SEMINAR: The inverse care law: permanent conundrum for dental public health

The Seminar: Objectives: In 1971 Tudor Hart first described the inverse care law, which states that the availability of good medical/dental care tends to vary inversely with the need for it in the population served. Does this still apply to modern day services? If so, why is this, given our current awareness and knowledge? The situation in Australia in this regard will be examined and discussed, with reference to specific subgroups in the population that experience poorer oral health. Whether there really exists a need for dental services in all areas where they are not available, will also be examined. Methods: Using various open access and existing population-level databases, and geographic information system (GIS) technology, the mal-distribution of the workforce and available services will be illustrated. Results: Results indicate that services are most accessible and available where they are needed less. Some parts of the population have no access at all, or very limited access, to dental services. Conclusion: These results leads to certain questions: does service provision not just create demand? Will more services ultimately improve population oral health? How realistic is equal dental workforce distribution in Australia? Reasons will be discussed as to why the dental workforce in Australia will never be equally distributed. Some other possible methods that might contribute towards achieving equity in access to good oral health care will be put forward.

The Speaker: Estie Kruger has been involved in dental public health teaching and research for the last 25 years, in three different countries, and is the developer and the coordinator of the only postgraduate program in Dental Public Health in Australia, at the University of Western Australia. She is also the research supervisor of several postgraduate research students. Estie has a wide range of research interests, including dental epidemiology, rural and remote dental health, oral health inequalities, oral health policy and strategy, accessibility, dental education and the use of Geographic Information Systems in health service planning and management. She is the author and co-author of more than 100 publications in peer-reviewed national and international journals. Estie has been part of the research team at the previous Centre for Rural and Remote Oral Health, and now the multi-national International Research Collaborative- Oral Health and Equity at UWA for more than a 15 years, and the group, despite its small size, is currently ranked the number one oral health research group in Western Australia, and one of the leading dental public health research groups in Australasia.