December 2016

Volume 33, Issue 4

Abstracts from the 21st Congress of the European Association of Dental Public Health, 29th September - 1st October, 2016, Budapest, Hungary

doi: 10.1922/CDH_EAPDHAbstracts2016


Speakers’ abstracts REDUCING SOCIAL INEQUALITIES IN HEALTH IN EUROPE Prof. Dr. Johan P. Mackenbach Department of Public Health, Erasmus MC, Rotterdam, Netherlands Reducing inequalities in health between socioeconomic groups within a country is one of the greatest challenges for public health, even in the highly developed welfare states of Europe. Recognizing this, several countries and the World Health Organization have set quantitative targets for reducing these inequalities. Since these targets were set, reports have appeared suggesting that inequalities in mortality have widened instead of narrowed. However, a systematic analysis of progress in reducing health inequalities has not been made. We therefore collected data from 11 European countries to assess whether there has been progress, and if so how much, in reducing inequalities in mortality in the period 1990-2010. Our findings show that remarkable mortality declines have occurred in lower socioeconomic groups in most European countries, but that whether or not progress has occurred is very much dependent on the perspective chosen. Absolute declines in all-cause mortality were often larger in lower than in higher socioeconomic groups (with absolute inequalities narrowing as a result) among men, but not among women. However, relative declines in mortality were almost always smaller in lower than in higher socioeconomic groups (with relative inequalities widening as a result). Narrowing of absolute inequalities was mainly driven by ischemic heart disease, smoking-related causes (men only), and causes amenable to medical intervention, whereas setbacks with widening inequalities can be seen in many countries for alcohol-related causes. Although, as these results show, recent trends in inequalities in mortality in Europe are more encouraging than commonly thought, they also raise important questions, such as whether the observed narrowing of inequalities in mortality can be interpreted as a beneficial effect of explicit policies, e.g. of national programs to reduce health inequalities. Unfortunately, the evidence suggests that that is not the case, and that wherever a narrowing has occurred this has been a side-effect of population-wide behavioural changes and improvements in prevention and treatment of conditions like cardiovascular disease. Another, more fundamental question is whether in public health we should aim for reducing absolute or relative inequalities in mortality. Quantitative targets are usually ambiguous and do not specify whether relative or absolute inequalities should be reduced. Our findings show that since 1990 no country has achieved a reduction of relative inequalities in mortality, but that in terms of absolute inequalities some countries have even surpassed the 25% reduction target that the World Health Organization proposed. Should we be satisfied with reducing absolute inequalities in mortality, or keep striving for a reduction of relative inequalities as well?


Other articles in this issue

Article Pages Access
Abstracts from the 21st Congress of the European Association of Dental Public Health, 29th September - 1st October, 2016, Budapest, Hungary 0-0 Download
Valedictory Editorial: The past six years 1-1 Download
An intervention study to assess the effectiveness of a reminder telephone call in improving patient appointment attendance at a Community Dental Service clinic 239-241 £10 single article
The acceptability of healthcare: from satisfaction to trust 242-251 Download
Patient characteristics in relation to dental care payment model: capitation vs fee for service 252-256 Download
Payment systems and oral health in Swedish dental care: Observations over six years 257-261 Download
A summary of knowledge about the oral health of older people in England and Wales 262-266 £10 single article
The use of diet diaries in general dental practice in England 267-273 £10 single article
Psychometric properties of the English version of the Oral Health Literacy Adults Questionnaire - OHL-AQ 274-280 £10 single article
Approximal caries increment in relation to baseline approximal caries prevalence among adolescents in Sweden with and without a school-based fluoride varnish programme 281-285 Download
Variation in methods used to determine national mean DMFT scores for 12-year-old children in European countries 286-291 £10 single article
Prevalence and severity of dental fluorosis in four English cities 292-296 Download
The relationship between maternal smoking during pregnancy and parental-reported experience of dental caries in Indigenous Australian children 297-302 £10 single article
Dental problems and Familismo: social network discussion of oral health issues among adults of Mexican origin living in the Midwest United States 303-308 £10 single article


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