title: Socioeconomic gradients in general and oral health of primary school children in Shiraz, Iran.
abstract: BACKGROUND
  Health status is largely determined by socio-economic status. The general health of individuals at higher social hierarchy is better than people in lower levels. Likewise, people with higher socio-economic status have better oral health than lower socio-economic groups. There has not been much work regarding the influence of socio-economic status on the health conditions of children in developing countries, particularly in Iran. The aim of this study was to compare the oral and general health conditions of primary school children of three different socio-economic areas in the city of Shiraz, Iran.
  
  
  METHODS
  This cross-sectional study was conducted on 335, 8- to 11-year-old primary schoolchildren in Shiraz. The children were selected by a three-stage cluster sampling method from three socio-economically different areas. Tools and methods used by the United Kingdom's Medical Research Council were used to obtain anthropometric variables as indicators of general health. The Decay, Missing, Filled Teeth (DMFT) Index for permanent teeth, dmft Index for primary teeth, the Modified Developmental Defects of Enamel (DDE) Index, the Gingival Index (GI) and the Debris Index-Simplified (DI-S) were used for oral health assessment.
  
  
  RESULTS
  Height (P<0.001), weight (P<0.001), and BMI (P=0.001) significantly increased as the socio-economic status of area increased. GI score (P<0.001), DI-S score (P<0.001), number of permanent teeth with DDE (P=0.008), and number of DDE lesions in permanent teeth (P=0.008) significantly decreased as the socio-economic status of area increased.
  
  
  CONCLUSIONS
  Findings of this study generally confirmed that social gradients exist in both general and oral health status of the primary schoolchildren of Shiraz. The influence of socio-economic status on health condition means children have different life chances based on their socio-economic conditions. These findings emphasize the significance of interventions for tackling socio-economic inequalities in order to improve the health status of children in lower socio-economic areas.
authors.affiliation: Department of Dental Public Health, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, 71345-1836, Iran; Research Department of Epidemiology and Public Health, University College London, London, WC1E 7HB, UK.
authors.forename: Ali
authors.initials: A
authors.lastname: Golkari
authors.affiliation: Department of Dental Public Health, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, 71345-1836, Iran.
authors.forename: Aira
authors.initials: A
authors.lastname: Sabokseir
authors.affiliation: Research Department of Epidemiology and Public Health, University College London, London, WC1E 7HB, UK.
authors.forename: Aubrey
authors.initials: A
authors.lastname: Sheiham
authors.affiliation: Research Department of Epidemiology and Public Health, University College London, London, WC1E 7HB, UK.
authors.forename: Richard G
authors.initials: RG
authors.lastname: Watt
keywords: Health status disparities; Inequalities; Oral health; Socio-economic factors