Residential Rurality and Oral Health Disparities: Influences of Contextual and Individual Factors
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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.
KeywordsOral 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.
- Aday, L. A., Begley, C. E., Lairson, D. R., & Balkrishnan, R. (2004). Evaluating the healthcare system: Effectiveness, efficiency, and equity (3rd ed.). Chicago, IL: Health Administration Press.Google Scholar
- Agresti, A. (1996). An introduction to categorical data analysis. New York, NY: Wiley-Interscience Publication.Google Scholar
- Annual Update of the HHS Poverty Guidelines, 71 Fed. Reg. 3848 (2006). Retrieved from http://aspe.hhs.gov/poverty/06fedreg.pdf.
- Binson, D., Canchola, J. A., & Catania, J. A. (2000). Random selection in a national telephone survey: A comparison of the kish, next-birthday, and last-birthday methods. Journal of Official Statistics, 16(1), 53–59.Google Scholar
- Donabedian, A. (1996). Evaluating quality of medical care. Milbank Quarterly, 44(Suppl), 166–206.Google Scholar
- Dye, B. A., Shenkin, J. D., Ogden, C. L., Marshall, T. A., Levy, S. M., & Kanellis, M. J. (2004). The relationship between healthful eating practices and dental caries in children aged 2–5 years in the United States, 1988–1994. Journal of the American Dental Association, 135(1), 55–66.PubMedGoogle Scholar
- Fos, P., & Hutchison, L. (2003). The state of rural oral health. In L. D. Gamm, L. L. Hutchison, B. J. Dabney, & A. M. Dorsey (Eds.), Rural Healty People 2010: A companion document to Healthy People 2010 (Vol. 1, pp. 199–203). College Station, TX: The Texas A&M University System Health Science Center, School of Rural Public Health, Southwest Rural Health Research Center.Google Scholar
- Haden, N. K., Catalanotto, F. A., Alexander, C. J., Bailit, H., Battrell, A., Broussard, J., Jr., et al. (2003). Improving the oral health status of all Americans:Roles and responsibilities of academic dental institutions: The report of the ADEA President’s Commission. Journal of Dental Education, 67(5), 563–583.PubMedGoogle Scholar
- Larson, P. D., & Poist, R. F. (2004). Improving response rates to mail surveys: A research note. Transportation Journal, 43(4), 67–74.Google Scholar
- Lissowska, J., Pilarska, A., Pilarski, P., Samolczyk-Wanyura, D., Piekarczyk, J., Bardin-Mikollajczak, A., et al. (2003). Smoking, alcohol, diet, dentition and sexual practices in the epidemiology of oral cancer in Poland. European Journal of Cancer Prevention, 12(1), 25–33.CrossRefPubMedGoogle Scholar
- Makhija, S. K., Gilbert, G. H., Boykin, M. J., Litaker, M. S., Allman, R. M., Baker, P. S., et al. (2006). The relationship between sociodemographic factors and oral health-related quality of life in dentate and edentulous community-dwelling older adults. Journal of the American Geriatrics Society, 54(11), 1701–1712.CrossRefPubMedGoogle Scholar
- McGrath, C., & Bedi, R. (2000). Gender variations in the social impact of oral health. Journal of the Irish Dental Association, 46(3), 87–91.Google Scholar
- StataCorp. (2007). Stata statistical software: Release 10. College Station, TX: Author.Google Scholar
- U.S. Census Bureau. (2009). State & county quickfacts. Retrieved from http://quickfacts.census.gov/qfd/index.html.
- U.S. Department of Agriculture. (2009). Measuring rurality: Urban Influence Codes. Retrieved from http://www.ers.usda.gov/Briefing/rurality/UrbanInf/.
- U.S. Department of Health and Human Services. (2000). Healthy People 2010: Objectives for improving health (2nd ed.). Washington, DC: U.S. Government Printing Office.Google Scholar