Associations between area-level disadvantage and DMFT among a birth cohort of Indigenous Australians

Background: Individual-levelfactors influence DMFT, but little is known about the influence of communityenvironment. This study examined associations between community-levelinfluences and DMFT among a birth cohort of Indigenous Australians aged 16-20years. 

Methods: Data were collected as part of Wave 3 of the Aboriginal Birth Cohortstudy. Fifteen community areas were established and the sample comprised 442individuals. The outcome variable was mean DMFT with explanatory variablesincluding diet and community disadvantage (access to services, infrastructureand communications). Data were analysed using multilevel regressionmodelling. 

Results: In a null model, 13.8% of the total variance in mean DMFT was betweencommunity areas, which increased to 14.3% after adjusting for gender, age anddiet. Addition of the community disadvantage variable decreased the variancebetween areas by 4.8%, indicating that community disadvantage explainedone-third of the area-level variance. Residents of under-resourced communitieshad significantly higher mean DMFT (β = 3.86, 95% CI 0.02, 7.70) afteradjusting for gender, age and diet. 

Conclusions: Living in under-resourced communitieswas associated with greater DMFT among this disadvantaged population,indicating that policies aiming to reduce oral health-related inequalitiesamong vulnerable groups may benefit from taking into account factors externalto individual-level influences.