Area-level deprivation, childhood dental ambulatory sensitive hospitalizations and community water fluoridation: evidence from New Zealand (2019)
Type of ContentJournal Article
PublisherOxford University Press (OUP)
Background: We examined the association between area-level deprivation and dental ambulatory sensitive hospitalizations (ASH) and considered the moderating effect of community water fluoridation (CWF). The hypothesis was that higher levels of deprivation are associated with higher dental ASH rates and that CWF will moderate this association such that children living in the most deprived areas have greater health gain from CWF. Methods: Dental ASH conditions (dental caries and diseases of pulp/periapical tissues), age, gender and home address identifier (meshblock) were extracted from pooled cross-sectional data (Q3, 2011 to Q2, 2017) on children aged 0–4 and 5–12 years from the National Minimum Dataset, New Zealand (NZ) Ministry of Health. CWF was obtained for 2011 and 2016 from the NZ Institute of Environmental Science and Research. Dental ASH rates for children aged 0–4 and 5–12 years (/1000) were calculated for census area units (CAUs). Multilevel negative binomial models investigated associations between area-level deprivation, dental ASH rate and moderation by CWF status. Results: Relative to CWF (2011 and 2016), no CWF (2011 and 2016) was associated with increased dental ASH rates in children aged 0–4 [incidence rate ratio (IRR) = 1.171 (95% confidence interval 1.064, 1.288)] and aged 5–12 years [IRR = 1.181 (1.084, 1.286)]. An interaction between area-level deprivation and CWF showed that the association between CWF and dental ASH rates was greatest within the most deprived quintile of children aged 0–4 years [IRR = 1.316 (1.052, 1.645)]. Conclusions: CWF was associated with a reduced dental ASH rate for children aged 0–4 and 5–12 years. Children living in the most deprived areas showed the greatest effect of CWF on dental ASH rates, indicating that the greater health gain from CWF occurred for those with the highest socio-economic disadvantage. Variation in CWF contributes to structural inequities in oral-health outcomes for children.
CitationHobbs M, Wade A, Jones P, Marek L, Tomintz M, Sharma K, McCarthy J, Mattingley B, Campbell M, Kingham S Area-level deprivation, childhood dental ambulatory sensitive hospitalizations and community water fluoridation: evidence from New Zealand. International Journal of Epidemiology.
This citation is automatically generated and may be unreliable. Use as a guide only.
KeywordsCommunity Water Fluoridation (CWF); dental ambulatory sensitive hospitalisation (ASH) rates; area-level deprivation; moderation; children; dentist
ANZSRC Fields of Research11 - Medical and Health Sciences::1105 - Dentistry::110599 - Dentistry not elsewhere classified
11 - Medical and Health Sciences::1117 - Public Health and Health Services::111704 - Community Child Health
11 - Medical and Health Sciences::1117 - Public Health and Health Services::111706 - Epidemiology
RightsAll rights reserved unless otherwise stated
Showing items related by title, author, creator and subject.
Water fluoridation and ethnic inequities in dental caries profiles of New Zealand children aged 5 and 12-13 years: analysis of national cross-sectional registry databases for the decade 2004-2013 Schluter, P.J.; Lee, M. (University of Canterbury. School of Health Sciences, 2016)Background: Gross and important inequities have historically existed in the oral health profiles of New Zealand children. Following the New Zealand Government's strategic oral health vision, launched in 2006, nationally ...
Veerasamy A; Gage J; Kirk, RC (2017)Introduction: Children and young people in India have a high prevalence of dental decay. As part of a broader epidemiological study we interviewed 10 head teachers to understand the status of, and challenges to, inclusion ...
Winter Is Coming: A Socio-Environmental Monitoring and Spatiotemporal Modelling Approach for Better Understanding a Respiratory Disease Marek L; Campbell M; Epton M; Kingham S; Storer M (2018)Chronic Obstructive Pulmonary Disease is a progressive lung disease affecting the respiratory function of every sixth New Zealander and over 300 million people worldwide. In this paper, we explored how the combination ...