2014 Funded Projects
CFDHRE Peer Reviewed Grant
Quantifying inequity in oral health and access to dental care in Canada.
Lead Principal Applicant
Carlos Quinonez, DMD, MSc, PhD, FRCD(C)
Title: Assistant Professor and Program Director, Dental Public Health
Host Institution/Organization: University of Toronto
Address: Room 515C, 124 Edward Street, Toronto, Ontario, Canada, M5G1G6
Co- Principal Applicant:
Julie Farmer, BSc (Hons), Dip(DH), RDH, MSc (cand)
Title: Registered Dental Hygienist; Student, candidate for Masters of Science in Dentistry (Dental Public Health)
Organization: University of Toronto
Address: Room 514A, 124 Edward Street, Toronto, Ontario, Canada, M5G1G6
Title: Assistant Professor, Department of Economics
Organization: Wilfred Laurier University
Address: 75 University Avenue W., Waterloo, Ontario, Canada, N2L 3C5
Background: In Canada, lower income people tend to have the most dental disease but the worst access to dental care, while higher income people tend to have the least dental disease but the best access to dental care (1-3). It is argued that the Canadian dental system promotes income-related inequity (2-6). Several studies have identified income-related inequity in Canada’s dental care system by determining absolute differences between high- and low- income people and rely on proxy measures of access and oral health status (6-11). Only one study has quantified the magnitude of inequities in clinical oral health outcomes, yet policy relevant drivers of income-related inequity in oral health, such as demographic, socioeconomic and behavoural factors, and the magnitude of income-related inequalities in access to dental care have not been identified (11).
Objective: To determine i) the magnitude of income-related inequity in access to dental care; ii) the main contributors to income-related inequity in oral health and access to dental care; iii) the magnitude of income-related inequity in oral health compared to general health.
Study Design: Observational study using cross-sectional, retrospective, secondary data.
Participants: 5,284 dentate individuals aged 6 to 79 years from the Canada Health Measures Survey 2007-2009.
Dependent Variables: (i) clinical measures of oral health; (ii) self-reported measures of general health; and (iii) access to dental care.
Explanatory & Control Variables: Equivalized household income. Demographic characteristics, socioeconomic status, and oral health practices will act as controls.
Methodology & Statistical Analyses: Quantitative analysis of income-related inequities through use of the health concentration index, including (i) the concentration curve (CC); and (ii) the concentration index (CI). Further analyses will use methods of indirect standardization and decomposition of the concentration index to determine contributors to income-related inequity. All analyses will be performed on Stata MP/dual core software.