Abstract
Background
In Japan, a universal health insurance coverage system has been established, and everyone has equal access to medical care. Therefore, Japan is often considered to have less disparity in living standards than other countries. However, there are few reports on a correlation between social class and health due to the image of fewer individual disparities.
Aim
This study aimed to investigate the association between childhood dental caries and socioeconomic background.
Methods
Using various government statistics sources, we examined the association between childhood dental caries and socioeconomic factors in Japan including the induced abortion rate and number of recognized criminal offenses as objective variables.
Four factors were selected as explanatory variables: monthly income per household, percentage of expenditure on other living expenses, number of penal-code offenses, and clearance rate of penal-code offenses. The induced abortion rates per 1000 women by age for prefectures or induced abortion rates per 1000 women aged 25–29 years for prefectures (‰) were correlated with the prevalence of dental caries in children as explanatory variables.
Results
This study demonstrated a significant effect (p<0.05) of induced abortion on increased childhood dental caries.
Conclusion
Our findings highlight the importance of dentists sharing medical knowledge about obstetrics and pediatrics with the community and other medical professionals through avenues such as community medicine and school health checkups.
1
Introduction
Childhood growth and health are greatly influenced by the economic status and social class of the household [ ]. Since the establishment of the public medical insurance system in Japan in 1961, all individuals in the country have equal access to medical care. Therefore, health disparities in Japan have narrowed and health standards have increased [ ]. Furthermore, Japan has universal health insurance and pension systems and is a country with small disparities in living standards compared with those of other countries. This has led to the misconception of Japan having fewer individual disparities; therefore, few studies have investigated the relationship between social background and health in Japan [ , ]. In recent years, a known association between children’s oral health and maltreatment has emerged in Japan [ ]. Moreover, various economic and social factors may influence the oral health of children in Japan.
This study aimed to examine the association between social backgrounds in Japan and childhood dental caries using data from various government statistics sources. In Japan, approximately 24% of the causes of deaths in judicial autopsies involving cases aged <10 years old between 1987 and 1996 were deaths from abuse in a narrow sense of the term; however, most victims of strangulation or blood loss were victims of forced double suicide, which is a form of child abuse in the sense that the parents have deprived their children of a future at their own discretion [ ]. Forced double suicide and infanticide should also be understood as child abuse in a broad sense. Induced abortion might also be considered a form of child abuse in that it could be perceived as depriving a child of a future based on a parent’s arbitrary decision. Therefore, data gathered included the induced abortion rate and the number of criminal offenses, as indicators in relation to determining the extent to which children are provided with protection and security. Additionally, we investigated the relationship between childhood dental caries and various other social factors. A census is conducted every five years in Japan, and the most recent census was completed in 2020. Therefore, other government statistics were selected from the years closest to 2020 for which data were available for all prefectures.
2
Materials and methods
2.1
Target and data
The used various government statistics sources are listed in Table 1 . They were collected from national statistics compiled by the Government Statistics Office, Statistics Bureau of the Ministry of Internal Affairs and Communications, Children and Families Agency, White Paper on the Aging Society, White Paper on the Police, White Paper on Crime in 2018, Ministry of Justice of Japan, and the expected aging rate in 2045 from the National Institute of Population and Social Security Research.
| Variables used | Source Statistics | Frequency of surveys | Subject of surveys | Social factors | Ministries and agency in charge |
|---|---|---|---|---|---|
| Students with dental caries (%: Number of students who have completed caries treatment and students with untreated dental caries x 100/all students undergoing school health checkups) in 2021 | School health statistics | Every year | All school students (6–17 years old) | Dental caries rate | Ministry of education, culture, sports, science and technology, Japan |
| Number of households for prefectures in 2020 (households) | Census | Every 5 years | Exhaustive survey | Number of households | Ministry of internal affairs and communications, Japan |
| Household members for prefectures in 2020 (people) | Census | Every 5 years | Exhaustive survey | Number of households | Ministry of internal affairs and communications, Japan |
| Family income and expenditure of households per prefecture in 2021 | Census | Every 5 years | Exhaustive survey | Standard of living indicators | Ministry of internal affairs and communications, Japan |
| Monthly income per household (two- or more-person households–worker households) (1000 yen) (%) | Census | Every 5 years | Exhaustive survey | Standard of living indicators | Ministry of internal affairs and communications, Japan |
| Monthly wages and salaries of household heads per household (two- or more-person households–worker households) (1000 yen) (%) | Census | Every 5 years | Exhaustive survey | Standard of living indicators | Ministry of internal affairs and communications, Japan |
| Annual income per household (1000 yen) | Census | Every 5 years | Exhaustive survey | Standard of living indicators | Ministry of internal affairs and communications, Japan |
| Annual income of household head per household (1000 yen) (%) | Census | Every 5 years | Exhaustive survey | Standard of living indicators | Ministry of internal affairs and communications, Japan |
| Monthly propensity to consume (two- or more-person households–worker households) (%) | Census | Every 5 years | Exhaustive survey | Standard of living indicators | Ministry of internal affairs and communications, Japan |
| Monthly living expenditures per household (two- or more-person households) (1000 yen) | Census | Every 5 years | Exhaustive survey | Standard of living indicators | Ministry of internal affairs and communications, Japan |
| Percentage of expenditure on food (two- or more-person households) (%) | Census | Every 5 years | Exhaustive survey | Standard of living indicators | Ministry of internal affairs and communications, Japan |
| Percentage of expenditure for housing (two- or more-person households) (%) | Census | Every 5 years | Exhaustive survey | Standard of living indicators | Ministry of internal affairs and communications, Japan |
| Percentage of expenditure on fuel, light, and water (two- or more-person households) (%) | Census | Every 5 years | Exhaustive survey | Standard of living indicators | Ministry of internal affairs and communications, Japan |
| Percentage of expenditure on furniture and household utensils (two- or more-person households) (%) | Census | Every 5 years | Exhaustive survey | Standard of living indicators | Ministry of internal affairs and communications, Japan |
| Percentage of expenditure on clothing and footwear (two- or more-person households) (%) | Census | Every 5 years | Exhaustive survey | Standard of living indicators | Ministry of internal affairs and communications, Japan |
| Percentage of expenditure on medical care (two- or more-person households) (%) | Census | Every 5 years | Exhaustive survey | Standard of living indicators | Ministry of internal affairs and communications, Japan |
| Percentage of expenditure on transportation and communication (two- or more-person households) (%) | Census | Every 5 years | Exhaustive survey | Standard of living indicators | Ministry of internal affairs and communications, Japan |
| Percentage of expenditure on reading and recreation (two- or more-person households) (%) | Census | Every 5 years | Exhaustive survey | Standard of living indicators | Ministry of internal affairs and communications, Japan |
| Percentage of expenditure on other living (%) (two- or more-person households) | Census | Every 5 years | Exhaustive survey | Standard of living indicators | Ministry of internal affairs and communications, Japan |
| Percentage of net savings and insurance to disposable income (two- or more-person households-worker households) (%) | Census | Every 5 years | Exhaustive survey | Standard of living indicators | Ministry of internal affairs and communications, Japan |
| Percentage of net savings to disposable income (two- or more-person households–worker households) (%) | Census | Every 5 years | Exhaustive survey | Standard of living indicators | Ministry of internal affairs and communications, Japan |
| Percentage of net decrease in debt for houses and land to disposable income (two- or more-person households–worker households) (%) | Census | Every 5 years | Exhaustive survey | Standard of living indicators | Ministry of internal affairs and communications, Japan |
| Household assets per prefecture in 2019 | Census | Every 5 years | Exhaustive survey | Standard of living indicators | Ministry of internal affairs and communications, Japan |
| Amount of savings per household (two- or more-person households) (1000 yen) | Census | Every 5 years | Exhaustive survey | Standard of living indicators | Ministry of internal affairs and communications, Japan |
| Percentage of deposits per household (two- or more-person households) (%) | Census | Every 5 years | Exhaustive survey | Standard of living indicators | Ministry of internal affairs and communications, Japan |
| Percentage of life insurance savings per household (two- or more-person households) (%) | Census | Every 5 years | Exhaustive survey | Standard of living indicators | Ministry of internal affairs and communications, Japan |
| Percentage of securities savings per household (two- or more-person households) (%) | Census | Every 5 years | Exhaustive survey | Standard of living indicators | Ministry of internal affairs and communications, Japan |
| Liabilities per household (two- or more-person households) (in 1000 yen) | Census | Every 5 years | Exhaustive survey | Standard of living indicators | Ministry of internal affairs and communications, Japan |
| Percentage of liabilities for houses and land per household (two-person or more households; %) | Census | Every 5 years | Exhaustive survey | Standard of living indicators | Ministry of internal affairs and communications, Japan |
| Population by sex and age (three groups: Under 15 years old, 15–64 years old, and 65 years old and older) for prefectures–total population, Japanese population as of October 1, 2022 | Census | Every 5 years | Exhaustive survey | Regional differences in population structure | Statistics bureau, ministry of internal affairs and communications Japan ( https://www.stat.go.jp/data/jinsui/2022np/index.html ) |
| Total population for prefecture in 2021 (1000 people) | Census | Every 5 years | Exhaustive survey | Regional differences in population structure | Statistics bureau, ministry of internal affairs and communications Japan ( https://www.stat.go.jp/data/jinsui/2022np/index.html ) |
| 65 years old and over population for prefecture in 2021 (1000 people) | Census | Every 5 years | Exhaustive survey | Regional differences in population structure | Statistics bureau, ministry of internal affairs and communications Japan ( https://www.stat.go.jp/data/jinsui/2022np/index.html ) |
| Aging rate in 2021 (%; 65 years old and over population/total population x 100) | Census | Every 5 years | Exhaustive survey | Aging indicators | Ministry of health, labour and welfare, Japan |
| Aging rate in 2020 (%; 65 years old and over population/total population x 100) | Census | Every 5 years | Exhaustive survey | Aging indicators | Ministry of health, labour and welfare, Japan |
| Expected growth in aging rate from 2021 to 2045 (national institute of population and social security Research, Tokyo, Japan, regional population projections for Japan: 2015–2045, 2018) | The research report of national institute of population and social security research | Every 5 years | Exhaustive survey | Aging indicators | Ministry of health, labour and welfare, Japan |
| Number of consultations received on child abuse in the child guidance center in 2021 and 2022 per prefecture children and families agency of Japan | Children and families agency of Japan press release | Every year | Exhaustive survey | Indicators of child safety | Children and families agency of Japan a |
| Number of consultations received on child abuse in the child guidance center in 2021 per prefecture | Children and families agency of Japan press release | Every year | Exhaustive survey | Indicators of child safety | Children and families agency of Japan a |
| Number of consultations received on child abuse in the child guidance center in 2022 per prefecture | Children and families agency of Japan press release | Every year | Exhaustive survey | Indicators of child safety | Children and families agency of Japan a |
| Increase or decrease in the number of consultations on child abuse in the child guidance centers in 2022 compared to the previous year per prefecture | Children and families agency of Japan press release | Every year | Exhaustive survey | Indicators of child safety | Children and families agency of Japan a |
| Ratio of the number of consultations received on child abuse in the child guidance center between 2021 and 2022 per prefecture | Children and families agency of Japan press release | Every year | Exhaustive survey | Indicators of child safety | Children and families agency of Japan a |
| Number of consultations received on child abuse in the child guidance center per 1000 population in 2021 per prefecture children and families agency of Japan | Children and families agency of Japan press release | Every year | Exhaustive survey | Indicators of child safety | Children and families agency of Japan a |
| Number of penal code offenses and the clearance rate of penal code offenses per 1000 people are known to the police | White paper on police 2021 | Every year | Exhaustive survey | Indicators of social security | National police agency of Japan |
| Number of felonious offenses known to the police per 1000 people and clearance rate of felonious offenses per 1000 people | White paper on police 2021 | Every year | Exhaustive survey | Indicators of social security | National police agency of Japan |
| Number of violent offenses known to the police per 1000 population and the clearance rate of violent offenses | White paper on police 2021 | Every year | Exhaustive survey | Indicators of social security | National police agency of Japan |
| Number of larceny offenses known to the police per 1000 population and the clearance rate of larceny offenses | White paper on police 2021 | Every year | Exhaustive survey | Indicators of social security | National police agency of Japan |
| Number of intellectual offenses known to the police per 1000 population and the clearance rate of intellectual offenses | White paper on police 2021 | Every year | Exhaustive survey | Indicators of social security | National police agency of Japan |
| Number of moral offenses known to the police per 1000 population and the clearance rate of moral offenses | White paper on police 2021 | Every year | Exhaustive survey | Indicators of social security | National police agency of Japan |
| Number of other penal code offenses known to the police per 1000 people and the clearance rate of other penal code offenses | White paper on police 2021 | Every year | Exhaustive survey | Indicators of social security | National police agency of Japan |
| Rate per population of juveniles cleared (including juvenile offenders under 14 who are guided by the police) for penal code offenses | White paper on crime in 2018 | Every year | Exhaustive survey | Indicators of social security | Ministry of justice, Japan |
| Total induced abortion rates per 1000 women by age for prefectures (‰) | Report on social welfare administration and services | Every year | Exhaustive survey | Indicators of the environment surrounding children | Ministry of health, labour and welfare, Japan |
| Induced abortion rates per 1000 women aged <20 years for prefectures (‰) | Report on social welfare administration and services | Every year | Exhaustive survey | Indicators of the environment surrounding children | Ministry of health, labour and welfare, Japan |
| Induced abortion rates per 1000 women aged 20–24 years for prefectures (‰) | Report on social welfare administration and services | Every year | Exhaustive survey | Indicators of the environment surrounding children | Ministry of health, labour and welfare, Japan |
| Induced abortion rates per 1000 women aged 25–29 years for prefectures (‰) | Report on social welfare administration and services | Every year | Exhaustive survey | Indicators of the environment surrounding children | Ministry of health, labour and welfare, Japan |
| Induced abortion rates per 1000 women aged 30–34 years for prefectures (‰) | Report on social welfare administration and services | Every year | Exhaustive survey | Indicators of the environment surrounding children | Ministry of health, labour and welfare, Japan |
| Induced abortion rates per 1000 women aged 35–39 years for prefectures (‰) | Report on social welfare administration and services | Every year | Exhaustive survey | Indicators of the environment surrounding children | Ministry of health, labour and welfare, Japan |
| Induced abortion rates per 1000 women aged 40–45 years for prefectures (‰) | Report on social welfare administration and services | Every year | Exhaustive survey | Indicators of the environment surrounding children | Ministry of health, labour and welfare, Japan |
| Induced abortion rates per 1000 women aged 45–49 years for prefectures (‰) | Report on social welfare administration and services | Every year | Exhaustive survey | Indicators of the environment surrounding children | Ministry of health, labour and welfare, Japan |
| Temperature (normal value) for prefectures (1991–2020 average) b | Statistical handbook of Japan 2023 | Every year | Point observation | Indicators of severity of living conditions | Statistics bureau, ministry of internal affairs and communications Japan |
Stay updated, free dental videos. Join our Telegram channel
VIDEdental - Online dental courses
