The impact of dental treatment on employment outcomes: A systematic review
ABSTRACT OBJECTIVE: Policy advocates in North America argue that access to dental care for low income and unemployed populations can help improve the chances of acquiring a job or attaining a better job, thus having positive economic and social benefits. Our objective is to review the evidence in support of the policy hypothesis that timely access to dental care can improve employment outcomes. METHODS: A systematic review was conducted by searching various scientific databases and search engines. Key words included Dental Care, Dental Intervention, Social Welfare, Unemployment, Employment, and Job. RESULTS: Seven articles were considered eligible for this review. They varied in study design, target population and intervention studied. Overall, they presented low levels of evidence due to small sample sizes, lack of control groups, combined interventions or being based on anecdotal reports. CONCLUSIONS: There is a limited amount of evidence concerning the assumption that dental care can improve employment outcomes. The scarcity of well-conducted studies and the poor quality of evidence makes it difficult to judge the effect of dental care on employment outcomes. More studies need to be conducted in order to confirm or dismiss this generalized assumption.
SourceAvailable from: Gunn Elisabeth Vist[Show abstract] [Hide abstract]
ABSTRACT: This article introduces the approach of GRADE to rating quality of evidence. GRADE specifies four categories-high, moderate, low, and very low-that are applied to a body of evidence, not to individual studies. In the context of a systematic review, quality reflects our confidence that the estimates of the effect are correct. In the context of recommendations, quality reflects our confidence that the effect estimates are adequate to support a particular recommendation. Randomized trials begin as high-quality evidence, observational studies as low quality. "Quality" as used in GRADE means more than risk of bias and so may also be compromised by imprecision, inconsistency, indirectness of study results, and publication bias. In addition, several factors can increase our confidence in an estimate of effect. GRADE provides a systematic approach for considering and reporting each of these factors. GRADE separates the process of assessing quality of evidence from the process of making recommendations. Judgments about the strength of a recommendation depend on more than just the quality of evidence.Journal of clinical epidemiology 04/2011; 64(4):401-6. DOI:10.1016/j.jclinepi.2010.07.015 · 5.48 Impact Factor
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ABSTRACT: The purpose of this analysis was to assess selected social consequences of maintaining oral health and treating oral diseases. The associations among socioeconomic and demographic factors with time lost from work or school and reductions in normal activities are explored. Data were gathered as part of the 1989 National Health Interview Survey from 50,000 US households (117,000 individuals), representing 240 million persons. The oral health care supplement was analyzed using the software SUDAAN to produce standard errors for estimates based on complex multistage sample designs. Because of dental visits or problems, 148,000 hours of work were lost per 100,000 workers, 117,000 hours of school were lost per 100,000 school-age children, and 17,000 activity days beyond work and school time were restricted per 100,000 individuals in 1989. Exploratory analyses suggest that sociodemographic groups have different patterns of such time loss and of reduced normal activities. Overall, there is low social impact individually from dental visits and oral conditions. At the societal level, however, such problems and treatments among disadvantaged groups appear to have a greater impact.American Journal of Public Health 01/1993; 82(12):1663-8. DOI:10.2105/AJPH.82.12.1663 · 4.23 Impact Factor
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ABSTRACT: We compared health status, access to care, and utilization of medical services in the United States and Canada and compared disparities according to race, income, and immigrant status. We analyzed population-based data on 3505 Canadian and 5183 US adults from the Joint Canada/US Survey of Health. Controlling for gender, age, income, race, and immigrant status, we used logistic regression to analyze country as a predictor of access to care, quality of care, and satisfaction with care and as a predictor of disparities in these measures. In multivariate analyses, US respondents (compared with Canadians) were less likely to have a regular doctor, more likely to have unmet health needs, and more likely to forgo needed medicines. Disparities on the basis of race, income, and immigrant status were present in both countries but were more extreme in the United States. United States residents are less able to access care than are Canadians. Universal coverage appears to reduce most disparities in access to care.American Journal of Public Health 08/2006; 96(7):1300-7. DOI:10.2105/AJPH.2004.059402 · 4.23 Impact Factor