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Introduction: Explanations for health inequalities include material, behavioural and psychosocial pathways. Social relationships are an important determinant of health, and research has consistently found that a lack of support networks may diminish favourable health outcomes. There is some evidence that social network structures, partly shaped by socioeconomic factors, contribute to health inequalities. This protocol will summarise the systematic review process. Methods and analyses: The Systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. An electronic database search of MEDLINE, Embase Classic + Embase and PsychINFO using the OvidSP platform will be undertaken. Databases will be searched from the earliest date of entry until 10 June 2022. Articles that have quantitatively assessed the role of social relationships in mediating or moderating health inequalities will be included and any health outcome (mental/physical) will be considered. The database search will be supplemented by reference list screening of all relevant full-text articles identified through the search. Two independent reviewers will be responsible for screening of articles, data extraction and assessment of bias. Observational studies will be risk assessed for bias using a modified version of the Newcastle-Ottawa Quality Assessment Scale, and intervention studies will be assessed using the revised Cochrane risk-of-bias tool. It is anticipated that the eligible studies will be highly variable; therefore, a meta-analysis will only be considered if the available data of the selected studies are similar. If the studies are too heterogeneous, a narrative synthesis of the extracted data will be presented. Conclusion: The results of the systematic review will examine the link between social relationships and health inequalities. The findings of the review will identify gaps in knowledge where further research is needed. Systematic review registration: PROSPERO CRD42020181706 [ABSTRACT FROM AUTHOR]

Background There are stark ethnic inequalities in the prevalence of UK childhood obesity. However, data on adolescent overweight in different ethnic groups are limited. This study assessed ethnic inequalities in overweight prevalence during mid-adolescence using body mass index (BMI) and explored the contribution of socioeconomic and behavioural factors. Methods We analyzed data from 10 500 adolescents aged between 13 and 15 years who participated in sweep six of the Millennium Cohort Study. Ethnic inequalities in overweight and mean BMI were assessed using multiple regression models. Results were stratified by sex and adjusted for socioeconomic and behavioural factors. Results Black Caribbean males had significantly higher BMI than White males after full adjustment [excess BMI 2.94, 95% confidence interval (CI) 0.70–5.19] and were over three times more likely to be overweight [odds ratio (OR): 3.32, 95% CI 1.95–5.66]. Black Africans females had significantly higher BMI compared with White females (excess BMI 1.86, 95% CI 0.89–2.83; OR for overweight 2.74, 95% CI 1.64–4.56), while Indian females had significantly lower BMI compared with White females (reduced BMI −0.73, 95% CI −1.37 to −0.09). Socioeconomic and behavioural factors often considered to be associated with overweight were more prevalent in some ethnic minority groups (lower socioeconomic position, lack of breakfast consumption, low fruit and vegetable intake, high sugar-sweetened beverage and fast-food consumption, and infrequent physical activity), but adjustment for these factors did not fully explain ethnic differences in overweight/BMI. Conclusion Ethnic inequalities in overweight prevalence are evident in mid-adolescence and vary according to sex. Differences in overweight/BMI between ethnic groups were not fully accounted for by socioeconomic or behavioural factors. [ABSTRACT FROM AUTHOR]

Abstract: Breastfeeding is an important public health issue worldwide. Breastfeeding rates in the United Kingdom, particularly for exclusive breastfeeding, are low compared with other OECD countries, despite its wide‐ranging health benefits for both mother and child. There is evidence that deprivation in the structural and social organisation of neighbourhoods is associated with adverse child outcomes. This study aimed to explore whether breastfeeding initiation, exclusive breastfeeding for at least 3 months, and any type of breastfeeding for at least 6 months were associated with neighbourhood context measured by neighbourhood deprivation and maternal neighbourhood perceptions in a nationally representative U.K. sample. A cross‐sectional analysis was conducted using data from the Millennium Cohort Study. Logistic regression was carried out on a sample of 17,308 respondents, adjusting for individual‐ and familial‐level socio‐demographic characteristics. Neighbourhood deprivation was independently and inversely associated with breastfeeding initiation. Compared with the least deprived areas, the likelihood of initiating breastfeeding was 40% lower in the most deprived neighbourhoods (OR: 0.60, 95% CI [0.50, 0.72]). The relationship between both exclusive and any type of breastfeeding at 3 and 6 months respectively with neighbourhood deprivation after adjustment for potential confounders was not entirely linear. Breastfeeding initiation (OR: 0.78, 95% CI [0.71, 0.85]), exclusivity for 3 months (OR: 0.84, 95% CI [0.75, 0.95]), and any breastfeeding for 6 months (OR: 0.82, 95% CI [0.73, 0.93]) were each reduced by about 20% among mothers who perceived their neighbourhoods lacking safe play areas for children. Policies to improve breastfeeding rates should consider area‐based approaches and the broader determinants of social inequalities. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Dental diseases are the most common chronic diseases worldwide. Healthy teeth are vital for quality of life, particularly diet and nutrition. However, little information exists to inform health policymakers about potentially long‐lasting influences of early‐life conditions. The purpose of this study was to investigate the relation between early‐life socioeconomic conditions and number of natural teeth at age 50 and above. Methods: Analyses were conducted on cross‐sectional data from the Survey of Health, Ageing and Retirement in Europe (SHARE wave 5), which includes information on 41 560 respondents aged 50 years or older from 14 European countries and Israel. Using SHARE life history information, a series of regression models (OLS, Tobit) were estimated to analyse the relationship between socioeconomic conditions in earlier life and the number of teeth at age 50+. Results: Childhood socioeconomic background was associated with the number of natural teeth at age 50 and above, even after controlling for current determinants of oral health. Respondents who had had more than 25 books in their childhood household had a mean 1.4 (95% CI: 1.2‐1.5) more teeth than respondents with fewer books. Respondents who reported poor financial conditions during childhood had a mean 0.6 (95% CI: 0.3‐0.9) fewer teeth than respondents who reported better financial conditions in childhood. Conclusion: These findings substantiate the association between socioeconomic conditions in the early years of life and tooth retention to older adulthood and highlight the long‐lasting relation between childhood living conditions and oral health through the lifecourse. [ABSTRACT FROM AUTHOR]

Objectives The aim of this study was to assess whether traumatic dental injuries ( TDI) were socially graded among children and adolescents in England, Wales and Northern Ireland, using nationally representative data from the Children's Dental Health Survey ( CDHS) 2013. Methods This cross-sectional study used data from the Children's Dental Health Survey 2013 which was conducted among a nationally representative sample of schoolchildren in England, Wales and Northern Ireland. Children's family socioeconomic position ( SEP) was measured through free school meal eligibility and relative area deprivation using the Indices of Multiple Deprivation. The analytical sample included 6707 schoolchildren aged 8, 12 and 15. Multiple logistic regression was used to model the associations between experience of TDI and the two markers of SEP, after adjusting for sex and age. Results The overall prevalence of traumatic dental injuries to permanent incisors was 9% ( n = 590). There were no statistically significant associations between TDI and either SEP measure. Further subgroup analyses ( n = 2650) showed also no significant associations between TDI and additional SEP markers (parental education and social class). The odds of having sustained a traumatic dental injury were higher for boys than for girls and were greater in older age groups. Conclusions This study found no significant relationships between the experience of traumatic dental injuries and two markers of family socioeconomic position among children living in England, Wales and Northern Ireland. This implies that rather than specifically targeting the more deprived sectors of society, TDI prevention policies should use upstream public health strategies incorporating a whole-population approach. [ABSTRACT FROM AUTHOR]

Prevalence of tooth loss has increased due to population aging. Tooth loss negatively affects the overall physical and social well-being of older adults. Understanding the role of socio-demographic and other predictors associated with tooth loss that are measured in non-clinical settings can be useful in community-level prevention. We used high-dimensional epidemiological data to investigate important factors in predicting tooth loss among older adults over a 6-year period of follow-up. Data was from participants of 2010 and 2016 waves of the Japan Gerontological Evaluation Study (JAGES). A total of 19,407 community-dwelling functionally independent older adults aged 65 and older were included in the analysis. Tooth loss was measured as moving from a higher number of teeth category at the baseline to a lower number of teeth category at the follow-up. Out of 119 potential predictors, age, sex, number of teeth, denture use, chewing difficulty, household income, employment, education, smoking, fruit and vegetable consumption, community participation, time since last health check-up, having a hobby, and feeling worthless were selected using Boruta algorithm. Within the 6-year follow-up, 3013 individuals (15.5%) reported incidence of tooth loss. People who experienced tooth loss were older (72.9 ± 5.2 vs 71.8 ± 4.7), and predominantly men (18.3% vs 13.1%). Extreme gradient boosting (XGBoost) machine learning prediction model had a mean accuracy of 90.5% (±0.9%). A visual analysis of machine learning predictions revealed that the prediction of tooth loss was mainly driven by demographic (older age), baseline oral health (having 10–19 teeth, wearing dentures), and socioeconomic (lower household income, manual occupations) variables. Predictors related to wide a range of determinants contribute towards tooth loss among older adults. In addition to oral health related and demographic factors, socioeconomic factors were important in predicting future tooth loss. Understanding the behaviour of these predictors can thus be useful in developing prevention strategies for tooth loss among older adults. • A variety of determinants are associated with tooth loss among older adults. • Machine learning can be adapted to predict tooth loss using epidemiological data. • Socio-demographic factors have a high impact on predicting tooth loss. • Actionable interpretations can be obtained from machine learning predictions. [ABSTRACT FROM AUTHOR]