The impact of sugar-sweetened beverage consumption on income inequalities in oral health among Australian children: A causal mediation analysis     — The Association Specialists
  1. Schedule
  2. Oral Presentations - Advancing Epidemiological Methods 1
  3. The impact of sugar-sweetened beverage consumption on income inequalities in oral health among Australian children: A causal mediation analysis    

The impact of sugar-sweetened beverage consumption on income inequalities in oral health among Australian children: A causal mediation analysis     (23839)

Ziyao Ge 1 , Yi Yang 1 , Claudia Marck 1 , Roisin McGrath 1 , Adya Gupta 2 , George Disney 1 , Ankur Singh 3
  1. University of Melbourne, Melbourne, VIC, Australia
  2. Deakin University, Melbourne, VIC, Australia
  3. University of Sdyney, Sdyney, NSW, Australia

Background

Dental caries exhibits substantial income inequalities among Australian children. Sugar-sweetened beverage (SSB) consumption is a key modifiable risk factor and socially patterned, suggesting it may act as a pathway linking income to oral diseases. However, the extent to which SSB consumption explains these inequalities remains unclear.

Method

We used data on 3,641 participants from the first four waves (2004-2010) of nationally representative birth cohort of Longitudinal Study of Australian Children (LSAC). Using interventional causal mediation analysis with g-computation within a target trial framework, we estimated the extent to which the effect of low household income (2-3 years) on dental caries and tooth loss due to caries (6-7 years) can be reduced under two hypothetical interventions on SSBs consumption (4-5 years): (1) shifting the distribution of SSB consumption among children from low-income households to that of high-income households, and (2) eliminating SSB consumption for all children.

Results

Equalising soft drink consumption was estimated to produce only a minimal reduction in income-related inequalities in oral health. The interventional indirect effect was 0.002 (95% CI −0.001 to 0.005) for dental caries, accounting for approximately 5% of the total effect, and 0.001 (0.000 to 0.002) for tooth loss due to caries, accounting for around 10%. Similarly, eliminating soft drink consumption reduced a small proportion of inequality in oral health. The proportion of the effect mediated by SSBs was 8.9% (95% CI: -1.028 to 1.206) for dental caries and 17.6% (95% CI: -1.902, 2.255) for tooth loss.

Conclusions

SSBs consumption explains only a small proportion of income inequalities in oral health. Intervention addressing oral health inequalities should therefore extend beyond SSB reduction to target the broader family context and food environment. Future research should investigate the other pathways that contribute to these inequalities, including wider social determinants such as access to nutrition food.