Structural Determinants and Children's Oral Health: A Cross-National Study
Por:
Baker, S. R., Page, L. Foster, Thomson, W. M., Broomhead, T., Bekes, K., Benson, P. E., Aguilar-Diaz, F., Do, L., Hirsch, C., Marshman, Z., McGrath, C., Mohamed, A., Robinson, P. G., Traebert, J., Turton, B., Gibson, B. J.
Publicada:
1 sep 2018
Categoría:
Dentistry (miscellaneous)
Resumen:
Much research on children's oral health has focused on proximal
determinants at the expense of distal (upstream) factors. Yet, such
upstream factors-the so-called structural determinants of health-play a
crucial role. Children's lives, and in turn their health, are shaped by
politics, economic forces, and social and public policies. The aim of
this study was to examine the relationship between children's clinical
(number of decayed, missing, and filled teeth) and self-reported oral
health (oral health-related quality of life) and 4 key structural
determinants (governance, macroeconomic policy, public policy, and
social policy) as outlined in the World Health Organization's Commission
for Social Determinants of Health framework. Secondary data analyses
were carried out using subnational epidemiological samples of 8- to
15-y-olds in 11 countries (N = 6,648): Australia (372), New Zealand
(three samples; 352, 202, 429), Brunei (423), Cambodia (423), Hong Kong
(542), Malaysia (439), Thailand (261, 506), United Kingdom (88, 374),
Germany (1498), Mexico (335), and Brazil (404). The results indicated
that the type of political regime, amount of governance (e.g., rule of
law, accountability), gross domestic product per capita, employment
ratio, income inequality, type of welfare regime, human development
index, government expenditure on health, and out-of-pocket (private)
health expenditure by citizens were all associated with children's oral
health. The structural determinants accounted for between 5% and 21%
of the variance in children's oral health quality-of-life scores. These
findings bring attention to the upstream or structural determinants as
an understudied area but one that could reap huge rewards for public
health dentistry research and the oral health inequalities policy
agenda.
Filiaciones:
Baker, S. R.:
Univ Sheffield, Sch Clin Dent, Unit Dent Publ Hlth, Sheffield S10 2TA, S Yorkshire, England
Page, L. Foster:
Univ Otago, Fac Dent, Dept Oral Sci, Sir John Walsh Res Inst, Otago, New Zealand
Thomson, W. M.:
Univ Otago, Fac Dent, Dept Oral Sci, Sir John Walsh Res Inst, Otago, New Zealand
Broomhead, T.:
Univ Sheffield, Sch Clin Dent, Unit Dent Publ Hlth, Sheffield S10 2TA, S Yorkshire, England
Bekes, K.:
Med Univ Vienna, Sch Dent, Dept Paediat Dent, Vienna, Austria
Benson, P. E.:
Univ Sheffield, Sch Clin Dent, Unit Dent Publ Hlth, Sheffield S10 2TA, S Yorkshire, England
Aguilar-Diaz, F.:
Univ Nacl Autonoma Mexico, Dept Publ Hlth, Leon Unit, Guanajuato, Mexico
Do, L.:
Univ Adelaide, Australian Res Ctr Populat Oral Hlth, Adelaide, SA, Australia
Hirsch, C.:
Univ Leipzig, Dept Paediat Dent, Leipzig, Germany
Marshman, Z.:
Univ Sheffield, Sch Clin Dent, Unit Dent Publ Hlth, Sheffield S10 2TA, S Yorkshire, England
McGrath, C.:
Univ Hong Kong, Fac Dent, Periodontol & Publ Hlth, Hong Kong, Hong Kong, Peoples R China
Mohamed, A.:
Minist Hlth, Dept Dent Serv, Muara, Brunei
Robinson, P. G.:
Univ Bristol, Bristol Dent Sch, Bristol, Avon, England
Traebert, J.:
Univ Southern Santa Catarina, Postgrad Program Hlth Sci, Tubarao, SC, Brazil
Turton, B.:
Univ Puthisastra, Dept Dent, Phnom Penh, Cambodia
Gibson, B. J.:
Univ Sheffield, Sch Clin Dent, Unit Dent Publ Hlth, Sheffield S10 2TA, S Yorkshire, England
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