title: The impact of functional health literacy and acculturation on the oral health status of Somali refugees living in Massachusetts.
abstract: OBJECTIVE
  We assessed the impact of health literacy and acculturation on oral health status of Somali refugees in Massachusetts.
  
  
  METHODS
  Between December 2009 and June 2011, we surveyed 439 adult Somalis who had lived in the United States 10 years or less. Assessments included oral examinations with decayed, missing, and filled teeth (DMFT) counts and measurement of spoken English and health literacy. We tested associations with generalized linear regression models.
  
  
  RESULTS
  Participants had means of 1.4 decayed, 2.8 missing, and 1.3 filled teeth. Among participants who had been in the United States 0 to 4 years, lower health literacy scores correlated with lower DMFT (rate ratio [RR] = 0.78; P = .016). Among participants who had been in the country 5 to 10 years, lower literacy scores correlated with higher DMFT (RR = 1.37; P = .012). Literacy was not significantly associated with decayed teeth. Lower literacy scores correlated marginally with lower risk of periodontal disease (odds ratio = 0.22; P = .047).
  
  
  CONCLUSIONS
  Worsening oral health of Somali refugees over time may be linked to less access to preventive care and less utilization of beneficial oral hygiene practices.
authors: Refugee and Immigrant Health Program, Massachusetts Department of Public Health, 300 South Street, Jamaica Plain, MA 02130, USA. paul.geltman@state.ma.us
authors: Paul L
authors: PL
authors: Geltman
authors: Jo Hunter
authors: JH
authors: Adams
authors: Jennifer
authors: J
authors: Cochran
authors: Gheorghe
authors: G
authors: Doros
authors: Denis
authors: D
authors: Rybin
authors: Michelle
authors: M
authors: Henshaw
authors: Linda L
authors: LL
authors: Barnes
authors: Michael
authors: M
authors: Paasche-Orlow
mesh_terms: D000069:Acculturation; D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004245:DMF Index; D005260:Female; D057220:Health Literacy; D006305:Health Status Indicators; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D009909:Oral Health; D011788:Quality of Life; D012998:Somalia / Q000208:ethnology; D011795:Surveys and Questionnaires