title: Exploring school oral health outcomes and neighbourhood factors in schools participating in Ontario's "Healthy Schools" recognition program.
abstract: OBJECTIVE
  This ecologic study compared school-level oral health outcomes in schools participating in Ontario's "Healthy Schools" program and nonparticipating schools in York Region, Ontario in 2007-2008 and examined the effect of neighbourhood socio-economic factors.
  
  
  METHODS
  School-aggregated data were obtained for all 243 elementary schools. York Region Public Health Unit provided oral health data from school dental screenings. We obtained information about schools participating in the Ontario's "Healthy Schools" program from publicly accessible websites. Neighbourhood socio-economic data based on school postcodes were extracted from Statistics Canada (2006) census databases. School oral health outcomes included the percentage of children in each school requiring preventive care, non-urgent dental treatment, urgent dental treatment and children with > or = two decayed teeth.
  
  
  RESULTS
  One hundred and six elementary schools (42%) participated in Ontario's "Healthy Schools" program in 2007-2008. Schools participating in the "Healthy Schools" program had a significantly lower percentage of children with > or = two decayed teeth (p < 0.001) and children requiring urgent dental treatment (p = 0.004) than non-participating schools. School participation/neighbourhood socio-economic factors interactions showed that a significantly lower percentage of children in low-income "Healthy Schools" had preventive and urgent dental treatment needs and > or = two decayed teeth than in low-income non-participating schools (p < 0.001).
  
  
  CONCLUSIONS
  Schools participating in Ontario's "Healthy Schools" program had better school oral health outcomes than non-participating schools. School neighbourhood socio-economic factors affected school oral health outcomes, which could suggest that schools situated in poorer neighbourhoods may benefit more from health promotion activities than schools situated in more affluent neighbourhoods.
authors.affiliation: Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK. v.muirhead@qmul.ac.uk
authors.forename: Vanessa E
authors.initials: VE
authors.lastname: Muirhead
authors.forename: Herenia P
authors.initials: HP
authors.lastname: Lawrence
mesh_terms: D002648:Child; D019140:Dental Care for Children; D003731:Dental Caries / Q000453:epidemiology / Q000517:prevention & control*; D006293:Health Promotion; D006297:Health Services Accessibility; D006801:Humans; D008403:Mass Screening; D009864:Ontario / Q000453:epidemiology; D009909:Oral Health; D011204:Poverty Areas; D012111:Residence Characteristics; D012572:School Health Services; D012959:Socioeconomic Factors; D035141:Voluntary Programs