Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
School of Dentistry, University of Birmingham, Birmingham, UK.
J Public Health Dent. 2022 Sep;82(4):453-460. doi: 10.1111/jphd.12486. Epub 2021 Nov 25.
To assess the magnitude of, and changes in, absolute and relative oral health inequality in Canada and the United States, from the 1970s till the first decade of the new millennium.
Data were obtained from four national surveys; two Canadian (NCNS 1970-1972 and CHMS 2007-2009) and two American (HANES 1971-1974 and NHANES 2007-2008). The slope and relative index of inequality were used to measure absolute and relative inequality, respectively. Percentage change in inequality was also calculated.
Relative inequality for untreated decay increased by 91% in Canada and 189% in the United States, while for filled teeth it declined by 63% in Canada and 16% in the United States. Relative inequality in edentulism rose by 200% and 78% in Canada and United States, respectively. Absolute inequality declined in both countries.
There was persistent absolute and relative inequality in Canada and the United States. An increase in relative inequality for adverse outcomes suggests that improvements in oral health were occurring primarily among the rich, while reductions in relative inequality for filled teeth indicate higher utilization of restorative services among the poor. These results point to the necessity of tackling the sociopolitical determinants of health to mitigate oral health inequality in Canada and the United States.
评估加拿大和美国从 20 世纪 70 年代到新千年的第一个十年间，绝对和相对口腔健康不平等的程度和变化。
数据来自四项全国性调查；两项加拿大调查（NCNS 1970-1972 年和 CHMS 2007-2009 年）和两项美国调查（HANES 1971-1974 年和 NHANES 2007-2008 年）。斜率和相对不平等指数分别用于衡量绝对和相对不平等。还计算了不平等程度的百分比变化。
未经治疗的龋齿的相对不平等在加拿大增加了 91%，在美国增加了 189%，而填充牙齿的相对不平等在加拿大减少了 63%，在美国减少了 16%。加拿大和美国的无牙颌相对不平等分别上升了 200%和 78%。两国的绝对不平等都有所下降。
加拿大和美国存在持续的绝对和相对不平等。不良结果的相对不平等增加表明，口腔健康的改善主要发生在富人中，而填充牙齿的相对不平等减少表明，穷人对修复服务的利用率更高。这些结果表明，必须解决健康的社会政治决定因素，以减轻加拿大和美国的口腔健康不平等。
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