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Oral health and healthy cities: An analysis of intra-urban differentials in oral health outcomes in relation to "healthy cities" policies in Curitiba, Brazil

Moyses, Samuel Jorge; (1999) Oral health and healthy cities: An analysis of intra-urban differentials in oral health outcomes in relation to "healthy cities" policies in Curitiba, Brazil. Doctoral thesis (Ph.D), UCL (University College London). Green open access

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Abstract

There is little research on the effect of healthy public policies on children's oral health. This study addresses the question of how policies related to a Healthy Cities approach affect children's oral health, in Curitiba, Brazil. The hypothesis is that healthy public policies, with the mediating effects of community social cohesion, affect the oral health of children. Matched deprived areas in Curitiba were selected; some of the areas had implemented healthy public policies systematically, while others had not. Data were derived from two complementary studies: a) the panel study gathered data on socio-environmental variables in 29 deprived communities with different degrees of healthy public policies implementation; b) the survey study collected individual clinical data on oral health outcome variables, and on covariates taken as potential confounders. The covariates referred to children's socio-economic, demographic, and dental characteristics. All children came from peripheral public schools in the 29 deprived communities, and were twelve years old (n = 2126). Fourteen variables from the panel study instruments were factor-analysed. Three components were extracted: physical environment, public social policies, and social cohesion. Rank correlation indicated that the relationship between components' scores and outcomes was statistically significant. The scores explained 48% of the variance for caries-free (DMF = 0), 42% for dental trauma, and 17% for dental pain. The final analysis used meta-analysis and meta-regression. Only sex remained significant as individually measured covariate: males had more dental trauma than females. The physical environment component had the strongest relationship with dental trauma. The public social policies component was strongly related to caries-free individuals, and to dental trauma. The social cohesion component was the strongest predictor for caries-free, and the only component predictor for dental pain. The conclusion is that healthy public policies and social cohesion can significantly affect oral health of children in relatively deprived communities.

Type: Thesis (Doctoral)
Qualification: Ph.D
Title: Oral health and healthy cities: An analysis of intra-urban differentials in oral health outcomes in relation to "healthy cities" policies in Curitiba, Brazil
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Thesis digitised by ProQuest.
URI: https://discovery.ucl.ac.uk/id/eprint/10107901
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