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Social capital and regional influences: key predictors of unmet dental care needs among older adults in Korea
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Ji-Yeon Lim, Ju-Mi Lee, Hae-Sung Nam
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Epidemiol Health. 2025;47:e2025025. Published online May 7, 2025
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DOI: https://doi.org/10.4178/epih.e2025025
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 Abstract
Summary
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Abstract
OBJECTIVES
Access to dental services is essential for improving quality of life, and social capital plays a key role in facilitating that access. This study aimed to identify individual-level and regional-level factors, including social capital, that predict unmet dental care needs among older adults.
METHODS We analyzed data from 59,414 older adults obtained from the 2023 Korea Community Health Survey and the Korean Statistical Information Service, employing a 2-level multilevel model. The dependent variables comprised 3 types of unmet dental care needs: overall, due to lack of acceptability, and due to economic reasons. Twelve independent variables, including social capital and other individual and regional factors, were examined.
RESULTS The prevalence of unmet needs was 14.15% overall, 8.70% for acceptability reasons, and 4.85% for economic reasons. Lower individual social capital was associated with higher odds of unmet dental care needs, whereas regional social capital factors demonstrated no significant association. Residing in regions with higher fiscal independence ratios was related to an increased likelihood of economic unmet needs (odds ratio [OR], 1.29; 95% confidence interval [CI], 1.09 to 1.52). In contrast, a greater density of dentists per 10,000 population was inversely associated with overall and acceptability-related unmet needs (OR, 0.82 for both; 95% CI, 0.73 to 0.92 and 0.73 to 0.93, respectively).
CONCLUSIONS Individual social capital and specific regional factors—namely, fiscal independence and density of dentists—may represent important determinants of unmet dental care needs among older adults. Policy interventions aimed at reducing unmet needs should consider these variables.
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Summary
Korean summary
· 낮은 사회적 자본(이웃에 대한 낮은 신뢰, 적은 연락빈도, 배우자의 부재, 낮은 사회참여)은 노인의 미충족 치과의료경험을 증가시킨다.
· 지역의 높은 재정자립도는 경제성 결여로 인한 미충족 치과의료경험을 증가시키며, 인구 1만명당 치과의사수가 높을수록 전체, 수용성 결여로 인한 미충족 치과의료경험을 감소시킨다.
Key Message
· Lower social capital (lower levels of trust in neighbors, less frequent contact, absence of a spouse, and lack of social participation) increases the risk of unmet dental care needs among older adults.
· Higher regional fiscal independence increases unmet dental care needs due to economic reasons, while a greater density of dentists reduces overall unmet dental care needs and those due to lack of acceptability.
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