The Journal of Primary Prevention

, Volume 32, Issue 1, pp 29–41 | Cite as

Residential Rurality and Oral Health Disparities: Influences of Contextual and Individual Factors

  • SangNam Ahn
  • James N. Burdine
  • Matthew Lee Smith
  • Marcia G. Ory
  • Charles D. Phillips
Original Paper


The purposes of the study were (a) to identify disparities between urban and rural adults in oral health and (b) to examine contextual (i.e., external environment and access to dental care) and individual (i.e., predisposing, enabling, and lifestyle behavioral) factors associated with oral health problems in a community population. Study data were derived from a two-stage, telephone-mailed survey conducted in 2006. The subjects were 2,591 adults aged 18 years and older. Cochran-Mantel-Haenszel statistics for categorical variables were applied to explore conditional independence between both health access and individual factors and oral health problems after controlling for the urban or rural residence. Logistic regression was used to investigate the simultaneous associations of contextual and individual factors in both rural and urban areas. Approximately one quarter (24.1%) of the study population reported oral health problems. Participants residing in rural areas reported more oral health disparities. Oral health problems were significantly associated with delaying dental care. These problems also were more common among those who were less educated, were African American, skipped breakfast every day, and currently smoked. The study findings suggest that oral health disparities persist for people in rural areas, and improving oral health status is strongly related to better access to oral health care and improved lifestyles in both rural and urban areas.


Oral health Older adults Dental care utilization Rural health 



This work was supported by Cooperative Agreement Number 1U48 DP001924 from the Centers for Disease Control and Prevention. The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • SangNam Ahn
    • 1
  • James N. Burdine
    • 1
  • Matthew Lee Smith
    • 1
  • Marcia G. Ory
    • 1
  • Charles D. Phillips
    • 2
  1. 1.Department of Social and Behavioral Health, School of Rural Public HealthTexas A&M University Health Science CenterCollege StationUSA
  2. 2.Department of Health Policy and Management, School of Rural Public HealthTexas A&M University Health Science CenterCollege StationUSA

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