Disparities in oral health status between older adults in a multiethnic rural community: the rural nutrition and oral health study.
OBJECTIVE
To compare oral health status according to ethnicity and socioeconomic status in African-American, American-Indian, and white dentate and edentulous community-dwelling older adults.


METHODS
Cross-sectional study; data from self-reports and oral examinations.


METHODS
A multistage cluster sampling design was used to recruit 635 participants aged 60 and older from rural North Carolina counties with substantial African-American and American-Indian populations.


METHODS
Participants completed in-home interviews and oral examinations. Self-reported data included sociodemographic indicators; self-rated oral health status; presence or 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
African Americans and American Indians had significantly lower incomes and educational attainment than whites. Self-rated oral health was significantly better in whites than in African Americans and American Indians. Prevalence of self-reported periodontal disease and bleeding gums was lower in whites. Of dentate participants, African Americans were significantly more likely than whites to have 11 to 20 teeth and one or two posterior occlusal contacts. Oral health deficits remained associated with ethnicity when adjusted for socioeconomic variables.


CONCLUSIONS
Oral health disparities in older adults in a multiethnic rural area were 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.
Quandt
Sara A
SA
Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA. squandt@wfubmc.edu
Chen
Haiying
H
Bell
Ronny A
RA
Anderson
Andrea M
AM
Savoca
Margaret R
MR
Kohrman
Teresa
T
Gilbert
Gregg H
GH
Arcury
Thomas A
TA
D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D016000:Cluster Analysis; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D009657:North Carolina; D009752:Nutritional Status; D009909:Oral Health; D012424:Rural Population; D012959:Socioeconomic Factors; D044465:White People / Q000706:statistics & numerical data