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Multidimensional causal model of dental caries development in low-income preschool children.

Despite the decline in the incidence of dental caries in the United States over the past several years, the condition remains a significant problem for the nation's poor children. Efforts to identify the factors responsible for caries development in samples of children of low socioeconomic status have primarily focused on a limited number of variables, and those have been predominantly biological (mutans streptococci, for example). Resulting models of caries development have usually shown good sensitivity but poor specificity. They have had limited implications for treatment. In an effort to produce a comprehensive model of caries development, 184 low-income preschool children were clinically assessed for mutans streptococci and for decayed, missing, or filled surfaces of deciduous teeth twice, first at age 4 years (baseline) and again a year later (year 1 assessment). As the clinical assessments were being done, caretakers were being interviewed to obtain data from five domains: demographics, social status, dental health behaviors, cognitive factors such as self-efficacy (self-confidence) and controllability, and perceived life stress. Data were analyzed using a structural equations modeling approach in which variables from all domains, plus baseline decayed missing and filled surfaces and baseline mutants, were used together to create a model of caries development in the year 1 assessment. Results confirmed earlier work that suggested that caries development at a 1-year followup was strongly dependent on earlier caries development. Early caries development in this sample was determined in part by mutans levels and by dental health behaviors. These behaviors themselves were accounted for partly by a cognitive factor. The results support the advantages of employing multidimensional models and provide some direction for intervention to reduce caries incidence.

Causality↗
PubMed1994

Causal debates in environmentalism.

Many public health policy analysts celebrate the renewed popularity of environmentalism and its importance for public health. But few recognize that there are three competing versions of environmentalism. Each one assigns blame for environmental degradation and responsibility for addressing it to a different group of people. It is incumbent upon public health professionals to take note of the debate and to consider the ramifications for policy should one of these versions come to predominate.

Causality↗
PubMed1993

[Research in epidemiology and causality: the example of the Basel Multiple Sclerosis Study 1980 to 1986].

Statistic evaluations on multiple sclerosis 1980 to 1986 in two Swiss cantons have been analyzed, using stochastic mathematical models in order to investigate significance of and possible reasons for variations in incidence. Fluctuation rates of up to 20% could hereby be demonstrated to be due to chance. This could be validated by computer simulations and comparisons with published data. The results show that such apparently large fluctuations in incidence rates should thus be attributed to possible causes with utmost care and prompt for more detailed rules for collection of data.

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