Centre for Research on Inner City Health, St. Michael's Hospital, 209 Victoria Street, Third Floor, Toronto, Ontario, Canada, M5C 1N8,
J Urban Health. 2013 Dec;90(6):1064-78. doi: 10.1007/s11524-013-9802-2.
The objective of this study was to assess the association between oral health and individual-level characteristics as well as both socioeconomic position (SEP) and service provision characteristics at the neighborhood level. Multilevel logistic analysis was undertaken of data from the Neighbourhood Effects on Health and Well-being Study in Toronto comprising 2,412 participants living in 47 neighborhoods and 87 census tracts. Three oral health outcomes were investigated: last dental visit, self-rated oral health, and self-rated oral pain. Results indicated that SEP was significantly associated with no dental visits in the last year, poor self-rated oral health, and experiencing oral pain after adjusting for age, gender, and immigrant status. Lack of dental insurance was associated with no visits to the dentist in the last year and poor self-rated oral health; however, no association was observed with oral pain. In adjusted regression models, few neighborhood level variables were significantly associated with dental visits and self-rated oral health and no neighborhood variables were associated with oral pain. Based on these results, SEP appears to be important in evaluating oral health outcomes. While insignificant in this study, neighborhood factors are important when considering the impact of service provision on oral health.
本研究旨在评估口腔健康与个体特征以及社会经济地位（SEP）和邻里层面服务提供特征之间的关联。采用多水平逻辑分析方法，对多伦多邻里健康与幸福感研究的数据进行了分析，该研究包含了 2412 名居住在 47 个邻里和 87 个普查区的参与者。研究调查了三种口腔健康结果：最近一次看牙医、自我报告的口腔健康状况以及自我报告的口腔疼痛。结果表明，在调整了年龄、性别和移民身份后，SEP 与去年没有看牙医、自我报告的口腔健康状况不佳以及经历口腔疼痛显著相关。缺乏牙科保险与去年没有看牙医和自我报告的口腔健康状况不佳有关，但与口腔疼痛无关。在调整后的回归模型中，很少有邻里层面的变量与看牙医和自我报告的口腔健康显著相关，也没有邻里变量与口腔疼痛相关。根据这些结果，SEP 在评估口腔健康结果方面似乎很重要。虽然在本研究中不显著，但在考虑服务提供对口腔健康的影响时，邻里因素很重要。
