RESUMO
Taxi and for-hire vehicle (FHV) drivers are a largely immigrant, low-income occupational group at increased cardiovascular disease (CVD) risk. Poor dental health is a CVD risk factor, and dental care access is an unexamined taxi/FHV driver CVD risk factor. A cross-sectional survey was administered to 422 taxi/FHV drivers (2016-2017) to identify predictors of access to dental health care among drivers. One-third (n = 128, 30.3%) reported needing dental care/tests/treatment within the past six months, and nearly one-half (n = 61, 48%) were delayed/unable to obtain care. Only 57.6% (n = 241) had past-year dental cleanings. Not having enough money to cover household expenses was a significant predictor of being delayed/unable to obtain needed dental care/tests/treatment in the prior six months (0.5 OR; 95% CI, 0.28-0.89; p < .05). Lack of dental insurance coverage (2.72 OR; 95% CI, 1.60-4.63; p < .001) or lack of primary care provider (2.72 OR; 95% CI, 1.60-4.63; p < .001) were associated with lack of past-year dental cleaning. Seventeen percent of drivers with Medicaid were unaware of their dental coverage, which was associated with both inability to access needed dental care/tests/treatment in the past 6 months (p = .026) and no past-year dental cleaning (p < .001). Limited understanding of dental coverage was associated with both an inability to access needed dental care/tests/treatment in the past 6 months (p = .028) and lack of past-year dental cleaning (p = .014). Our findings can inform targeted intervention development to increase taxi/FHV driver dental care access/uptake, potentially improving their CVD risk.
Assuntos
Condução de Veículo , Emigrantes e Imigrantes , Estudos Transversais , Atenção à Saúde , Humanos , Cobertura do SeguroRESUMO
BACKGROUND: New York City's (NYC's) taxi/for-hire vehicle (FHV) drivers have occupational and demographic characteristics associated with food insecurity (low income, comorbidities, minority race/ethnicity). OBJECTIVE: To analyze food insecurity rates in a sample of NYC drivers and to identify associated factors. METHODS: At health fairs, we recruited a cross-sectional sample of licensed taxi/FHV drivers willing to receive study text messages. Most lacked a primary care provider. Food insecurity prevalence and associations with health and economic indicators were analyzed. RESULTS: Of 503 participants who completed a 2-item food security screener, 39.2% were food insecure. Significantly fewer food insecure than food secure drivers reported a doctor visit within the past year (48% vs 25%; Pâ<â.001). Food insecure drivers had greater weekly traffic ticket expenditure ($34 vs $24; Pâ=â.02) and were more likely to report insufficient household income (61% vs 39%; Pâ<â.001) and history of depression (14% vs 7%; Pâ=â.02), to have elevated (>200) measured total cholesterol (50% vs 37%; Pâ=â.02), and to have Perceived Stress Scale scores indicating greater stress than food secure drivers (14 vs 11; Pâ=â.002). In a binary logistic regression analysis, drivers who reported that their total household income was enough to meet their basic needs had significantly lower odds of being food insecure (0.695 odds ratio; Pâ=â.016). CONCLUSION: Food insecurity was high in this group of taxi/FHV drivers. Food insecurity interventions are needed and could be occupationally based, with worksite screening and resource navigation. Policies should address improving wages and healthcare access.