Social Inequalities in Periodontal Diseases

说明(申请人提供)：虽然随着时间的推移，美国人口的健康状况有所改善，但各群体之间，即种族/族裔或社会经济群体之间的差距持续存在，表明这种改善是不均衡的。事实上，这种改善差距实际上导致了差距的扩大。此外，尽管美国健康比较的长期焦点是种族/民族，但“富人”和“穷人”之间的差异多年来一直被记录在案，而且仍然普遍存在。其中一个差异是口腔健康，更具体地说是牙周病差异，这是多年来从国家和地方调查中报告的。以前的研究表明，不同种族/民族以及收入和教育等个人社会经济指标对牙周健康的影响存在差异。然而，种族/民族、SES和传统危险因素并不能完全解释观察到的牙周健康差异。这些发现表明，牙周疾病差异的决定因素可能超出了个体特征。因此，为了缩小群体之间的差距，在研究牙周健康差异(即人们生活和互动的地方可能影响和塑造他们的健康概况和行为模式)时，需要采取多层次和跨学科的研究方法，解决更远或更上游的因素。 这个职业转折奖将为我提供一个独特的机会，以获得新的和创新的方法，不仅研究牙周病和其他牙齿疾病的社会决定因素，而且研究一般的健康。提出了三个培训领域：口腔流行病学、高级流行病学方法以及统计分析和社会流行病学。我在这些领域的培训将由五位导师监督：Brian A.Burr，BDS，公共卫生硕士，博士；Rueben C.Warren DDS，DrPH，Ana V.Diez-Roux，医学博士，博士；Bruce Link，博士和Harold W.Neighbors，博士。我的目标是成为一名独立的调查者，使用健康的社会决定因素来解决研究问题，包括个人及其周围环境。 这项拟议的研究将通过以下方式扩展我们对牙周病决定因素的理解：1)评估个人和邻里层面的社会因素的贡献；2)研究个人风险因素对牙周病的种族/民族和社会经济差异的贡献；3)调查个人和邻里层面的社会因素之间的相互作用；以及4)探索牙周健康差异随时间的趋势。

DESCRIPTION (provided by applicant): While some improvements in the health of the United States population have occurred over time, the persistence of disparities between groups, namely racial/ethnic or socioeconomic groups, indicates that such improvement has been uneven. Indeed, this improvement differential has actually contributed toward widening the disparities gap. Furthermore, although the long-standing focus of health comparisons in the US has been race/ethnicity, differences between the "haves" and the "have-nots" have been documented for years and remained pervasive. One such disparity is oral health, and more specifically periodontal disease disparities, which have been reported from national and local surveys for years. Previous studies show differences in periodontal health by race/ethnicity and personal socioeconomic indicators such as income and education. However, race/ethnicity, SES, and traditional risk factors do not fully explain the observed disparities in periodontal health. These findings suggest that the determinants of disparities in periodontal diseases may extend beyond individual characteristics. Therefore, to reduce the gap among groups, multilevel and interdisciplinary research approaches addressing more distant or upstream factors will need to be undertaken in studying periodontal health disparities (i.e., the place where people live and interact could influence and shape their health profiles and behaviors patterns). This career transition award will provide me with a unique opportunity to obtain new and innovative ways for studying not only the social determinants of periodontal diseases and other dental conditions but also health in general. Three areas of training are proposed: Oral Epidemiology, Advanced Epidemiological Methods and Statistical Analysis and Social Epidemiology. My training in these areas will be overseen by five mentors: Brian A. Burr, BDS, MPH, PhD; Rueben C. Warren DDS, DrPH, Ana V. Diez-Roux, MD, PhD; Bruce Link, PhD and Harold W. Neighbors, PhD. My goal is to become an independent investigator that tackles research questions using a social determinant of health approach including individuals as well as their immediate environment. The proposed research will extend our understanding on the determinants of periodontal diseases by: 1) assessing the contribution of both individual and neighborhood-level social factors; 2) examining the contribution of individual risk factors to racial/ethnic and socioeconomic differences in periodontal diseases; 3) investigating interactions across individual and neighborhood-level social factors; and 4) exploring periodontal health disparity trends over time.