IADR Abstract Archives
Use of Simulation Methods to Investigate Neighbourhood Effects on Caries
Objectives: There is little known to date on the mechanisms and pathways by which neighbourhoods impact on oral health outcomes. Theoretical work suggests there are a number of potential pathways including built, physical and social features of neighbourhoods that lead to worse health outcomes. The aim of this study was therefore to investigate features of neighbourhood environments that may influence tooth decay levels in adults.
Methods: Relevant literature was mapped onto a neighbourhood-based framework (Macintyre et al, 2002) to create numerous pathways by which neighbourhoods may influence tooth decay. Spatial microsimulation was used to combine data from the UK Adult Dental Health Survey (2009) with Census data to create a synthetic population of individuals at the small area level for Sheffield (UK), including associated demographic, socio-economic, and dental characteristics. This data formed the basis of the agent-based models which were used to test the theoretical pathways in two study regions in Sheffield with contrasting deprivation and decay scores.
Results: Data trends produced by the agent-based models indicated the same pathway (the interaction between shops, diet and sugar intake) had the largest impact in both study regions, leading to statistically significant increases in decay (p<0.05). The results of a hypothetical simulation involving the addition of an extra shop revealed a statistically significant decrease in decay in the more affluent study region (p<0.05), while no significant difference was seen in the less affluent study region.
Conclusions: The findings suggest the interactions between shops, diet and sugar intake may be the most important neighbourhood based mechanisms for tooth decay, regardless of socio-economic status. However, additional simulations pointed to more opportunities to reduce decay in the more affluent study region through the local food environment. Such methods have huge potential for understanding complex systems in dentistry and the pathways by which ‘place’ impacts on oral health, and inequalities.
Methods: Relevant literature was mapped onto a neighbourhood-based framework (Macintyre et al, 2002) to create numerous pathways by which neighbourhoods may influence tooth decay. Spatial microsimulation was used to combine data from the UK Adult Dental Health Survey (2009) with Census data to create a synthetic population of individuals at the small area level for Sheffield (UK), including associated demographic, socio-economic, and dental characteristics. This data formed the basis of the agent-based models which were used to test the theoretical pathways in two study regions in Sheffield with contrasting deprivation and decay scores.
Results: Data trends produced by the agent-based models indicated the same pathway (the interaction between shops, diet and sugar intake) had the largest impact in both study regions, leading to statistically significant increases in decay (p<0.05). The results of a hypothetical simulation involving the addition of an extra shop revealed a statistically significant decrease in decay in the more affluent study region (p<0.05), while no significant difference was seen in the less affluent study region.
Conclusions: The findings suggest the interactions between shops, diet and sugar intake may be the most important neighbourhood based mechanisms for tooth decay, regardless of socio-economic status. However, additional simulations pointed to more opportunities to reduce decay in the more affluent study region through the local food environment. Such methods have huge potential for understanding complex systems in dentistry and the pathways by which ‘place’ impacts on oral health, and inequalities.