Nguyen Lien, Häkkinen Unto, Knuuttila Matti, Järvelin Marjo-Riitta
Centre for Health Economics - CHESS, National Research and Development Centre for Welfare and Health (STAKES), Lintulahdenkuja 4, Helsinki, Finland.
Health Econ. 2008 Feb;17(2):267-86. doi: 10.1002/hec.1258.
We explore the determinants of dental ill-health as measured by the occurrence of caries. A recursive bivariate probit model that was derived from health production and demand theory is employed to model caries, while taking account of dental care use. The data are from a follow-up questionnaire used in a longitudinal study of the Northern Finland 1966 Birth Cohort, with respondents aged 31 (n = 5020). The factors controlled for relate to family background and health behavior during their youth, current socioecononomic variables and dental health stock. The total effects on the occurrence of caries of the explanatory variables are computed. Among females, factors increasing caries are body mass index and intake of alcohol, sugar and soft drinks, and those reducing caries are birth weight and adolescent school achievement. Among males, caries is positively related to the metropolitan residence and negatively related to education and healthy diet. Smoking increases caries, whereas dental care use, regular dental attendance and brushing teeth at least twice a day decrease caries. To promote oral health, attention should focus on policies to improve dental health education and to reduce the impacts of common risk factors.
我们探究了以龋齿发生率衡量的口腔健康不佳的决定因素。采用了一个基于健康生产和需求理论推导出来的递归双变量概率模型来对龋齿进行建模，同时考虑到牙科护理的使用情况。数据来自于对1966年芬兰北部出生队列进行的一项纵向研究中使用的后续调查问卷，受访者年龄为31岁（n = 5020）。所控制的因素涉及他们年轻时的家庭背景和健康行为、当前的社会经济变量以及口腔健康存量。计算了解释变量对龋齿发生率的总体影响。在女性中，增加龋齿的因素有体重指数、酒精、糖和软饮料的摄入量，而减少龋齿的因素有出生体重和青少年学业成绩。在男性中，龋齿与居住在大都市呈正相关，与教育和健康饮食呈负相关。吸烟会增加龋齿，而使用牙科护理、定期看牙医以及每天至少刷牙两次会减少龋齿。为促进口腔健康，应将注意力集中在改善口腔健康教育以及减少常见风险因素影响的政策上。
