Marcos P Pattussi1, Rebecca Hardy, Aubrey Sheiham. 1. Programa de Pós-Graduação em Saúde Coletiva, Universidade do Vale do Rio dos Sinos. São Leopoldo-RS, Brazil. mppattussi@unisinos.br
Abstract
OBJECTIVE: Empowerment has been considered a dimension of social capital. It refers to social interaction processes that enable people to enhance their individual and collective skills and to exert greater control over their lives. This relationship has not been explored in relation to dental health. The objective of this study was to investigate the association between neighborhood empowerment and dental caries in adolescents. METHODS: A multilevel study was designed to assess the individual and neighborhood effects on the oral health of adolescents. Four sources of data were used: (a) clinical examinations (WHO), (b) students' questionnaires, (c) parents' questionnaires and (d) census data. The study population was 1302, 14/15-year-old students from 39 public schools of two cities of the Distrito Federal (DF), Brazil. Data analysis used logistic multilevel modeling at two levels: students (sources a and b) and neighborhood as defined by catchment areas of schools (sources c and d). RESULTS: High DMFT (DMFT > median, DMFT > or =3) rates were significantly lower in areas with higher levels of empowerment. This relationship was independent of socioeconomic variables at the individual and area levels and of all other individual risk factor variables such as sex, fluoride, sugar consumption, tooth brushing and dental attendance [OR for low compared with high empowerment was 1.54 (95% CI = 1.09-2.18), P = 0.014]. CONCLUSIONS: Neighborhood empowerment may play an important role in explaining inequalities in the levels of dental caries. New perspectives are needed so that more effective interventions can be implemented using area-based perspectives.
OBJECTIVE: Empowerment has been considered a dimension of social capital. It refers to social interaction processes that enable people to enhance their individual and collective skills and to exert greater control over their lives. This relationship has not been explored in relation to dental health. The objective of this study was to investigate the association between neighborhood empowerment and dental caries in adolescents. METHODS: A multilevel study was designed to assess the individual and neighborhood effects on the oral health of adolescents. Four sources of data were used: (a) clinical examinations (WHO), (b) students' questionnaires, (c) parents' questionnaires and (d) census data. The study population was 1302, 14/15-year-old students from 39 public schools of two cities of the Distrito Federal (DF), Brazil. Data analysis used logistic multilevel modeling at two levels: students (sources a and b) and neighborhood as defined by catchment areas of schools (sources c and d). RESULTS: High DMFT (DMFT > median, DMFT > or =3) rates were significantly lower in areas with higher levels of empowerment. This relationship was independent of socioeconomic variables at the individual and area levels and of all other individual risk factor variables such as sex, fluoride, sugar consumption, tooth brushing and dental attendance [OR for low compared with high empowerment was 1.54 (95% CI = 1.09-2.18), P = 0.014]. CONCLUSIONS: Neighborhood empowerment may play an important role in explaining inequalities in the levels of dental caries. New perspectives are needed so that more effective interventions can be implemented using area-based perspectives.
Authors: Andrea M de Silva; Shalika Hegde; Bridget Akudo Nwagbara; Hanny Calache; Mark G Gussy; Mona Nasser; Hannah R Morrice; Elisha Riggs; Pamela M Leong; Lisa K Meyenn; Reza Yousefi-Nooraie Journal: Cochrane Database Syst Rev Date: 2016-12-22
Authors: Jacqueline M Burgette; Deborah E Polk; Nilesh Shah; Anchal Malik; Richard J Crout; Daniel W Mcneil; Betsy Foxman; Robert J Weyant; Mary L Marazita Journal: Pediatr Dent Date: 2019-05-15 Impact factor: 1.874
Authors: Andrea M de Silva; Shalika Hegde; Bridget Akudo Nwagbara; Hanny Calache; Mark G Gussy; Mona Nasser; Hannah R Morrice; Elisha Riggs; Pamela M Leong; Lisa K Meyenn; Reza Yousefi-Nooraie Journal: Cochrane Database Syst Rev Date: 2016-09-15
Authors: Donald L Chi; Erin E Masterson; Adam C Carle; Lloyd A Mancl; Susan E Coldwell Journal: Am J Public Health Date: 2014-03-13 Impact factor: 9.308