Social Inequalities in Periodontal Diseases

描述（由申请人提供）：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（即种族/民族或社会经济群体）之间的差异持续存在，表明这种改善是不均衡的。事实上，这种改善差异实际上有助于扩大不平等差距。此外，尽管美国健康比较的长期重点是种族/民族，但多年来一直记录了“富人”和“穷人”之间的差异，并且仍然普遍存在。一个这样的差距是口腔健康，更具体地说，牙周病的差距，这已经从国家和地方调查报告多年。之前的研究表明，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，社会经济地位和传统的危险因素并不能完全解释牙周健康的差异。这些研究结果表明，牙周病差异的决定因素可能超出了个人特征。因此，为了减少群体之间的差距，在研究牙周健康差异时，需要采用多层次和跨学科的研究方法来解决更遥远或上游的因素（即，人们生活和互动的地方可以影响和塑造他们的健康状况和行为模式）。 这个职业过渡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科疾病的社会决定因素，而且还研究一般健康。建议培训三个领域：口腔流行病学、高级流行病学方法和统计分析以及社会流行病学。我在这些领域的培训将由五位导师监督：Burr，BDS，MPH，PhD; Rueben C. Warren DDS，DrPH，Ana V. Diez-Roux，MD，PhD;布鲁斯Link，PhD和Harold W.邻居博士我的目标是成为一名独立的调查员，使用健康方法的社会决定因素（包括个人及其直接环境）来解决研究问题。 这项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）评估个人和社区水平社会因素的贡献; 2）检查个人危险因素对牙周病种族/民族和社会经济差异的贡献; 3）调查个人和社区水平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.