IntroductionTooth preservation in adults and children is one of the Healthy People 2020 goals for oral health. Although the overall prevalence of tooth loss has been declining in the United States, substantial racial/ethnic differences in preventable tooth loss persist as a public health problem. We examined the strength of the association of health risk factors and tooth loss in Hawai‘i.MethodsWe used data from the Hawai‘i Behavioral Risk Factor Surveillance System survey collected from 2011 through 2014. Participant responses were included if they self-identified as Native Hawaiian, white, Japanese, or Filipino. Differences in excess tooth loss (6 or more teeth) and known risk factors (demographics, diabetes, and dental visits) were analyzed by using univariate analyses and adjusted stepwise, logistic regression models.ResultsWe identified oral health inequity among the 4 ethnic groups studied; among the groups, Native Hawaiians had the largest proportion of excess tooth loss. The univariate analyses found differences in the strength of these associations among the 4 racial/ethnic groups. The stepwise analyses found that the associations of excess tooth loss and race/ethnicity were not significant after adjusting for demographics, diabetes status, and dental visits.ConclusionFindings suggest a need for programs and policies that improve access to oral health care in Hawai‘i for those with low levels of income and education and those with diabetes.
Introduction
Dental service utilisation is an important global health problem. Studies report that when people are able to access oral health care, they are more likely to receive basic preventive services than emergency care. Previous studies also report that dental‐care utilisation varies according to individual patient and place factors. However, studies on the interplay of individual and place factors are limited. This study investigated the associations of dental‐care utilisation according to urban/rural setting and individual patient factors, such as demographic, health care, health behaviour and financial autonomy.
Methods
The association of dental‐care utilisation according to individual factors and place was investigated by analysing information obtained from the Hawaii Behavioral Risk Factor Surveillance Survey (BRFSS). The BRFSS is a health‐related telephone survey system that collects state data on US residents regarding their health‐related risk behaviours, chronic health conditions and use of preventive services.
Results
We found that health care, behaviours and financial autonomy were not substantially different between urban sites and rural sites in terms of the odds of dental‐service utilisation. Our results showed that individual factors, such as financial autonomy, were more consistently associated with dental‐service utilisation.
Discussion
Financial autonomy, as well as socio‐economic factors, need to be considered to improve dental‐service utilisation in Hawaii.
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