UBC Theses and Dissertations

UBC Theses Logo

UBC Theses and Dissertations

Family socioeconomic status, psychosocial factors, and oral health in children and adolescents Gazzaz, Arwa Zohair


Socioeconomic status (SES)- and disability-based inequalities in oral health are well documented, but the pathways underlying these relationships are not fully understood. To understand these pathways, this dissertation includes three research projects focusing on psychosocial factors and their associations with oral health inequalities in children and adolescents. Several hypotheses guided by the Stress Process Model were tested using data from nationally representative Canadian and United States (US) surveys. The first study analyzed the 2012 US National Survey of Children Health (NSCH) (n=21,596 children and n=23,584 adolescents) and found that (a) parents with lower income and lower educational levels reported greater parenting stress; (b) parenting stress was associated with worse child oral health, but not child preventive dental visits; and (c) child/adolescent age-related differences were observed in the association between household SES and parenting stress, but not in the association between parenting stress and child oral health-related outcomes. The second study analyzed data from the Canadian 2014 Health Behaviour in School‐aged Children study (n=20,357 adolescents) and revealed the following: (a) adolescents from lower affluence families were less likely to have family and peer social support, (b) family social support was associated with lower probability of oral health-risk behaviours, and (c) peer social support was associated with frequent toothbrushing and high sugar-sweetened beverage consumption. The third study analyzed the US NSCH (n=27,874 children and n=31,328 adolescents) and showed that (a) parents of children and adolescents with (versus without) special health care needs were more likely to report high parenting stress and low social support (instrumental or emotional), (b) parental instrumental social support was associated with unmet child dental needs, and (c) parental instrumental social support mitigated some of the negative associations between parenting stress and child dental care. Altogether, these studies highlight the importance of the interplay between social and psychosocial factors on the oral health of children and adolescents. The findings contribute to knowledge gaps for understanding oral health inequalities, such as the importance of family and peer support in promoting oral health behaviours and the broader role of parental psychosocial factors in shaping oral health inequalities.

Item Media

Item Citations and Data


Attribution-NonCommercial-NoDerivatives 4.0 International