{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T01:05:09Z","timestamp":1789347909478,"version":"build-2803163510"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oral Health"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Socioeconomic inequalities in access to dental care remain a critical public health challenge in Spain, where adult coverage is limited and largely financed through out-of-pocket payments. This study aims to estimate the magnitude of socioeconomic inequality in unmet dental care needs among the Spanish adult population in 2024 and to decompose the contribution of its determinants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional analysis was conducted using data from the 2024 Spanish Living Conditions Survey (ECV). The analytic sample included 32,425 adults who reported a perceived need for dental care in the previous 12 months. Socioeconomic position was measured using equivalised disposable household income. Income-related inequalities were quantified using the Concentration Index (CI) for relative inequality and the Slope Index of Inequality (SII) for absolute inequality. Furthermore, a Wagstaff decomposition analysis was performed to isolate the specific contribution of multidimensional factors such as material deprivation and housing tenure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among individuals with perceived need, 10.44% reported unmet dental care needs, with economic constraints identified as the overwhelming barrier (78.9%). The analysis revealed a robust pro-poor gradient, indicated by a Concentration Index of \u22120.361 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). The Slope Index of Inequality was \u22120.237 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), reflecting an absolute gap of approximately 23.7 percentage points in the probability of unmet needs between the lowest and highest income extremes. Decomposition analysis identified material deprivation as the primary driver, explaining 28.0% of the total inequality, followed by social class (11.1%) and education (7.2%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The findings confirm that the \u201cInverse Care Law\u201d persists in the Spanish dental healthcare system, driven fundamentally by structural economic vulnerability rather than demographic factors. The current model fails to protect the most deprived groups. Policy interventions must prioritize the expansion of public coverage and implement targeted financial protection mechanisms to effectively reduce these inequities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/froh.2026.1768458","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T06:04:17Z","timestamp":1775801057000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Socioeconomic inequalities in unmet dental care needs in Spain"],"prefix":"10.3389","volume":"7","author":[{"given":"Sergio","family":"Zuniga-Jara","sequence":"first","affiliation":[{"name":"School of Business Sciences, Universidad Catolica del Norte","place":["Coquimbo, Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Zuniga-Soria","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universidad Catolica del Norte","place":["Coquimbo, Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Ruiz-Campo","sequence":"additional","affiliation":[{"name":"Business Administration Department, Universidad Francisco de Vitoria","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karla","family":"Soria-Barreto","sequence":"additional","affiliation":[{"name":"School of Business Sciences, Universidad Catolica del Norte","place":["Coquimbo, Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1364119","DOI":"10.3389\/fpubh.2024.1364119","article-title":"Factors related to depression in adults with oral health problems in Spain (2017 to 2020)","volume":"12","author":"Cebrino","year":"2024","journal-title":"Front Public Health"},{"key":"B2","volume-title":"Global Oral Health status Report: Towards Universal Health Coverage for Oral Health by 2030","year":"2022"},{"key":"B3","first-page":"12","article-title":"Oral health survey in Spain 2020","volume":"25","author":"Bravo P\u00e9rez","year":"2020","journal-title":"Rev Illust Consejo Gen Coll Odont\u00f3logos Estomat\u00f3logos Esp (RCOE)"},{"key":"B4","volume-title":"Health at a Glance 2023: OECD Indicators","year":"2023"},{"key":"B5","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1111\/cdoe.12056","article-title":"Socio-economic inequalities in the use of dental care services in Europe: what is the role of national health systems?","volume":"42","author":"Pal\u00e8ncia","year":"2014","journal-title":"Community Dent Oral Epidemiol"},{"key":"B6","first-page":"1","article-title":"Oral health care in Europe: financing, access and provision","volume":"24","author":"Winkelmann","year":"2022","journal-title":"Health Syst Transit"},{"key":"B7","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1016\/S0140-6736(71)92410-X","article-title":"The 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State of Health in the EU","year":"2021"}],"container-title":["Frontiers in Oral Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/froh.2026.1768458\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T14:47:57Z","timestamp":1776437277000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/froh.2026.1768458\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,10]]},"references-count":19,"alternative-id":["10.3389\/froh.2026.1768458"],"URL":"https:\/\/doi.org\/10.3389\/froh.2026.1768458","relation":{},"ISSN":["2673-4842"],"issn-type":[{"value":"2673-4842","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,10]]},"article-number":"1768458"}}