Abstract
Objective To examine associations between NHS child dental registration data and area deprivation scores of English Health Authorities (N=100) in 1996/97 and 1997/98.
Method The Department of the Environment index of local conditions and the Jarman Underpriviledge Area Score from the 1991 census were used to measure deprivation. Prior to September 1997, children got free dental treatment under a capitation scheme with an NHS dentist. If they did not attend within 24 months their registration lapsed on the last day of December of the second registration year and they were deleted from the capitation list. After September 1997 the registration period was reduced to 15 months.
Outcome Curve-linear regression of the Health Authority (HA) percentage of children registered, lapses in capitation registrations and deprivation scores.
Results In England 68% of children were registered in December 1996. The percentage registered in each Health Authority was associated with deprivation (DoE, r2=0.33, Jarman, r2=0.27 p<0.01). In January 1997, 17.8% (1,345,142) of children registered lapsed (HA range 12.8% to 30.3%) and this was also significantly associated with deprivation (DoE r2=0.66, Jarman, r2=0.51 p<0.01). Similar results were found in 1997/98.
Conclusions Registration and lapse rates were significantly associated with social deprivation confirming that there is an inverse 'dental' care law for children in England. NHS capitation may widen dental health inequalities.
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References
Saving lives: our healthier nation. Department of Health, Cm4286, London, Stationary Office, 1999.
Independent Inquiry into Inequalities in Health. Chairman, Sir Donald Acheson. London, Stationary Office, 1998.
Tudor-Hart J . The Inverse Care Law. The Lancet i: 1971 405–412.
Whitehead M . The Health Divide. London. Penguin 1988.
Whitehead M . Tackling inequalities: a review of policy initiative. In Benzeval M, Judge K; Eds. Tackling inequalities in health an agenda for action. London. Kings Fund 1995.
Carmichael C L . Inner City Britain: A challenge for the dental profession. Review of Dental and Related Deprivation in Inner City Newcastle-upon-Tyne. Br Dent J 1985; 159, 24–27.
The Future Role of the Community Dental Service. Health Circular (89)2 Department of Health. London 1989.
Primary Care Dental Services. Health Services Guidelines Department of Health, London. (97)4 1997.
Scarrott D M, Changes in the regional distribution of general dental service manpower. Br Dent J 1978; 144, 1978. 359–63.
Cook P J and Walker R D . The geographical distribution of dental care in the United Kingdom. Br Dent J 1967; 122: 551–559.
Buck D . Dental health, population size and the distribution of general dental practitioners in England. Community Dent Health 1999 16: 149–153.
Beal J . Social factors and preventive dentistry. In Murray J J ed. The prevention of oral disease. Oxford University Press, Oxford. 3rd edition 1996. pp217–233.
General Dental Services, Amendment 80 to the Statement of Dental Remuneration DoH, London.HSC 1998/042.
GDS Quarterly Statistics. Registrations: England and Wales. Dental Practice Board, Eastbourne 1993 - 1998.
GDS Capitation Registrations. Dental Practice Board, Eastbourne 1993–1998.
Index of Local Conditions (an analysis based on 1991 census data). Department of Environment, 1994.
University of Surrey 1996: Public Health Common Data Set. Brighton. University of Surrey.
Townsend P, Davidson N and Whitehead M . The Black Report. Inequalities in Health: The Black Report and the Health Divide. 2nd Edition, Penguin, London, 1992.
Carstairs V, Morris R . Deprivation and Health in Scotland; 1991. Aberdeen University Press.
1991 Census, Sex, Age and Marital Status 1993, Great Britain. OPCS. HMSO. London.
1991 Census Migration 1994. Great Britain. Part 1, Vol 1. OPCS. HMSO. London.
CRD report 3, Review of the research on the effectiveness of health service interventions to reduce variations in health. NHS centre for reviews and dissemination, The University of York, 1995.
Kravitz T . GDSC Chairman looks forward. British Dental Association News. 1999: 12: 3.
Davies J A . Enhancing dental attendance rates for children from deprived areas in the UK. Br Dent J 1999; 187, 323–326.
Acknowledgements
Thanks to Mrs C Stirling for secretarial expertise, Dr Z Nugent, Mr L Holden and Mrs M A MacDonald for advice and constructive criticism and Mr K Woods, Director of the North West Dental Public Health Resource Centre. I also acknowledge the comments of the two anonymous referees whose guidance greatly improved the paper.
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Jones, C. Capitation registration and social deprivation in England. An inverse 'dental' care law?. Br Dent J 190, 203–206 (2001). https://doi.org/10.1038/sj.bdj.4800925
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DOI: https://doi.org/10.1038/sj.bdj.4800925
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