Social Capital and Dental Service Utilisation Among Japanese Older Adults: A Multilevel Longitudinal Study Using the Japan Gerontological Evaluation Study (JAGES) Data.

内容摘要

Social capital is an important social determinant of health linked to oral health and health-related behaviours. Several studies assessed its association with dental service utilisation; however, findings remain inconsistent. This study aimed to examine the association between individual- and community-level social capital and dental service utilisation within the past 12 months among Japanese older adults. This longitudinal study utilised self-report data from the Japan Gerontological Evaluation Study in 2019 and 2022. Individual-level civic participation, social cohesion, and reciprocity were assessed and aggregated to community-level using factor analysis. The outcome was dental service utilisation (preventive, treatment, and overall dental visits). Multilevel Poisson regression analysis was used to examine their associations. The mean age of 11,642 participants from 48 municipalities was 73.8 years (range: 65-95), and 51.4% were female. Participation in three or more civic groups was associated with 22%, 12%, and 16% higher likelihood of preventive (prevalence ratio [PR] = 1.22, 95% confidence interval [CI] = 1.15-1.30), treatment (PR = 1.12, 95% CI = 1.06-1.18), and overall visits (PR = 1.16, 95% CI = 1.10-1.22), respectively. Higher community-level civic participation was positively associated with preventive (PR for the highest tertile group = 1.20, 95% CI = 1.02-1.42), treatment (PR = 1.11, 95% CI = 1.02-1.21), and overall visits (PR = 1.13, 95% CI = 1.03-1.24). Individual- and community-level civic participation was positively associated with dental visits. Promoting civic participation could improve utilisation of dental care by older adults.