Explaining social inequality in population oral health using a multilevel approach [ 2003 - 2004 ]

Research Grant

Researchers: Prof A. John Spencer (Principal investigator) ,  Dr Anne Sanders ,  Dr Wagner Marcenes ,  Mr Knute Carter ,  Prof Gavin Turrell

Brief description Our preliminary research demonstrated a social gradient in the oral health of Australian adults. Adults who occupy higher positions on the social hierarchy experienced less disease and symptom experience, enhanced quality of life, and better self-rated oral health. Not only were associations made between social position and oral health, but a range of other factors such as personal control, social support, stress, life satisfaction, and workplace and childhood social environments were also associated with oral wellness. This work is new Australian research and is yet to be published. In an expansion of this project, we move from describing oral health inequalities and identifying their social determinants to provide a better understanding of pathways to population oral health. In doing so we shift the focus from the individual to the social context in which individuals live. We suggest that characteristics of social environments contribute independently to the variation in oral health outcomes accounted for by the characteristics of the residents themselves. In particular, we seek to demonstrate that social cohesion (the social integration, trust, and reciprocity within an area) influences conditions linked to oral health. Previous research has demonstrated variation in health according to area. Such studies are able to demonstrate a clustering of health, but are not able to distinguish whether observed social patterns in health reflect characteristics of residents or some feature of the area itself. Such conclusions require multilevel statistical models designed to separate individual effects from contextual effects while simultaneously examining interactions between both levels. Oral health is ideally suited as a proxy for general health because of the ubiquity of dental diseases, the broad utilisation of dental services within the population, and the shared risk factors between oral disease and a wide range chronic health conditions.

Funding Amount $AUD 103,500.00

Funding Scheme NHMRC Project Grants

Notes Standard Project Grant