Geography matters: state-level variation in children's oral health care access and oral health status.
Public Health
; 134: 54-63, 2016 May.
Article
em En
| MEDLINE
| ID: mdl-26995567
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. STUDYDESIGN:
Observational study using cross-sectional surveys.METHODS:
Using the 2007 National Survey of Children's Health, we examined state variation in parents' 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 neighbourhood-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 the 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 â¼» of the state variation in no preventive visit and â¼½ 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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Características de Residência
/
Saúde Bucal
/
Assistência Odontológica
/
Disparidades nos Níveis de Saúde
/
Acessibilidade aos Serviços de Saúde
Tipo de estudo:
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Child
/
Child, preschool
/
Humans
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Public Health
Ano de publicação:
2016
Tipo de documento:
Article