Abasaeed Rania, Kranz Ashley M, Rozier R Gary
University of Washington, Seattle, WA, USA.
J Am Dent Assoc. 2013 Sep;144(9):1038-46. doi: 10.14219/jada.archive.2013.0232.
The authors conducted a study to determine the impact of the Great Recession on untreated dental caries in kindergarten-aged children in North Carolina (NC).
During the seven school years from 2003-2004 through 2009-2010, the state dental public health program assessed 608,339 kindergarten students for untreated decayed primary teeth (dt) as part of the statewide public health surveillance system. The authors aggregated observations to the school level and matched 7,660 school-year observations for 1,215 schools to National School Lunch Program (NSLP) participation rates, their primary economic indicator of the Great Recession. The authors included additional county-level economic indicators and measures of dentist supply and Medicaid enrollment. They used ordinary least squares regression with school-and year-fixed effects to examine the association of variables with the proportion of children with more than one dt for all schools and for schools with a greater than 10 percent increase in NSLP participation after 2006.
The authors found a small but statistically significant association between the proportion of children in the schools participating in the NSLP and the proportion of kindergarten students who had more than one dt (β, 0.031; 95 percent confidence interval [CI], 0.001 to 0.0604). This association was greater in schools that had a greater than 10 percent increase in NSLP participation (β, 0.068; 95 percent CI, -0.007 to 0.143). Regression estimates indicate a 1.3- and 3.1-percentage point cumulative increase in the proportion of children with more than one dt during the period from 2008 through 2009 for all schools and high-risk schools, respectively.
Increased NSLP enrollment was associated with less treatment for dental caries in 5-year-old children.
Fewer children are receiving needed dental treatment because of the Great Recession. Recent gains made in the treatment of dental caries in children in NC have slowed as a result.
作者开展了一项研究，以确定大衰退对北卡罗来纳州（NC）幼儿园儿童未经治疗的龋齿的影响。
在2003 - 2004年至2009 - 2010年的七个学年中，作为全州公共卫生监测系统的一部分，该州的牙科公共卫生项目对608,339名幼儿园学生的未经治疗的乳牙龋齿（dt）进行了评估。作者将观察结果汇总到学校层面，并将1215所学校的7660个学年观察结果与国家学校午餐计划（NSLP）参与率相匹配，NSLP参与率是他们衡量大衰退的主要经济指标。作者纳入了其他县级经济指标以及牙医供应和医疗补助登记的衡量指标。他们使用具有学校和年份固定效应的普通最小二乘法回归，来检验变量与所有学校以及2006年后NSLP参与率增长超过10%的学校中患有不止一颗dt的儿童比例之间的关联。
作者发现，参与NSLP的学校中儿童的比例与有不止一颗dt的幼儿园学生的比例之间存在虽小但在统计学上显著的关联（β，0.031；95%置信区间[CI]，0.001至0.0604）。在NSLP参与率增长超过10%的学校中，这种关联更大（β，0.068；95%CI， - 0.007至0.143）。回归估计表明，在2008年至
