Engelsk titel: Social determinants of oral health. - Do social inequalities still exist?
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Författare:
Holst D
Email: dholst@odont.uio.no
Språk: Nor
Antal referenser: 32
Dokumenttyp:
Översikt
UI-nummer: 08023090
Sammanfattning
Social inequality appears to be universal, even in countries with a long tradition of oral health promotion (Chen 1995). The purpose of this paper is to relate recent knowledge about the social determinants of oral health to the process of improving oral health in many European countries. There have been few studies of social determinants and children"s oral health in the Nordic countries. It has probably been assumed that universal coverage of public dental care has evened out social differences in oral health. In adult populations national studies have shown marked improvement in dental status indicators. This improvement has been greatest in low status groups. In a Norwegian study from 1975 to 2002 that included four cross-sectional materials the results showed that the distribution of persons in five income quintiles related to edentulousness and that functional dentition can be described by a gradient. The mechanisms of how social determinants relate to oral health are not, however, well understood. In international literature the explanations are related to material resources, health behaviour and lifestyle, psycho-social stress factors, and organisation of dental care. Measurement of dental status, such as the DMF index, poses additional problems. The DMF index measures both disease occurrence and its treatment, and it is difficult to disentangle the social determinants of disease from the social pattern of utilization of dental care. Promotion of oral health and prevention of oral diseases must be based on knowledge of the causes of both. Social determinants are causes of disease occurrence in a population.