HEALTH INEQUALITIES

AND SOCIAL
DETERMINANTS OF
ORAL HEALTH
An outline
Health Inequalities
■ Health inequalities are the unjust and avoidable
differences in people’s health across the population
and between specific population groups.
■ They can exist on an individual level as well as
between populations.
– E.g between people who are vaccinated and non-
vaccinated, people with non-communicable
diseases such as diabetes, cancer etc, urban and
rural people
– E.g between life expectancies of various countries,
such as Japan where the life expectancy is over 80
years, Brazil 72 years and one of several African
countries, less than 50 years. (Commission on Social
Determinants of Health - Final Report)
– E.g an increase in the incidence of dental caries and
periodontal disease in people as they get older
(indicates adequate treatment is not being provided)
– E.g differences in incidences of dental caries between
developed and developing countries
Social Determinants of Oral Health
■ What are “social determinants”?
Conditions in which people are born, grow, live, work
and age; shaped by the distribution of:
• Money
• Power
• Resources
 At the local, national and global levels
 Play a strong role in shaping health inequalities
Health Challenges Faced Globally
■ In 2004, Scotland’s health minister stated that the
hepatitis C virus is the most serious and significant
public health risk of our generation.
■ Lifestyle-related diseases even in developing nations,
ailments such as obesity, cancer, heart disease and
psychiatric disorders are expected to overtake issues
like child malnutrition and infectious diseases.
■ The HIV pandemic is a serious and continuing problem
worldwide, especially in Sub-Saharan African countries.
(66% of new infections.)
■ Etc
Oral Health Challenges Faced Globally
■ Dental Caries is a major public health problem in
most industrialized countries, 60-90% of
schoolchildren and the vast majority of adults have
dental caries.
■ Dental caries is prevalent in several American and
Asian countries, less in African countries but
expected to increase due to growing sugar
consumption and low fluoride exposure.
Steps to Eliminate Health Inequalities
■ Acknowledging the health inequalities is the first
step that should be taken towards strengthening the
performance of health delivery system and
improving oral health.
■ Ensuring universal healthcare for every individual
without economic, geographical, social, gender or
cultural barriers.
■ Overcoming social and economic inequities.
■ Initiate programs that promote improved physical
environments and better living standards.
■ Increase awareness of oral health problems through
education.
■ Programs that reduce unemployment in vulnerable
groups or areas and that promote physical and
mental health.
■ Early years programmes.
Social Policies Currently In Place To Improve
Oral Health
 Current goals of oral health policy, following the reports
of the WHO Commission on Social Determinants of
Health:
o Emphasizing the significance of pychosocial
determinants – especially in underprivileged areas.
o Engaging with partners like WHO, International
Association for Dental Research (IADR) to develop
an approach to reduce oral health inequalities
o Oral health care professionals should be
advocates for oral and general health, as
recommended by FDI’s Vision 2020.
o Highlighting oral health inequalities in public
debates and the principle of proportionate
universality for improvement of health of the
underprivileged.
■ European countries are divided into four main groups:
o Group A: countries with no action on reduction of
inequalities such as Greece and Cyprus
o Group B: countries with isolated initiatives on the
reduction of inequalities, no national strategies e.g
Belgium and France
o Group C: countries with a clear strategy for reducing
inequalities within broader policy to promote health
e.g Hungary and Denmark
o Group D: countries with an integrated plan to reduce
inequalities in health e.g Sweden & England