Socioeconomic factors that affect international caries levels.
Health policy makers have examined the impact of economic policies and a nation's social development on the health of its population.


OBJECTIVE
The purpose of this research was to investigate the association between health care expenditures, socioeconomic factors, and caries levels in 109 countries representing an array of social and economic conditions, and to determine how such factors are related to caries experience at different levels of economic development.


METHODS
Countries were divided into established market economies and three groups of developing nations, based on their GNP (high, medium, low income). Total health expenditures as percent GDP and as US dollars per capita, public expenditures and aid flow as percent of total health expenditures, dentists per 100,000 population, per capita sugar consumption, and urbanization of the population were compared among these countries. Correlations between these variables, and decayed, missing and filled teeth (DMFT) of 12-year-olds in these countries were assessed.


RESULTS
The highest correlations were found between DMFT and public expenditures, sugar consumption, and urbanization. Highly significant differences emerged across nation groups by stages of development on several variables.


CONCLUSIONS
The findings suggest that it is important to consider the stage of development of a given country when planning caries prevention policies and programs. Such a contextual approach is more likely to be successful in reducing caries levels.
Diehnelt
D E
DE
Department of Oral and Maxillofacial Surgery, University of Washington, Seattle, USA. Jhirakawa@compuserve.com
Kiyak
H A
HA
D002648:Child; D004245:DMF Index; D003731:Dental Caries / Q000191:economics / Q000453:epidemiology*; D003815:Dentists / Q000600:supply & distribution; D019049:Developed Countries / Q000191:economics / Q000706:statistics & numerical data; D003906:Developing Countries / Q000191:economics / Q000706:statistics & numerical data; D019422:Dietary Sucrose / Q000008:administration & dosage; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D007391:International Cooperation; D015995:Prevalence; D012044:Regression Analysis; D012959:Socioeconomic Factors; D014507:Urbanization
D019422:Dietary Sucrose