Geography matters: state-level variation in children's oral health care access and oral health status

Abstract

Objectives To ascertain differences across states in children's oral health care access and oral health status and the factors that contribute to those differences Study Design Observational study using cross-sectional surveys Methods Using the 2007 National Survey of Children's Health, we examined state variation in parent's report of children's oral health care access (absence of a preventive dental visit) and oral health status. We assessed the unadjusted prevalences of these outcomes, then adjusted with child-, family-, and neighborhood-level variables using logistic regression; these results are presented directly and graphically. Using multilevel analysis, we then calculated the degree to which child-, family-, and community-level variables explained state variation. Finally, we quantified the influence of state-level variables on state variation. Results Unadjusted rates of no preventive dental care ranged 9.0-26.8% (mean 17.5%), with little impact of adjusting (10.3-26.7%). Almost 9% of population had fair/poor oral health; unadjusted range 4.1-14.5%. Adjusting analyses affected fair/poor oral health more than access (5.7-10.7%). Child, family and community factors explained ~¼ of the state variation in no preventive visit and ~½ of fair/poor oral health. State-level factors further contributed to explaining up to a third of residual state variation. Conclusion Geography matters: where a child lives has a large impact on his or her access to oral health care and oral health status, even after adjusting for child, family, community, and state variables. As state-level variation persists, other factors and richer data are needed to clarify the variation and drive changes for more egalitarian and overall improved oral health.

Acceso a servicios de salud dental en menores de doce años en Perú, 2014

“…Pueden ser múltiples los factores que modelan los patrones del acceso a los servicios de salud dental en menores, tales como factores culturales del niño y sus padres, lugar de vivienda urbana o rural, factores socioeconómicos, distancia a los centros de salud, la disposición y distribución de profesionales odontólogos en una determinada área geográfica, o la presencia o no de programas sociales que incentiven el uso de los servicios de salud (29,30) . Además, se conoce que dichos factores pueden variar, entre ubicaciones geográficas y grupos demográficos, en un mismo país (31,32) . Siendo así, es importante estudiar todos estos factores, partiendo de la identificación de la situación actual y las variaciones que pueden acontecer dentro de un territorio.…”

Association between socio-economic status and dental caries in elderly people in Sichuan Province, China: a cross-sectional study

“…Exploring the relationships between dental caries, SES and possible contributing factors may be beneficial for developing targeted interventions and healthcare policies. 22 …”

Oral health status of elementary-school children varied according to school they attended

“…Place of residence 25 or schools where children attended 26 may account for access to dental care and risks for dental health problems. Children with similar social background may attend the same school.…”