• 한국치위생학회지
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• 제22권5호
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• pp.417-424
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• 2022

Objectives: This study aimed to find a way to solve oral health inequality in old age by understanding the effect of the socioeconomic level of the elderly on oral health. Methods: We used data from the 7th Korea National Health and Nutrition Examination Survey. A chi-square test was performed to investigate differences in oral health according to socioeconomic status and demographic and oral health-related factors. Socioeconomic status and oral health inequality were analyzed using multiple logistic regression. Results: The average number of teeth in the elderly was 17.20, which is insufficient for the minimum number of teeth required for mastication. In the analysis of the correlation between socioeconomic status and oral health inequality, education level, income level, and home ownership were factors influencing the oral health of the elderly; education level was found to have the strongest effect. Conclusions: Oral health inequality according to socioeconomic status was confirmed, and it is necessary to measure the level of oral health inequality with active efforts at the government level to resolve the gap in oral health by social class.

• 한국산학기술학회논문지
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• 제19권4호
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• pp.439-445
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• 2018

본 연구는 소득 불평등의 심화가 건강 불평등을 가속화시키는 중요한 경로가 되고 있기에 한국 성인의 경제적 수준에 따른 구강건강상태 및 행태의 현황을 확인하여 구강건강 불평등 완화를 위한 대책과 함께 구강건강증진의 효율적 방안을 모색하는데 기초자료를 제공하고자 한다. 국민건강영양조사 제6기 3차년도(2015) 원시자료를 이용하여 분석하였고, 전체 대상자 중에서 만 19세 이상의 성인 총 5855명을 연구대상으로 선정하였다. 연구결과 가구소득이 적을수록, 기초생활수급 경험이 있는 사람일수록 DMFT는 높게 나타났고, DMFT와 경제적 불평등 변수와의 상관성은 DMFT가 높을수록 가구소득이 적고, 교육수준이 낮고, 기초생활보장 수급자 경험이 있는 것으로 나타났다. 이에 경제적 불평등은 객관적 구강건강과 구강건강행태 불평등으로 나타나는 것을 확인하였다. 또한 동에 거주하는 기초생활보장 수급자보다 읍, 면에 거주하는 기초생활보장 수급자의 객관적 구강건강상태가 좋았는데 그것은 정부의 구강보건사업이 도시 지역보다 농어촌 지역으로 편중되어 있기 때문으로 판단된다. 이에 취약계층의 구강보건사업을 지역별 구강보건사업 보다 더 나은 효율적인 방안을 모색하여야 할 것이며, 단순히 의료적 접근 등의 해소가 아닌 건강의 사회적 결정요인에 대한 포괄적인 중재정책과 공중보건사업을 통해 예방활동 강화가 필요할 것으로 판단되었다.

• 치위생과학회지
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• 제23권3호
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• pp.185-192
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• 2023

Background: The establishment of a strategy for the reduction and prevention of oral disease, a global pervasive disease, is considered one of the important national health policy strategies. In Korea, the 5th Comprehensive National Health Promotion Plan is currently in progress, but there is insufficient research on the transition process or improvement direction in the field of oral health. Methods: Changes in Comprehensive National Health Promotion Plan's Oral health sector in three countries were compared, and the direction of the three countries (Korea, the United States, and Canada) in accordance with the recent Oral health paradigm was confirmed. In this study, we reviewed the existing literature using the narrative review method to draw implications for strategies and directions for oral health promotion in Korea. Results: In Korea, the oral health promotion strategy is included in the 5th Comprehensive National Health Promotion Plan, and the project is being led by the government. The United States prepared a national-led oral health promotion strategy and suggested multi-disciplinary cooperation to improve overall oral health and reduce the oral health inequality. For more active intervention, Canada established an oral health-related department and assigned experts, while emphasizing cooperation between the government and the private sector. Conclusion: As a result of this study, Korea is also making efforts to improve oral health, but more active government intervention is needed to reduce the inequality in oral health by population group. To this end, it is necessary to establish a strong multi-sectoral cooperation system and prepare a strategy for implementation.

• 한국치위생학회지
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• 제19권4호
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• pp.565-575
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• 2019

Objectives: In this study, both subjective and objective levels of oral health were used to identify the relationship between oral health inequalities. Methods: Korean National Health and Nutritional Examination Survey data from 2013 to 2015 were combined to create an analysis plan. Oral health questions categorized as subjective oral health conditions and oral health-related diseases used dental tissue disease status as data measured by the Community Periodical Index(CPI) and decayed, missing, filled teeth(DMFT) experience. Other data on oral health behaviors such as toothache experience, the frequency of toothbrush use, chewing problems, oral examination status, and unmet dental care needs were classified and analyzed according to the socioeconomic level. Data were analyzed using frequency and cross analyses, and the statistical significance level was set at 0.05. Results: It was found that higher the economic and educational level, better was the subjective oral health, lower the CPI, lower the experience of toothache, higher the frequency of toothbrush use, lower the number of people having chewing problems, and higher the frequency of oral checkups. Conclusions: Oral health inequality exists among social classes. It is suggested that continuous research and efforts be carried out to promote oral health while considering socioeconomic and educational levels. Further, active government efforts will be needed to address polarization by social class.

• 대한장애인치과학회지
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• 제2권1호
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• pp.17-30
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• 2006

Federal disability law has evolved from several laws geared to protect people with disabilities since the late 1960s and early 1970s. When U.S. Congress passed the Americans with Disabilities Act (ADA) in 1990, no federal statute prohibited the majority of employers, program administrators, owners and managers of places of public accommodation and others from discriminating against people with disabilities. Toward the ends to assure equality of opportunity, full participation, independent living, and economic self-sufficiency for individuals with the disabilities, the ADA pursues three major strategies: Title I addresses inequality in employment, Title II, inequality in public services, and Title III, inequality in services and accommodations offered by private entities. The purposes of the study were to analyze the impact of the ADA on health care for persons with disabilities and to review the ongoing health policy reforms at the federal and state governments. Essential remedies that the ADA contemplates are based on two principles, simple discrimination and reasonable accommodation, which significantly improved access to quality care, especially long-term care, by persons with disabilities. However, the ongoing Medicaid policy reforms to control rising health care costs in the U.S. could threaten the access to care by persons with disabilities in optional groups and to optional care services by persons with disabilities in mandatory groups.

• Journal of Preventive Medicine and Public Health
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• 제50권5호
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• pp.303-310
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• 2017

Objectives: The aim of this study was to evaluate socioeconomic inequalities in the prevalence of dental caries among an urban population. Methods: This study was conducted among 2000 people 15-40 years of age living in Kurdistan, Iran in 2015. Using a questionnaire, data were collected by 4 trained dental students. The dependent variable was the decayed, missing, and filled teeth (DMF) index. Using principal component analysis, the socioeconomic status (SES) of families was determined based on their household assets. Inequality was measured using the concentration index; in addition, the Oaxaca analytical method was used to determine the contribution of various determinants to the observed inequality. Results: The concentration index for poor scores on the DMF index was -0.32 (95% confidence interval [CI], -0.40 to -0.36); thus, poor DMF indices had a greater concentration in groups with a low SES (p<0.001). Decomposition analysis showed that the mean prevalence of a poor DMF index was 43.7% (95% CI, 40.4 to 46.9%) in the least privileged group and 14.4% (95% CI, 9.5 to 9.2%) in the most privileged group. It was found that 85.8% of the gap observed between these groups was due to differences in sex, parents' education, and the district of residence. A poor DMF index was less prevalent among people with higher SES than among those with lower SES (odds ratio, 0.31; 95% CI, 0.19 to 0.52). Conclusions: An alarming degree of SES inequality in oral health status was found in the studied community. Hence, it is suggested that inequalities in oral health status be reduced via adopting appropriate policies such as the delivery of oral health services to poorer groups and covering such services in insurance programs.

• 한국융합학회논문지
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• 제8권9호
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• pp.49-57
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• 2017

본 연구는 제6기 국민건강영양조사 자료를 이용하여 사회경제적 요인, 치주질환 및 영구치 우식경험에 따른 구강건강의 격차를 확인하고, 구강건강 관련 삶의 질에 영향을 미치는 융합적 요인을 분석하여 정책 계획의 기초자료를 제시하고자 실시하였다. 연구 대상은 본인이 인지하는 구강상태에 응답한 7,639명으로 하였고, 분석방법은 복합 표본 교차분석과 로지스틱 회귀분석으로 시행하였다. 결과는 연령이 높고, 가구 소득과 교육수준이 낮을수록 주관적 구강건강이 나쁘고, 구강검사를 한 대상자는 구강건강을 좋게, 치주질환이나 영구치우식경험자는 구강건강을 나쁘게 인식하였다. 사회경제적 취약계층, 치주질환 경험자, 영구치우식경험자 등이 구강건강에 부정적임을 확인할 수 있었다. 따라서 이러한 구강건강의 불평등을 근본적으로 해결하기 위한 정책개발이 필요할 것으로 사료된다.

• 한국치위생학회지
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• 제18권6호
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• pp.921-932
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• 2018

Objectives: The aim of this study was to investigate the number of existing permanent teeth and the denture usage status in elderly adults aged 65 years and above living in metropolitan cities and to confirm the degree of oral health inequality caused by the differences in oral conditions in each metropolitan city using the Lorenz curve and the Gini coefficient. Methods: The raw data for the analysis were obtained from the dataset of the sixth Korea National Health and Nutrition Examination Survey conducted between 2013 and 2015. The subjects included 1,764 people who underwent oral examination and answered questions. The complex samples general linear model was used to analyze the number of existing permanent teeth adjusted for age and monthly household income. The proportion of edentulousness and the denture status was analyzed using complex samples crosstabs. Results: The number of existing permanent teeth in the elderly adults aged 65 years and above was lowest in Ulsan (15.41) and highest in Gwangju (20.44). The proportion of edentulousness was highest in Busan (14.5%) and lowest in Daejeon (4.0%). With regard to the proportion of denture users, Busan had the highest tendency for denture usage (50.4%) and Gwangju had the lowest tendency (34.9) (p=0.172). The Gini's coefficient for the number of existing teeth was lowest in Busan (0.332). Oral health inequality was most severe in metropolitan cities. Conclusions: We found that oral health inequality exists among elderly adults living in the metropolitan cities of Korea using the Lorenz curve and Gini's coefficient.

• 한국학교ㆍ지역보건교육학회지
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• 제16권3호
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• pp.41-50
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• 2015

Objectives: The purpose of this study was to apply an effective oral health promotion program and effect for underprivileged lower grade students. This study attempted to resolve some oral health inequality issues by providing underprivileged children with an oral health action program designed to promote positive oral health maintenance habits. Methods: This study was carried from May to August of 2009 with 77(control group 27 subjects, experimental group 36 subjects) elementary school students selected among first to third graders attending regional welfare center's after school program in Seoul. To the control group, conventional education methods were applied. To the experimental group, newly designed program was conducted by three project experts(1 expert, 1 dentist, 1 dental hygienist). It consisted of 5 sessions and progressed with various activities. It was focused on achieving target knowledge and changing oral health behavior. In order to evaluate the designed educational program, learners' achievement was evaluated with implementing the questionnaire and one-on-one interviews. And also the oral health improvement was evaluated based on change of Patient Hygiene Performance(PHP) index. Results: Based on the results of learners' achievement, the experimental group showed the significant increment of the oral health knowledge by the relapsed time, and it maintained after finished the program(p<0.001). The patient hygiene performance index showed not significant changed(p>0.05), but 1 month later the control group showed an increment of the PHP score, but the experimental group showed a decrement of it. Conclusions: Oral health promotion program by project approach could give a long-lasting educational effect to the children and encouraged proper oral hygiene behavioral changes.

• Journal of Korean Academy of Oral Health
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• 제42권4호
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• pp.136-144
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• 2018

Objectives: The aim of this study is to analyze the differences in factors related to the incidence of dental caries between children in fluoridated and non-fluoridated areas and compared the DMFT and DMFS scores to confirm the effect of water fluoridation program (WFP) in Geoje and Changwon. Methods: The oral health examination and questionnaire survey were conducted in fluoridated and non-fluoridated areas. The number of surveyed children aged 8, 10, and 12 years in the fluoridated and non-fluoridated area of two cities was 1,524 and 1,383, respectively. Self-recorded questionnaires included self-perception of their own dental health, daily toothbrushing frequency, intake frequency of cariogenic sweet snacks and beverages, experience of gingival bleeding, experience of unmet dental treatment, and use of oral hygiene device except for toothbrush and toothpaste. The prevalence of caries and fissure-sealant status were surveyed. The logistic regression analysis was used to analyze the difference in children's self-rated oral health status between the fluoridated and non-fluoridated area. The mean number of sealed teeth and surfaces, marginal means of the DMFT and DMFS scores adjusted for the difference in the samples' sex distribution, and region were compared between the fluoridated and non-fluoridated areas. Results: In the fluoridated area, the experience rate of unmet dental treatments was higher among children aged 10 years, intake frequency of cariogenic sweet snacks and beverages were higher among the whole sample, and experience rate of professional fluoride application were lower than in the non-fluoridated area. The DMFT score for permanent dentition adjusted for differences in sex, region, and mean number of fissure-sealed teeth in the fluoridated area was significantly lower among whole samples and 8-, 10-, and 12-year-olds alone than in the non-fluoridated area. Conclusions: WFP can alleviate oral health inequality because it is effective in reducing the incidence of caries among children is disadvantaged demographic, socioeconomic, and cultural contexts.