Risk indicators for severe impaired oral health among indigenous Australian young adults

Background Oral health impairment comprises three conceptual domains; pain, appearance and function. This study sought to: (1) estimate the prevalence of severe oral health impairment as assessed by a summary oral health impairment measure, including aspects of dental pain, dissatisfaction with dental appearance and difficulty eating, among a birth cohort of Indigenous Australian young adults (n = 442, age range 16-20 years); (2) compare prevalence according to demographic, socio-economic, behavioural, dental service utilisation and oral health outcome risk indicators; and (3) ascertain the independent contribution of those risk indicators to severe oral health impairment in this population. Methods Data were from the Aboriginal Birth Cohort (ABC) study, a prospective longitudinal investigation of Aboriginal individuals born 1987-1990 at an Australian regional hospital. Data for this analysis pertained to Wave-3 of the study only. Severe oral health impairment was defined as reported experience of toothache, poor dental appearance and food avoidance in the last 12 months. Logistic regression models were used to evaluate effects of demographic, socio-economic, behavioural, dental service utilisation and clinical oral disease indicators on severe oral health impairment. Effects were quantified as odds ratios (OR). Results The percent of participants with severe oral health impairment was 16.3 (95% CI 12.9-19.7). In the multivariate model, severe oral health impairment was associated with untreated dental decay (OR 4.0, 95% CI 1.6-9.6). In addition to that clinical indicator, greater odds of severe oral health impairment were associated with being female (OR 2.0, 95% CI 1.2-3.6), being aged 19-20 years (OR 2.1, 95% CI 1.2-3.6), soft drink consumption every day or a few days a week (OR 2.6, 95% 1.2-5.6) and non-ownership of a toothbrush (OR 1.9, 95% CI 1.1-3.4). Conclusions Severe oral health impairment was prevalent among this population. The findings suggest that public health strategies that address prevention and treatment of dental disease, self-regulation of soft drink consumption and ownership of oral self-care devices are needed if severe oral health impairment among Indigenous Australian young adults is to be reduced.Lisa M Jamieson, Kaye F Roberts-Thomson and Susan M Sayer

Simulating alternative sustainable water futures

In the United States of America, urban areas of the arid Southwest are prone to drought risk and changing precipitation patterns; future water supplies are uncertain. A collaborative working group of researchers and practitioners developed alternative future scenarios for 2060—sustainable water futures—that incorporate standard and novel water-adaptation strategies for the Phoenix metropolitan area (hereafter “Phoenix”) in central Arizona, USA. The authors adapted WaterSim-6, a water policy and planning model, to explore differences in water demand and supply for three scenarios as influenced by (1) runoff from the rivers that supply surface water to Phoenix, (2) population growth, (3) water use efficiency, (4) annual rainfall, and (5) land-cover land-use changes. Centralized water-management strategies (direct and indirect potable water reuse and reclaimed supplies) and decentralized strategies (rainwater harvesting and greywater use) were explored. We observed decreased reliance on surface water supplies, offset by increased municipal groundwater pumping in the Strategic scenario, but by alternative water supplies (non-potable water sources including greywater, reclaimed water, and rainwater harvested) in the Desert Wetland and Almost Zero Waste (AZW) scenarios. Even under modest policy implementation and service-connection adoption rates associated with our Strategic scenario, by 2060 alternative supplies from non-potable sources could offset 30% or more of outdoor water demand. Aggressive policy implementations associated with the AZW scenario suggest that up to 80% of outdoor water demand could likewise be met. The WaterSim platform combined with co-produced future scenarios illuminates tradeoffs in support of decision making for long-term sustainability of a water-limited region