Comparison and relative utility of inequality measurements: as applied to Scotland's child dental health.

This study compared and assessed the utility of tests of inequality on a series of very large population caries datasets. National cross-sectional caries datasets for Scotland's 5-year-olds in 1993/94 (n = 5,078); 1995/96 (n = 6,240); 1997/98 (n = 6,584); 1999/00 (n = 6,781); 2002/03 (n = 9,747...

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Autores principales:	Yvonne I Blair, Alex D McMahon, Lorna M D Macpherson
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/fed3970b6a3b49139d6e777a97b8b51f
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spelling	oai:doaj.org-article:fed3970b6a3b49139d6e777a97b8b51f2021-11-18T07:54:08ZComparison and relative utility of inequality measurements: as applied to Scotland's child dental health.1932-620310.1371/journal.pone.0058593https://doaj.org/article/fed3970b6a3b49139d6e777a97b8b51f2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23520524/?tool=EBIhttps://doaj.org/toc/1932-6203This study compared and assessed the utility of tests of inequality on a series of very large population caries datasets. National cross-sectional caries datasets for Scotland's 5-year-olds in 1993/94 (n = 5,078); 1995/96 (n = 6,240); 1997/98 (n = 6,584); 1999/00 (n = 6,781); 2002/03 (n = 9,747); 2003/04 (n = 10,956); 2005/06 (n = 10,945) and 2007/08 (n = 12,067) were obtained. Outcomes were based on the d3mft metric (i.e. the number of decayed, missing and filled teeth). An area-based deprivation category (DepCat) measured the subjects' socioeconomic status (SES). Simple absolute and relative inequality, Odds Ratios and the Significant Caries Index (SIC) as advocated by the World Health Organization were calculated. The measures of complex inequality applied to data were: the Slope Index of Inequality (absolute) and a variety of relative inequality tests i.e. Gini coefficient; Relative Index of Inequality; concentration curve; Koolman & Doorslaer's transformed Concentration Index; Receiver Operator Curve and Population Attributable Risk (PAR). Additional tests used were plots of SIC deciles (SIC(10)) and a Scottish Caries Inequality Metric (SCIM(10)). Over the period, mean d3mft improved from 3.1(95%CI 3.0-3.2) to 1.9(95%CI 1.8-1.9) and d3mft = 0% from 41.1(95%CI 39.8-42.3) to 58.3(95%CI 57.8-59.7). Absolute simple and complex inequality decreased. Relative simple and complex inequality remained comparatively stable. Our results support the use of the SII and RII to measure complex absolute and relative SES inequalities alongside additional tests of complex relative inequality such as PAR and Koolman and Doorslaer's transformed CI. The latter two have clear interpretations which may influence policy makers. Specialised dental metrics (i.e. SIC, SIC(10) and SCIM(10)) permit the exploration of other important inequalities not determined by SES, and could be applied to many other types of disease where ranking of morbidity is possible e.g. obesity. More generally, the approaches described may be applied to study patterns of health inequality affecting worldwide populations.Yvonne I BlairAlex D McMahonLorna M D MacphersonPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 3, p e58593 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Yvonne I Blair Alex D McMahon Lorna M D Macpherson Comparison and relative utility of inequality measurements: as applied to Scotland's child dental health.
description	This study compared and assessed the utility of tests of inequality on a series of very large population caries datasets. National cross-sectional caries datasets for Scotland's 5-year-olds in 1993/94 (n = 5,078); 1995/96 (n = 6,240); 1997/98 (n = 6,584); 1999/00 (n = 6,781); 2002/03 (n = 9,747); 2003/04 (n = 10,956); 2005/06 (n = 10,945) and 2007/08 (n = 12,067) were obtained. Outcomes were based on the d3mft metric (i.e. the number of decayed, missing and filled teeth). An area-based deprivation category (DepCat) measured the subjects' socioeconomic status (SES). Simple absolute and relative inequality, Odds Ratios and the Significant Caries Index (SIC) as advocated by the World Health Organization were calculated. The measures of complex inequality applied to data were: the Slope Index of Inequality (absolute) and a variety of relative inequality tests i.e. Gini coefficient; Relative Index of Inequality; concentration curve; Koolman & Doorslaer's transformed Concentration Index; Receiver Operator Curve and Population Attributable Risk (PAR). Additional tests used were plots of SIC deciles (SIC(10)) and a Scottish Caries Inequality Metric (SCIM(10)). Over the period, mean d3mft improved from 3.1(95%CI 3.0-3.2) to 1.9(95%CI 1.8-1.9) and d3mft = 0% from 41.1(95%CI 39.8-42.3) to 58.3(95%CI 57.8-59.7). Absolute simple and complex inequality decreased. Relative simple and complex inequality remained comparatively stable. Our results support the use of the SII and RII to measure complex absolute and relative SES inequalities alongside additional tests of complex relative inequality such as PAR and Koolman and Doorslaer's transformed CI. The latter two have clear interpretations which may influence policy makers. Specialised dental metrics (i.e. SIC, SIC(10) and SCIM(10)) permit the exploration of other important inequalities not determined by SES, and could be applied to many other types of disease where ranking of morbidity is possible e.g. obesity. More generally, the approaches described may be applied to study patterns of health inequality affecting worldwide populations.
format	article
author	Yvonne I Blair Alex D McMahon Lorna M D Macpherson
author_facet	Yvonne I Blair Alex D McMahon Lorna M D Macpherson
author_sort	Yvonne I Blair
title	Comparison and relative utility of inequality measurements: as applied to Scotland's child dental health.
title_short	Comparison and relative utility of inequality measurements: as applied to Scotland's child dental health.
title_full	Comparison and relative utility of inequality measurements: as applied to Scotland's child dental health.
title_fullStr	Comparison and relative utility of inequality measurements: as applied to Scotland's child dental health.
title_full_unstemmed	Comparison and relative utility of inequality measurements: as applied to Scotland's child dental health.
title_sort	comparison and relative utility of inequality measurements: as applied to scotland's child dental health.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/fed3970b6a3b49139d6e777a97b8b51f
work_keys_str_mv	AT yvonneiblair comparisonandrelativeutilityofinequalitymeasurementsasappliedtoscotlandschilddentalhealth AT alexdmcmahon comparisonandrelativeutilityofinequalitymeasurementsasappliedtoscotlandschilddentalhealth AT lornamdmacpherson comparisonandrelativeutilityofinequalitymeasurementsasappliedtoscotlandschilddentalhealth
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Comparison and relative utility of inequality measurements: as applied to Scotland's child dental health.

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