Development and Testing of a Social Determinants Model of Oral Health

描述（由申请人提供）：尽管最近口腔健康总体上有所改善，但口腔疾病在美国仍然是一个重大的公共卫生问题。为了有效地实现持续和有意义的改善，未来的干预措施需要解决口腔疾病的根本原因。目前的生物医学和个人主义行为方法无法解释口腔疾病的潜在决定因素。基于土拨鼠健康的社会决定因素模型，本提案旨在开发和测试一个新的口腔健康概念模型。二级数据分析将使用NHANES（1999-2004）和其他美国人口调查的数据进行。将使用口腔健康的临床和主观措施，包括蛀牙、牙齿脱落、牙周病、牙齿损伤、自评口腔健康和与口腔健康有关的生活质量措施。与口腔健康相关的行为包括吃糖、看牙医、吸烟、饮酒和牙齿清洁。将进行回归分析，以检查健康行为和口腔健康与社会心理、社区和环境因素之间的关系。最后，探讨聚类行为与口腔健康、社会心理、社区和环境因素之间的关系。除了回归模型外，还将进行先进的多层次分析。这项新颖和创新的研究将为美国人口口腔疾病的潜在原因提供有价值的见解。

DESCRIPTION (provided by applicant): Despite of recent overall improvements in oral health, oral diseases remain a significant public health problem in the US. To effectively achieve sustained and meaningful improvements, future interventions need to tackle the fundamental causes of oral diseases. Current biomedical and individualistic behavorial approaches fail to explain the underlying determinants of oral diseases. Based upon the Marmot Social Determinants Model of Health, this proposal aims to develop and test a new conceptual model for oral health. Secondary data analysis will be performed using data from NHANES (1999-2004) and other US population surveys. Clinical and subjective measures of oral health will be used, including counts of decayed teeth, tooth loss, periodontal disease, dental injuries, self-rated oral health and oral health related quality of life measures. Oral health related behaviours will include sugar consumption, dental attendance, smoking, alcohol, and tooth cleanliness. Regression analysis will be conducted to examine the relationship between health behaviours and oral health on the one hand and psychosocial, community and environmental factors on the other. Finally, the relationship between the clustered behaviors with oral health, and the psychosocial, community and environmental factors will be examined. Advanced multi-level analyses will be undertaken in addition to the regression models. This novel and innovative study will provide valuable insights into the underlying causes of oral diseases in the US population. PUBLIC HEALTH RELEVANCE: Current biomedical and behavioral approaches fail to fully explain the underlying determinants of oral diseases. More innovative and novel conceptual models are needed to explain the mechanisms by which the various determinants of oral health interact with each other to influence oral health outcomes. This study aims to develop and test a social determinants conceptual model of oral health. The findings will provide valuable insights into the fundamental causes of oral diseases in the US population.