A life course approach to understanding oral health inequalities

澳大利亚青春期前儿童的蛀牙率比几乎所有其他经济发达国家的儿童都要低。澳大利亚的成年人却不是这样。事实上，35-44岁的澳大利亚成年人的蛀牙率高于大多数其他经济发达国家的同龄人。澳大利亚成年人在步入中年之前不仅口腔健康状况相对较差，而且在龋齿方面的社会经济不平等在这一阶段比之前或之后的任何其他阶段都更为明显。这项研究旨在了解年轻人的口腔健康是如何受到他们童年、青春期和成年早期经历的影响。这种方法基于最近的证据，这些证据指出生命早期对成人健康的重要性。从这一生命历程的角度来看，处境不利个人的健康状况较差，被认为是由于在其整个生命历程中不断和累积地暴露于困难和不利的环境中。这项研究将追踪和跟踪近10,000名南澳大利亚人，他们的社会，家庭，经济和牙科行为信息是在1991-92年收集的，当时这些人的年龄在5到15岁之间。这些人现在年龄在19岁至29岁之间，将被邀请参加牙科检查并完成一项调查，该调查将提供有关健康行为和生活环境的信息，这些信息被证明是一般健康状况和口腔健康状况的重要决定因素。其中一个目的是探讨澳大利亚成年人相对较差的口腔健康状况的原因。第二个目的是调查不同生命阶段口腔疾病的社会经济不平等程度。这些发现将增加对口腔疾病病因学的了解，并在了解整个生命过程中累积的风险的基础上，为开发促进口腔健康的新方法提供机会。

Preadolescent children in Australia have lower rates of dental decay than children in almost all other economically developed countries. This is not the case for Australian adults. In fact, Australian adults aged 35-44 years have higher rates of dental decay than adults of similar age in most other economically developed countries. Not only do Australian adults have comparatively poor oral health in the lead-up to midlife, but also socioeconomic inequalities in dental decay are more pronounced at this stage of life than at any other stage before or after. This study proposes to look at how oral health in young adults in shaped by their experiences across childhood, adolescence and early adulthood. This approach is based on recent evidence that points to the importance to adult health of the early years of life. In this life course perspective, the poorer health of disadvantaged individuals is seen to result from ongoing and cumulative exposure to difficult and disadvantaged circumstances across their life course. This study will trace and follow up a cohort of almost 10, 000 South Australians for whom social, familial, economic and dental behavioural information was collected in 1991-92 when these individuals were aged from five to 15 years. Now aged from 19 to 29 years, these individuals will be invited to attend a dental examination and complete a survey that will provide information on health behaviours and life circumstances shown to be important determinants of general and oral health status. One purpose will be to explore reasons for the comparatively poorer oral health status of Australian adults. A second purpose will be to investigate the magnitude of socioeconomic inequalities in oral disease at different life stages. The findings will add to the knowledge of the etiology of oral disease and open up opportunities to develop new methods of oral health promotion based on the understanding of accumulated risk across the life course.