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Introduction: Community water fluoridation (CWF) is a costeffective intervention to reduce dental caries at population level. This Australian study used a difference-in-difference (DiD) analysis to measure dental caries in children exposed to CWF in the Northern Territory (NT), Australia. Methods: Oral health data obtained from the NT Department of Health contained 64 399 person-year observations from 2008 to 2020, totalling 24 546 children aged 1-17 years. Drinking water quality data for fluoride levels, held by the Power and Water Corporation, were obtained for 50 remote communities and linked to the oral health dataset. The DiD analysis used a treatment group and two control groups to compare the effects of CWF on dental caries outcomes in children, measured using the decayed, missing and filled teeth (dmft/DMFT) index. The treatment group consisted of records from children residing in five remote NT communities that implemented CWF in 2014.The control 1 group included records of children residing in communities with naturally occurring fluoride in drinking water supplies at levels at or above the Department of Health policy threshold of 0.5 mg/L. The control 2 group included records of children residing in communities with naturally occurring fluoride in drinking water supplies below the level recommended by the Department of Health policy (<0.5 mg/L). The data were grouped into time periods prior to the inception of CWF in five remote communities in 2014 (preintervention) and after 2014 (post-intervention). Results: Our results demonstrated that dental caries was significantly decreased for children in the treatment group following the implementation of CWF at a greater magnitude than both control groups for the same time period. Overall, children assigned to the treatment group exhibited a decline in the number of teeth affected by caries by an average of 0.28 (p=0.001). Notably, children of ages 7-10 years and 11-17 years experienced significantly greater post-intervention declines in average dmft/DMFT, by 0.32 (p=0.051) and 0.40 (p=0.012) fewer affected teeth respectively. Conclusion: While dental caries disproportionately impacts Aboriginal children in remote and very remote NT, it is clear that CWF produces population-level reductions in overall dental caries for these populations. Additionally, our study demonstrates the application of the DiD method in a public health policy evaluation. Our findings suggest that the longstanding policy position of the NT Department of Health on CWF has supported improvements in oral health among child populations that experience high levels of dental caries in remote NT communities. [ABSTRACT FROM AUTHOR]

Objectives: To assess the adequacy of the Northern Territory health workforce with respect to population size and burden of disease, overall and by selected health specialties; to assess its sustainability by investigating changes in workforce numbers., Study Design: Analysis of Australian Health Practitioner Regulation Agency (AHPRA) health workforce data (2013-2021) and burden of disease data (disability-adjusted life-years, DALYs) drawn from national and NT burden of disease studies (and projected for 2019-2021)., Setting, Participants: NT and Australian health workforces, 2009-2021., Main Outcome Measures: Adequacy of the NT health workforce, assessed as the ratio of the mean annual numbers of NT health workers per 1000 population or health workers per 1000 DALYs (2009-2013 and 2014-2018) to those of the Australian workforce (2013 and 2018); sustainability of the NT health workforce, defined as the number of health workers per 1000 population or per 1000 DALYs increasing between 2013 and 2021., Results: The number of health workers per 1000 population was slightly higher in the NT than for Australia in both time periods (2009-2013 v 2013: 23.30 v 21.79 per 1000 population, 6.9% larger; 2014-2018 v 2018: 25.79 v 23.47 per 1000 population, 9.9% larger); however, it was smaller with respect to burden of disease (2009-2013 v 2013: 82.6 v 107.4 health workers per 1000 DALYs, 23.1% fewer; 2014-2018 v 2018: 91.5 v 117.1 per 1000 DALYs, 21.8% fewer). In particular, 464 more nurses and midwives (11.4% more than the mean for 2013-2021), 196 more physiotherapists (115%), 189 more psychologists (102%), 152 more pharmacists (79%), and 144 more dentists (106%) are needed in the NT to match the corresponding numbers of health workers by disease burden for Australia as a whole. The number of Aboriginal health practitioners per 100 000 DALYs fell during the study period., Conclusion: Health worker population density alone does not reliably assess health workforce needs; burden of disease information is important for workforce planning that meets population health needs. The NT health workforce needs to be increased by about 28% to reflect the population burden of disease and injury. Shortages in the NT health workforce must be eliminated to close health gaps between Indigenous and non-Indigenous Australians., (© 2024 AMPCo Pty Ltd.)