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歯科領域にみられる健康格差と ヘルスプロモーション PowerPoint PPT Presentation


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歯科領域にみられる健康格差と ヘルスプロモーション. NPO 法人日本むし歯予防フッ素推進会議 研修セミナー 2007 年 9 月 2 日 東京仕事センター 東北大学大学院歯学研究科 国際歯科保健学分野 相田潤. 健康の地域格差. がんの標準化死亡比(男、 2000 年). (引用、国立がんセンターがん対策情報センター : http://ganjoho.ncc.go.jp/public/statistics/pub/todoufuken.html ). がんの標準化死亡比(女、 2000 年).

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歯科領域にみられる健康格差と ヘルスプロモーション

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NPO

200792


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2000

http://ganjoho.ncc.go.jp/public/statistics/pub/todoufuken.html


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2000

http://ganjoho.ncc.go.jp/public/statistics/pub/todoufuken.html


3 2000

32000

60-100

50-59.9

40-49.9

30-39.9

20-29.9

0-19.9


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The Black report (1980)The Achesonreport (1998)


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1930-32

(Department of Health 1999, UK)


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Smr 1950 52 100

SMR1950-52100

Public health act (1875)

, ,

NHS

(1948)

19


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BCG

15

15


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  • (McKeown 1979)

  • 17

    (Tarlov 1996)


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  • (Nadanovsky and Sheiham 1995)


Social determinants of health

Social determinants of health

(Dahlgren G, and Whitehead M in the Acheson Report ,1998)


Who commission on social determinants of health

WHOCommission on Social Determinants of Health

http://www.prof-tt-publichealth.com/pdf/solidfacts.pdf


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3


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3

2000

60-100

50-59.9

40-49.9

30-39.9

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0-19.9

. 3. .2004.54.566-576


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39.4 %

Aida J, Ando Y, Aoyama H, Tango T, Morita M.An ecological study on the association of public dental health activities and sociodemographic characteristics with caries prevalence in Japanese 3-year-old children.Caries Res.2006.40.466-472


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3


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2007


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Poulton R, Caspi A, Milne BJ, Thomson WM, Taylor A, Sears MR, Moffitt TE. Association between childrens experience of socioeconomic disadvantage and adult health: a life-course study. Lancet. 2002 Nov 23;360(9346):1640-5.


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,2006


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Materialist

  • Material

  • Materialist

Sisson KL.Theoretical explanations for social inequalities in oral health. Community Dent Oral Epidemiol 2007; 35: 8188.


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  • SES


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  • social capital


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Life course

  • 3


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  • cf.Rose

  • 110


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  • 1990


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Aida J, Ando Y, Oosaka M, Niimi K, Morita M. Contributions of social context to inequality in dental caries: a multilevel analysis of Japanese 3-year-old children, Community Dentistry and Oral Epidemiology, (In press, 23-Oct-2006 accepted)


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A

B

Ni-Hon-San Study

Social determinants of health


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3

32005


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X

X


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3


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2000

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1244

3


Multilevel 3086

Multilevel3086

dmft100%

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1930-32

(Department of Health 1999, UK)


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3


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25882

14

*311240

* 2005

214

*


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Upstream-downstream!

McKinlay, J. (1979). A case for refocusing upstream: the political economy of health

, In Patients, physicians and illness (ed. E. Jaco), pp.96-120. Basingstoke, Macmillan.


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Social determinants of health1

Social determinants of health

(Dahlgren G, and Whitehead M in the Acheson Report ,1998)


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New public health movement


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1978


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  • , , , , , ,


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  • ,

  • ,

  • ,


New public health movement

New public health movement


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An international conference on health promotion

The moves towards a new public health


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  • 1. :

    • , .

  • 2. :

    • , , .

Daly B, Watt R, Paul B, Treasure E: Essential Dental Public Health. Oxford University Press, New York,1st ed., 2002.


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  • 3.:

    • , , , , .

  • 4. :

    • ,


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  • 5. :


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WHO

  • 1

  • 19861117-21

  • 2

  • 198845-9


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  • 3

  • 199169-15

  • 4

  • 1997721-25

  • - 21

  • 21


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  • 5

  • 200065-9

  • 6

  • 200587-11

wikiF


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2002 9 21 kyoto declaration on health promotion

20029.21Kyoto Declaration on Health Promotion

http://www.kenkounippon21.gr.jp/kenkounippon21/katsudo/jirei/jichitai/kuni/kyotosengen_20020921.html


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127


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  • 237

  • 50


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  • etc


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EBM

  • JAMA=Journal of American Medical Association


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  • ,EBM,,,,,,

  • ,,,,,,,,,

  • ,,,,


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  • Roles and responsibilities of epidemiologists.

    Weed DL, Mink PJ. Ann Epidemiol. 2002 Feb;12(2):67-72.

  • Science and social responsibility in public health.

    Weed DL, McKeown RE. Environ Health Perspect. 2003 Nov;111(14):1804-8. Review.


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Gray 2005)


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  • mediate


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  • 1

J.A.Muir Gray .2005


Oxford textbook of public health

Oxford textbook of public health

  • , . , , .

  • , . , . , , .

  • , , .

  • , , , .

Roger Detels, James Mcewen, Robert Beaglehole, and Heizo Tanaka eds.2002


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. 62157-92007


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(Dahlgren G, and Whitehead M in the Acheson Report ,1998)


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dmft1993

12 (DMFT)2002


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Chen M, Andersen RM, Barmes DE, Leclerq M-H, Lyttle SC. Comparing Oral Health Systems. A Second International Collaborative Study. Geneva: World Health Organization; 1997.

Petersen PE.Sociobehavioural risk factors in dental caries - international perspectives.Community Dent Oral Epidemiol. 2005 Aug;33(4):274-9.


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    • , ,

    • , , ()

    • ,, , .

    • , , .

Woodward A, Kawachi I: Why should physicians be concerned about health inequalities? Because inequalities are unfair and hurt everyone. West J Med,175: 6-7, 2001.


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Watt RG. From victim blaming to upstream action: tackling the social determinants of oral health inequalities. Community Dent Oral Epidemiol. 2007 Feb;35(1):1-11.


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2003 11

200311


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