权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Investigating socioeconomic inequalities in oral health using the Adult Dental Health Survey

使用成人牙齿健康调查调查口腔健康方面的社会经济不平等

基本信息

批准号：
ES/K004689/1
负责人：
John Wildman
金额：
$ 19.98万
依托单位：
Newcastle University
依托单位国家：
英国
项目类别：
Research Grant
财政年份：
2013
资助国家：
英国
起止时间：
2013 至无数据
项目状态：
已结题

来源：
https://gtr.ukri.org/projects?ref=ES%2FK004689%2F1
关键词：
Investigating socioeconomic inequalities oral health

项目摘要

An overview of the dental conditions of the British population suggests that the best oral health is enjoyed by those towards the top of the social scale, while the worst oral health afflicts those towards the bottom. This project aims to measure the unequal distribution of good oral health across the population, to investigate why it is unequal, and to establish whether it is getting more or less unequal over time. This is an important time in the development of dental services and the findings will feed directly into the development of health policy in the UK and inform international efforts to reduce inequalities in oral health.It is understandable that not everyone enjoys the same level of health, because of the ageing process, gender differences and different genetic endowments. However, when people are in need of care, there are over-arching equity considerations. These determine that individuals with different levels of need are treated differently in order to meet their needs (vertical equity), while those with the same level of need are treated the same (horizontal equity).The problem for policy makers and practitioners are the health inequalities that are potentially avoidable and unjust, specifically those that are related to wealth, education or social position. These reflect wider inequalities in life's opportunities, in turn preventing people from maximising their own potential, affecting the wider economy and society as a whole.Oral health is a key element of health overall, and those suffering from poor oral health face considerable social and financial burdens. The impact on a person's employment opportunities from having (for example) unattractive teeth as a young adult, or social opportunities because of poorly-fitting dentures later in life, are easy to see. Further, the costs of improving oral health can spiral, even within a national health system. Expenditure on oral health reaches over £5Bn annually in England alone (NHS and private), yet it is an area which has been largely overlooked in the inequalities literature. In this study we investigate the issues surrounding oral health inequalities through the analysis of a unique secondary dataset - the UK Adult Dental Health Survey. This has been run five times, roughly every decade from 1968 to 2009, and in this study we will use the 1988, 1998 and 2009 data.This project will investigate four issues. Firstly, it is important to measure the level of socioeconomic inequalities and to know what aspect of oral health to measure. Using statistical methods applied to a range of oral health outcomes and socioeconomic indicators, we will identify a broad range of oral health inequality measures, revealing the differences between inequalities in clinical measures (e.g. the number of teeth) and how people report their own health (e.g. oral health related quality of life). This is a time of great change in dental services, so these will provide benchmarks against which policy interventions can be assessed. Secondly, this project will investigate the interactions and influences of a range of indicators of social position and wealth on oral health. These are often complex and unless they are understood it is difficult to develop policies to improve health for everyone, but understanding them means that it is possible to intervene to improve health. Thirdly, the project will investigate how these myriad social and economic influences lead to inequalities. This means that any intervention or policy change intended to improve health, improves health for those who most need it. The final element will be to look at the time trend of oral health inequality, comparing recent data (2009) with data from the decades previously (1988 and 1998). This is a unique possibility with the data we have and will give a richer understanding of how the world of oral health is changing and how urgent any intervention may be.

对英国人口牙齿状况的概述表明，最好的口腔健康是由那些接近社会规模顶端的人享有的，而最差的口腔健康则困扰着那些接近社会底层的人。该项目旨在衡量良好口腔健康在人口中的不平等分布，调查为什么不平等，并确定随着时间的推移是否越来越不平等。这是牙科服务发展的一个重要时期，研究结果将直接影响英国卫生政策的制定，并为减少口腔健康不平等的国际努力提供信息。可以理解的是，由于衰老过程，性别差异和不同的遗传禀赋，并非每个人都享有相同的健康水平。然而，当人们需要照顾时，有过度的公平考虑。这就决定了需要程度不同的人得到不同的待遇，以满足他们的需要（纵向公平），而需要程度相同的人得到相同的待遇（横向公平），决策者和从业人员面临的问题是卫生不平等，这种不平等可能是可以避免的，也是不公正的，特别是那些与财富、教育或社会地位有关的不平等。这反映了生活中机会的不平等，从而阻碍了人们最大限度地发挥自己的潜力，影响了整个经济和社会。口腔健康是整体健康的关键因素，口腔健康不佳的人面临着相当大的社会和经济负担。一个人的就业机会的影响（例如）不好看的牙齿作为一个年轻的成年人，或社会机会，因为不合适的假牙在以后的生活中，很容易看到。此外，即使在国家卫生系统内，改善口腔健康的成本也会螺旋上升。仅在英格兰（NHS和私人），口腔健康的支出每年就超过50亿英镑，但这是一个在不平等文献中被忽视的领域。在这项研究中，我们通过分析一个独特的二次数据集-英国成人牙科健康调查调查的口腔健康不平等的问题。从1968年到2009年，大约每十年进行一次，共进行了五次，在这项研究中，我们将使用1988年、1998年和2009年的数据。首先，重要的是要衡量社会经济不平等的程度，并了解口腔健康的哪些方面来衡量。使用适用于一系列口腔健康结果和社会经济指标的统计方法，我们将确定广泛的口腔健康不平等措施，揭示临床措施（例如牙齿数量）和人们如何报告自己的健康（例如口腔健康相关的生活质量）之间的差异。这是一个牙科服务发生巨大变化的时代，因此这些将为评估政策干预提供基准。其次，本项目将调查一系列社会地位和财富指标对口腔健康的相互作用和影响。这些问题往往很复杂，除非了解这些问题，否则很难制定改善每个人健康的政策，但了解这些问题意味着有可能采取干预措施改善健康。第三，该项目将调查这些无数的社会和经济影响如何导致不平等。这意味着任何旨在改善健康的干预措施或政策变化都能改善那些最需要它的人的健康。最后一个因素是看口腔健康不平等的时间趋势，将最近的数据（2009年）与之前几十年的数据（1988年和1998年）进行比较。这是一个独特的可能性与我们所拥有的数据，并将提供一个更丰富的了解世界的口腔健康是如何变化的，以及如何紧急任何干预可能。