Department of Epidemiology and Public Health, University College London, WHO Collaborating Centre for Oral Health Inequalities and Public Health, 1-19 Torrington Place, London, WC1E 6BT, UK.
Division of Public and Child Dental Health, School of Dental Science, Trinity College Dublin and Dublin Dental University Hospital, Lincoln Place, Dublin 2, Ireland.
Br Dent J. 2019 Jul;227(1):49-54. doi: 10.1038/s41415-019-0472-7.
Vulnerable and socially excluded groups in society persistently experience significantly worse oral health and poorer access to dental services than the mainstream population. Action to tackle these unfair, unjust and avoidable inequalities in oral health needs to be informed by an understanding of the broad range of interacting factors that ultimately influence oral health across society and specifically the most vulnerable and marginalised. Failure to understand the underlying factors that create and perpetuate the oral health equity gap risks the development and implementation of ineffective interventions that do not achieve meaningful improvements in oral health for the most vulnerable. This paper presents a theoretical framework that combines a broad public health perspective on oral health inequalities, combined with more specific factors determining the oral health of vulnerable and marginalised groups. Actions to improve access to dental services and policies to combat oral health inequalities among vulnerable adult populations are then presented.
社会中的弱势群体和被社会排斥的群体在口腔健康方面持续面临着明显差于主流人群的状况，并且获得口腔医疗服务的机会也较少。为了解决这些不公平、不公正和可避免的口腔健康不平等问题，需要了解广泛的相互作用因素，这些因素最终会影响整个社会的口腔健康，特别是最脆弱和边缘化的群体。如果不了解造成和延续口腔健康公平差距的潜在因素，就有可能制定和实施无效的干预措施，而这些措施并不能为最弱势群体带来有意义的口腔健康改善。本文提出了一个理论框架，将口腔健康不平等的广泛公共卫生视角与决定脆弱和边缘化群体口腔健康的更具体因素相结合。然后提出了改善弱势群体获得牙科服务的途径和打击脆弱成年人群体口腔健康不平等的政策。
