MEASURING & DOCUMENTING DISPARITIES IN ORAL HEALTH: A PRACTICAL APPROACH

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，但不同群体之间，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。尽管这些差异多年来已被记录在案，一些研究也试图检查随着时间的推移的趋势，但由于缺乏统一或标准的方法来衡量健康差异及其随时间的趋势，估计不同群体之间这些差异的程度和方向一直是一项挑战。口腔健康差异也不是这一挑战的例外。这项建议的目标是开发和测试一种方法，以评估随着时间的推移在人群中龋齿和牙周病方面的口腔健康差异。为了实现这一目标，我们提出了以下两个具体目标：目标1：使用NHANES III的数据开发敏感的方法，以衡量美国人口中龋齿和牙周病的差异，并考虑到不同研究中病例定义的差异。这些方法的制定将考虑并考虑到：a)按年龄、性别、种族/族裔和社会经济地位(SEP)指标划分的疾病在人口中的分布；b)最佳参考群体的选择；c)使用疾病的相对和绝对衡量方法得出的结果的比较。目的2：使用NHANES 1999-2002年的数据来测试在目标1中开发的评估龋齿和牙周病的口腔健康差异的措施。使用NHANES 1999-2002年的数据测试目标1中开发的方法的有效性和可靠性，将使我们能够提供使用统一和标准化措施的指导方针和建议，以记录随着时间的推移，在地方和国家层面的人口群体研究中存在的口腔健康差距。这项提案的目标与国家数据和数据研究中心战略计划的交叉领域--健康差距和数据获取与分析--以及《2010年健康人》S消除美国部分人口健康差距的目标是一致的。具体地说，实现这项拟议研究的目标有可能有助于我们了解美国的口腔健康差距；提供工具，在地方和国家层面的研究中使用统一的衡量标准来衡量口腔健康差距的大小和方向；并为随着时间的推移跨研究和人群的口腔健康差距比较建议指南。最后，所开发的措施有可能被用来衡量与年龄、性别、种族/民族和社会经济地位有关的健康差距对其他口腔健康结果和一般健康结果的影响。

DESCRIPTION (provided by applicant): While some improvements in the health of the United States (US) population have occurred over time, the persistence of disparities between groups, namely racial/ethnic or socioeconomic groups, indicates that such improvement has been uneven. Although these disparities have been documented over the years and some studies have attempted to examine trends over time, it has been challenging to estimate the magnitude and direction of these disparities across groups due to the lack of a uniform or standard methodology to measure health disparities and their trends across time. Oral health disparities are not an exception to this challenge. The goal of this proposal is to develop and test a methodology to assess oral health disparities in dental caries and periodontal diseases across populations over time. In order to accomplish this goal, we propose the following two specific aims: Aim 1: Use data from NHANES III to develop sensitive methods to measure disparities in dental caries and periodontal disease in the US population accounting for the difference in case definitions across studies. These methods will be developed considering and accounting for: a) the distribution of disease in the population by age, gender, race/ethnicity and socioeconomic position (SEP) indicators; b) the selection of the best reference group; and c) the comparison of results obtained using relative versus absolute measures of disease. Aim 2: Use data from NHANES 1999-2002 to test the measures developed in Aim 1 to assess oral health disparities in dental caries and periodontal disease. Testing the validity and reliability of the developed methodology in Aim 1 using the NHANES 1999-2002 data will allow us to provide guidelines and recommendations for the use of uniform and standardized measures to document the existing oral health disparities in studies at the local and national levels across groups of the population over time. This proposal's aims are consistent with the NIDCR Strategic Plan's Crosscutting Areas-Health Disparities and Data acquisition and Analysis-and the Healthy People 2010's goal of eliminating health disparities among segment of the US population. Specifically, accomplishing this proposed study's aims has the potential to contribute to our understanding of oral health disparities in the US; to provide the tools to gauge the magnitude and direction of oral health disparities using uniform measures in studies at the local and national levels; and to recommend guidelines for oral health disparity comparisons across studies and populations over time. Finally, the developed measures have the potential to be used to measure health disparities related to age, gender, race/ethnicity and socioeconomic position on other oral health outcomes and health outcomes in general.