探讨美国 20 岁及以上成年人牙周病的差异：NHANES III（1988-1994 年）和 NHANES 1999-2004 年。
Examining periodontal disease disparities among U.S. adults 20 years of age and older: NHANES III (1988-1994) and NHANES 1999-2004.
机构信息
The City University of New York, Lehman College, Department of Health Sciences, New York, NY 10468, USA.
出版信息
Public Health Rep. 2012 Sep-Oct;127(5):497-506. doi: 10.1177/003335491212700505.
OBJECTIVE
We examined disparities in periodontal disease in U.S. adults according to age, sex, race/ethnicity, country of birth, education, income, and poverty-income ratio within and between the third National Health and Nutrition Examination Survey (NHANES III, 1988-1994) and NHANES 1999-2004.
METHODS
We assessed disparities and changes therein using prevalence differences and ratios, as well as the Symmetrized Theil Index (STI). While these measures document disparities between pairs of population subgroups, and changes in relative disparities between surveys, the STI is a summary measure of health disparities that also tracks between-group disparities relative to the total population.
RESULTS
Prevalence differences and ratios for the prevalence of periodontitis, the mean pocket depth (PD), and the mean clinical attachment loss (CAL) suggest that periodontal disease significantly decreased between NHANES III and NHANES 1999-2004 (p<0.01). However, the STI for the prevalence of periodontitis suggests that disparities significantly increased within categories of race/ethnicity, country of birth, and education in NHANES 1999-2004 compared with NHANES III. These findings were corroborated for mean PD and mean CAL (p<0.001): the overall STI significantly increased for mean PD from 4.53% in NHANES III to 11.02% in NHANES 1999-2004 and for mean CAL for teeth with CAL >0 from 31.73% in NHANES III to 43.36% in NHANES 1999-2004.
CONCLUSIONS
Our findings suggest that inequalities in periodontal disease significantly decreased between NHANES III and NHANES 1999-2004 in the total population and across selected characteristics of the population. However, these inequalities increased within groups of the population in NHANES 1999-2004 compared with NHANES III. These findings call attention to the absolute and relative differences not only between population groups across surveys, but also within population groups within and between surveys.
目的
我们根据年龄、性别、种族/民族、出生国、教育程度、收入和贫困收入比，在美国成年人中检查了牙周病的差异，这些差异存在于第三次全国健康和营养检查调查（NHANES III，1988-1994 年）和 NHANES 1999-2004 年之间和之内。
方法
我们使用患病率差异和比率以及对称 Theil 指数（STI）来评估差异和差异变化。虽然这些措施记录了人群亚组之间的差异，以及调查之间相对差异的变化，但 STI 是衡量健康差异的综合指标，还可以跟踪相对于总人口的组间差异。
结果
牙周炎患病率、平均牙周袋深度（PD）和平均临床附着丧失（CAL）的患病率差异和比率表明，牙周病的患病率在 NHANES III 和 NHANES 1999-2004 之间显著下降（p<0.01）。然而，STI 对于牙周炎的患病率表明，与 NHANES III 相比，NHANES 1999-2004 年种族/民族、出生国和教育程度的类别内差异显著增加。这些发现得到了平均 PD 和平均 CAL 的证实（p<0.001）：NHANES III 中的总体 STI 从 4.53%显著增加到 NHANES 1999-2004 中的 11.02%，NHANES III 中 CAL>0 的牙齿的平均 CAL 从 31.73%增加到 43.36%。
结论
我们的研究结果表明，NHANES III 和 NHANES 1999-2004 年间，牙周病的不平等在总人口和选定的人口特征中显著减少。然而，与 NHANES III 相比，NHANES 1999-2004 年期间，人口群体内的这些不平等现象有所增加。这些发现不仅引起了人们对不同调查人群之间的绝对和相对差异的关注，也引起了人群内调查之间的绝对和相对差异的关注。
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