Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brasil.
Community Dent Oral Epidemiol. 2010 Jun;38(3):197-205. doi: 10.1111/j.1600-0528.2010.00531.x. Epub 2010 Mar 29.
To investigate social determinants of oral health, analysing the occurrence of associations between millennium development goals (MDG) indicators and oral health (OH) indicators.
An ecological study was performed in two distinct phases. In Phase 1, MDG indicators and related covariates were obtained from the demographic census of the Brazilian Institute of Geography and Statistics, the Ministry of Health database and the 2000 Human Development Atlas, making up the whole set of independent variables. Principal component analysis was carried out for the independent variables showing the correlations among the variables comprising the main components, and generating a synthetic index allowing the performance of the cities to be known with regard to the MDG (MDG index). In Phase 2, the DMFT index (mean number of decay, missing or filled permanent teeth) and the CF index (prevalence of caries-free individuals), in 12 years old were obtained from the epidemiological survey undertaken in 2002-2003, in 49 cities in southern Brazil, and were analysed in relation to the MDG index using Spearman's correlation.
A statistically significant correlation was found for the DMFT and CF indices, respectively, with: the MDG index (R(2)=0.49 and 0.48; P = 0.00); the socioeconomic status of the population (R(2)= 0.12 and 0.12; P = 0.02); the socioenvironmental characteristics (R(2)=0.41 and 0.46; P= 0.00).
The MDG synthetic index of the cities analysed and the respective components relating to their socioeconomic and socioenvironmental status demonstrated a positive correlation with OH indicators. As such, intersectoral public policies based on population strategies that act on social determinants of general and oral health need to be integrated so as to impact on the MDG and OH outcomes.
调查口腔健康的社会决定因素,分析千年发展目标(MDG)指标与口腔健康(OH)指标之间的关联。
进行了一项生态研究,分为两个不同阶段。在第一阶段,从巴西地理与统计研究所的人口普查、卫生部数据库和 2000 年人类发展图集获取 MDG 指标和相关协变量,构成了整个独立变量集。对显示主要组成部分之间变量相关性的独立变量进行主成分分析,生成一个综合指数,以了解城市在千年发展目标方面的表现(MDG 指数)。在第二阶段,从 2002-2003 年在巴西南部 49 个城市进行的流行病学调查中获得 12 岁儿童的 DMFT 指数(龋齿、缺失或填充的恒牙平均数)和 CF 指数(无龋个体的流行率),并使用 Spearman 相关分析分析与 MDG 指数的关系。
DMFT 和 CF 指数分别与 MDG 指数(R(2)=0.49 和 0.48;P=0.00)、人口的社会经济地位(R(2)=0.12 和 0.12;P=0.02)和社会环境特征(R(2)=0.41 和 0.46;P=0.00)呈显著相关。
分析城市的 MDG 综合指数及其与社会经济和社会环境状况相关的各自组成部分与 OH 指标呈正相关。因此,需要整合基于人口战略的部门间公共政策,以解决影响 MDG 和 OH 结果的社会决定因素。