Regional inequalities and multilevel determinants of subjective oral health perception among Korean adults
10.11149/jkaoh.2025.49.4.198
- Author:
Se-Hwan JUNG
1
;
A-Rang LIM
Author Information
1. Department of Preventive and Public Health Dentistry, College of Dentistry & Research Institute of Oral Science, Gangneung-Wonju National University, Gangneung, Korea
- Publication Type:Original Article
- From:Journal of Korean Academy of Oral Health
2025;49(4):198-204
- CountryRepublic of Korea
- Language:English
-
Abstract:
Objectives:This study aimed to examine regional disparities in self-rated oral health among Korean adults and identify individual- and community-level determinants associated with poor oral health perception.
Methods:Data were obtained from the 2024 Korea Community Health Survey, that included 231,728 adults aged 19 years and older. The dependent variable was self-rated oral health, which was dichotomized as either good or poor. Individual-level variables included age, sex, marital status, education, occupation, income, receipt of basic livelihood security, tooth brushing after lunch, smoking, unmet dental care needs, and dental scaling experience. Community-level factors such as fiscal self-reliance, social welfare expenditure, number of basic livelihood security recipients, and dental infrastructure (number of dentists and dental clinics) were obtained from national statistics.Complex sample and multilevel logistic regression analyses were conducted using STATA version 18.0, with the significance level set at 0.05.
Results:Overall, 24.7% of adults perceived their oral health as “poor,” with substantial regional differences ranging from 12.2% in Seo-gu (Daejeon) to 42.8% in Hampyeong-gun (Jeonnam), a 30.6-percentage-point gap. At the individual level, older age, lower education and income, basic livelihood security, not brushing teeth after lunch, smoking, lack of dental scaling, and unmet dental needs were significantly associated with poor oral health perception. At the community level, lower fiscal self-reliance, smaller proportions of social welfare expenditure, and lower levels of dental infrastructure were linked to negative perceptions of oral health. Multilevel analysis revealed that although individual factors explained most of the variance, significant inter-regional differences remained, indicating structural influences at the community level.
Conclusions:Self-rated oral health among Korean adults was influenced not only by individual socioeconomic and behavioral factors but also by community-level fiscal and welfare environments. The findings highlight the need to reduce regional disparities in oral health infrastructure and strengthen preventive equity-oriented oral health policies.
