Disparities in Oral Health Status Between Older Adults in a Multiethnic Rural Community: The Rural Nutrition and Oral Health Study

Abstract

Objectives To compare oral health status by ethnicity and socioeconomic status among African American (AA), American Indian (AI), and white dentate and edentulous community-dwelling older adults. Design Cross-sectional study; data from self-reports and oral examinations. Participants A multi-stage cluster sampling design was used to recruit 635 participants aged 60+ from rural North Carolina counties with substantial AA and AI populations. Measurements Participants completed in-home interviews and oral examinations. Self-reported data included socio-demographic indicators, self-rated oral health status, and presence/absence of periodontal disease, bleeding gums, oral pain, dry mouth, and fit of prostheses. Oral examination data included number of teeth and numbers of anterior and posterior functional occlusal units. Results Compared to whites, AAs and AIs had significantly lower incomes and educational attainment. Self-rated oral health was significantly higher in whites, compared to both AAs and AIs. Prevalence of self-reported periodontal disease and bleeding gums was lower in whites. Among dentate participants, AAs were significantly more likely than whites to have moderately reduced numbers of teeth (11–20 teeth) and posterior occlusal contacts. Oral health deficits remained associated with ethnicity when adjusted for socioeconomic variables. Conclusions Oral health disparities in older adults in a multi-ethnic rural area are largely associated with ethnicity and not socioeconomic status. Clinicians should be aware of these health disparities in oral health status and their possible role in disparities in chronic disease. Further research is necessary to understand whether these oral health disparities reflect current or lifetime access to care, diet, or attitudes toward oral health care.

Associação entre resiliência e qualidade de vida relacionada à saúde bucal em idosos

“…Studies about changing marital status, especially from married to separated people or widowers, point out to increasing prevalence of mental, physical, chronic and acute diseases 22 . According to literature, the daily use of health services is less frequent among people living in rural zones 23 , which seems to be explained by the lack of access and the fewer resources; these range from health care itself to water fluoridation 24 . These difficulties may be related to unfavorable oral health, which increases the impacts on quality of life.…”

Social stratification and tooth loss among middle‐aged and older Americans from 1988 to 2004

“…These findings suggest that much of the racial/ethnic disparities are explained by socioeconomic status. Some anecdotal evidence has suggested that minorities , such as Blacks, are particularly concerned about saving their teeth for aesthetic reasons (14). We surmise the level of concern may be greater for those with relatively higher socioeconomic status.…”

Dry Mouth and Dietary Quality in Older Adults in North Carolina

“…21 Weighted sample sizes are reported. Rao-Scott Chi-Square tests were used to compare categorical demographic and health characteristics by XI tertiles, and linear regressions were used to compare continuous variables, such as age and BMI.…”