Jamieson Lisa M, Armfield Jason M, Roberts-Thomson Kaye F
Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, SA, Australia.
Community Dent Oral Epidemiol. 2006 Aug;34(4):267-76. doi: 10.1111/j.1600-0528.2006.00277.x.
To describe oral health inequalities among indigenous and nonindigenous children in the Northern Territory of Australia using an area-based measure of socioeconomic status (SES).
Data were obtained from indigenous and nonindigenous 4-13-year-old children enrolled in the Northern Territory School Dental Service in 2002-2003. The Socio-Economic Indices For Areas (SEIFA) were used to determine socioeconomic relationships with dental disease experience.
Some 12,584 children were examined, 35.1% of whom were indigenous. Across all age-groups, socially disadvantaged indigenous children experienced higher mean dmft and DMFT levels than their similarly aged, similarly disadvantaged nonindigenous counterparts. Indigenous children aged 5 years had almost four times the dmft of their nonindigenous counterparts in the same disadvantage category (P < 0.05), while indigenous children aged 10 years had almost five times the DMFT of similarly disadvantaged nonindigenous children (P < 0.05). A distinct social gradient was apparent among indigenous and nonindigenous children, respectively, whereby those with the highest dmft/DMFT levels were in the most disadvantaged SES category and those least disadvantaged had the lowest dmft/DMFT levels. In most age-groups, indigenous children who were least disadvantaged had worse oral health than the most disadvantaged nonindigenous children.
The findings suggest that indigenous status and SES have strong oral health outcome correlations but are not mutually dependent, that is, indigenous status influences oral health outcomes irrespective of social disadvantage. From a health policy perspective, greater oral health gains may be possible by concentrating public health and clinical effort among all indigenous children irrespective of SES status.
采用基于区域的社会经济地位(SES)衡量指标,描述澳大利亚北领地原住民和非原住民儿童之间的口腔健康不平等情况。
数据来源于2002 - 2003年参加北领地学校牙科服务的4 - 13岁原住民和非原住民儿童。使用区域社会经济指数(SEIFA)来确定社会经济状况与牙科疾病经历之间的关系。
共检查了约12,584名儿童,其中35.1%为原住民。在所有年龄组中,社会处境不利的原住民儿童的平均乳牙龋失补牙面数(dmft)和恒牙龋失补牙面数(DMFT)水平高于年龄相仿、社会处境同样不利的非原住民儿童。处于相同不利类别的5岁原住民儿童的dmft几乎是非原住民儿童的四倍(P < 0.05),而10岁原住民儿童的DMFT几乎是社会处境同样不利的非原住民儿童的五倍(P < 0.05)。在原住民和非原住民儿童中分别出现了明显的社会梯度,即dmft/DMFT水平最高的儿童处于最不利的SES类别,而最不处于不利地位的儿童dmft/DMFT水平最低。在大多数年龄组中,社会处境最不不利的原住民儿童的口腔健康状况比社会处境最不利的非原住民儿童更差。
研究结果表明,原住民身份和SES与口腔健康结果有很强的相关性,但并非相互依赖,也就是说,无论社会处境是否不利,原住民身份都会影响口腔健康结果。从卫生政策角度来看,通过将公共卫生和临床工作集中于所有原住民儿童,而不论其SES状况如何,可能会在口腔健康方面取得更大进展。