Socioenvironmental sugar promotion and geographical inequalities in dental health of 5-year-old children in England

IF 1.8 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Community dentistry and oral epidemiology Pub Date : 2024-03-20 DOI:10.1111/cdoe.12957

Suruchi G. Ganbavale, Chris Louca, Liz Twigg, Kristina Wanyonyi

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引用次数: 0

Abstract

Objectives

To investigate the relationship between socioenvironmental sugar promotion and geographical inequalities in the prevalence of dental caries amongst 5-year-olds living across small areas within England.

Methods

Ecological data from the National Dental Epidemiology Programme (NDEP) 2018–2019, comprising information on the percentage of 5-year-olds with tooth decay (≥1 teeth that are decayed into dentine, missing due to decay, or filled), and untreated tooth decay (≥1 decayed but untreated teeth), in lower-tier local authorities (LAs) of England. These were analysed for association with a newly developed Index of Sugar-Promoting Environments Affecting Child Dental Health (ISPE-ACDH). The index quantifies sugar-promoting determinants within a child's environment and provides standardized scores for the index, and its component domains that is, neighbourhood-, school- and family-environment, with the highest scores representing the highest levels of sugar promotion in lower-tier LAs (N = 317) of England. Linear regressions, including unadjusted models separately using index and each domain, and models adjusted for domains were built for each dental outcome.

Results

Participants lived across 272 of 317 lower-tier LAs measured within the index. The average percentage of children with tooth decay and untreated tooth decay was 22.5 (SD: 8.5) and 19.6 (SD: 8.3), respectively. The mean index score was (0.1 [SD: 1.01]). Mean domain scores were: neighbourhood (0.02 [SD: 1.03]), school (0.1 [SD: 1.0]), and family (0.1 [SD: 0.9]). Unadjusted linear regressions indicated that the LA-level percentage of children with tooth decay increased by 5.04, 3.71, 4.78 and 5.24 with increased scores of the index, and neighbourhood, school and family domains, respectively. An additional model, adjusted for domains, showed that this increased percentage predicted by neighbourhood domain attenuated to 1.37, and by family domain it increased to 6.33. Furthermore, unadjusted models indicated that the LA-level percentage of children with untreated tooth decay increased by 4.72, 3.42, 4.45 and 4.97 with increased scores of the index, and neighbourhood, school, and family domains, respectively. The model, adjusted for domains, showed that this increased percentage predicted by neighbourhood domain attenuated to 1.24 and by family domain rose to 6.47. School-domain was not significantly associated with either outcome in adjusted models.

Conclusions

This study reveals that socioenvironmental sugar promotion, particularly within neighbourhood- and family-environments, may contribute to geographical inequalities in dental caries in children. Further research involving data on individual-level dental outcomes and confounders is required.

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英国 5 岁儿童牙齿健康方面的社会环境糖宣传和地域不平等。

目的：调查社会环境糖宣传与英格兰小地区 5 岁儿童龋齿发生率地域不平等之间的关系：调查生活在英格兰各小地区的 5 岁儿童龋齿患病率的社会环境糖促进与地理不平等之间的关系：来自 2018-2019 年国家牙科流行病学计划（NDEP）的生态数据，包括英格兰低级地方当局（LA）中龋齿（≥1 颗牙齿蛀入牙本质、因龋齿而缺失或补牙）和未治疗龋齿（≥1 颗龋齿但未治疗的牙齿）的 5 岁儿童的百分比信息。分析结果与新开发的影响儿童牙齿健康的促糖环境指数（ISPE-ACDH）相关。该指数对儿童所处环境中的促糖决定因素进行量化，并为该指数及其组成部分（即邻里环境、学校环境和家庭环境）提供标准化得分，得分最高的地区代表英格兰较低级别的地方行政区（N = 317）中促糖水平最高的地区。针对每个牙科结果建立了线性回归模型，包括使用指数和每个领域分别建立的未调整模型，以及根据领域进行调整的模型：结果：在指数测量的 317 个较低级别的 LA 中，参与者居住在 272 个地区。蛀牙儿童和未治疗蛀牙儿童的平均比例分别为 22.5（标准差：8.5）和 19.6（标准差：8.3）。平均指数得分为（0.1 [SD: 1.01]）。平均领域得分分别为：邻里（0.02 [SD: 1.03]）、学校（0.1 [SD: 1.0]）和家庭（0.1 [SD: 0.9]）。未经调整的线性回归结果表明，随着指数、邻里、学校和家庭领域得分的增加，洛杉矶一级的蛀牙儿童比例分别增加了 5.04、3.71、4.78 和 5.24。根据领域调整后的附加模型显示，邻里领域预测的百分比增加值减小到 1.37，家庭领域则增加到 6.33。此外，未经调整的模型显示，随着指数、邻里、学校和家庭领域得分的增加，洛杉矶一级未治疗蛀牙儿童的百分比分别增加了 4.72、3.42、4.45 和 4.97。根据领域调整后的模型显示，邻里领域预测的百分比增加值降低到 1.24，家庭领域预测的百分比增加值上升到 6.47。在调整后的模型中，学校领域与这两种结果均无明显关联：这项研究揭示了社会环境对糖分的促进作用，尤其是在邻里和家庭环境中，可能会造成儿童龋齿的地域不平等。需要对个人层面的牙科结果和混杂因素数据进行进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Community dentistry and oral epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

4.40

自引率

8.70%

发文量

审稿时长

6 months

期刊介绍： The aim of Community Dentistry and Oral Epidemiology is to serve as a forum for scientifically based information in community dentistry, with the intention of continually expanding the knowledge base in the field. The scope is therefore broad, ranging from original studies in epidemiology, behavioral sciences related to dentistry, and health services research through to methodological reports in program planning, implementation and evaluation. Reports dealing with people of all age groups are welcome. The journal encourages manuscripts which present methodologically detailed scientific research findings from original data collection or analysis of existing databases. Preference is given to new findings. Confirmations of previous findings can be of value, but the journal seeks to avoid needless repetition. It also encourages thoughtful, provocative commentaries on subjects ranging from research methods to public policies. Purely descriptive reports are not encouraged, nor are behavioral science reports with only marginal application to dentistry. The journal is published bimonthly.