain.
authors: Silvia
authors: S
authors: Calzón Fernández
authors: Área de Salud Pública. Escuela Andaluza de Salud Pública, Granada, Spain.
authors: Alberto
authors: A
authors: Fernández Ajuria
authors: Facultad de Ciencias Económicas y Empresariales, University of Granada, Granada, Spain.
authors: José Jesús
authors: JJ
authors: Martín
authors: Área de Salud Pública. Escuela Andaluza de Salud Pública, Granada, Spain.
authors: Matthew Joseph
authors: MJ
authors: Murphy
mesh_terms: D000328:Adult; D002908:Chronic Disease / Q000191:economics / Q000453:epidemiology*; D003729:Dental Care / Q000191:economics* / Q000706:statistics & numerical data; D057172:Economic Recession; D004522:Educational Status; D004651:Employment; D005260:Female; D054625:Healthcare Disparities / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D017533:Marital Status; D015999:Multivariate Analysis; D015995:Prevalence; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires
keywords: DENTAL HEALTH; EMPLOYMENT; Health inequalities; SOCIAL EPIDEMIOLOGY; SOCIAL INEQUALITIES