Cilia Mejia-Lancheros1, James Lachaud2, Rosane Nisenbaum2,3, Andrea Wang2, Vicky Stergiopoulos2,4,5, Stephen W Hwang2,6, Patricia O'Campo2,7. 1. MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, 30 Bond St, Toronto, ON, M5B 1W8, Canada. Cilia.Mejia-Lancheros@unityhealth.to. 2. MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, 30 Bond St, Toronto, ON, M5B 1W8, Canada. 3. Applied Health Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada. 4. Centre for Addiction and Mental Health, Toronto, Canada. 5. Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Canada. 6. Division of General Internal Medicine, Department of Medicine, University of Toronto, Toronto, Canada. 7. Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Abstract
BACKGROUND: Dental problems (DPs) and physical chronic diseases (CDs) are highly prevalent and incident in people with low socioeconomic status such as homeless individuals. Yet, evidence on the association between DPs and physical CDs in this population is limited. In the present study, we assessed the association between DPs and type and number of CDs in individuals experienced chronic homelessness and serious mental health problems. METHODS: We analyzed cross-sectional baseline data from 575 homeless adults with serious mental health problems participating in the Toronto site of the At Home/Chez Soi randomized controlled trial. Chronic DPs (lasting at least 6 months) were the primary exposure variable. Presence of self-reported CDs, including heart disease, effect of stroke, hypertension, diabetes, asthma, chronic bronchitis/emphysema, stomach or intestinal ulcer, inflammatory bowel disease, migraine, thyroid problems, arthritis, kidney/bladder problems, liver disease (other than hepatitis), and iron-deficiency anemia, were the primary outcomes. The total number of CDs was also analyzed as a secondary outcome. Logistic regression models were used to assess the association between DPs with each of the studied CDs, and negative binomial regression was used to test the association between DPs with the number of CDs. RESULTS: In our 575 homeless participants (68.5% males) with mean age 40.3 (11.8) years, a high proportion had DPs (42.5%). The presence of DPs was positively associated with heart disease (adjusted odds ratio (AOR):4.19,1.67-10.52), diabetes (AOR:2.17,1.13-4.17), chronic bronchitis (AOR:2.34,1.28-4.29), stomach or intestinal ulcer (AOR:3.48,1.80-6.73), inflammatory bowel disease (AOR:2.52,1.38-4.60), migraine (AOR:1.80,1.20-2.72), arthritis (AOR:2.71,1.71-4.29), kidney/bladder problems (AOR:2.43,1.30-4.54), and iron-deficiency anemia (AOR:3.28,1.90-5.65). DPs were also associated with a higher number of CDs (IRR: 1.62,1.38-1.90). CONCLUSION: Dental health problems in homeless individuals with serious mental disorders are associated with several CDs. Dental care should be better integrated into existing social and health programs serving this population to improve their overall health status. The AH/CS study is registered with the International Standard Randomized Control Trial Number Register (ISRCTN42520374).
BACKGROUND: Dental problems (DPs) and physical chronic diseases (CDs) are highly prevalent and incident in people with low socioeconomic status such as homeless individuals. Yet, evidence on the association between DPs and physical CDs in this population is limited. In the present study, we assessed the association between DPs and type and number of CDs in individuals experienced chronic homelessness and serious mental health problems. METHODS: We analyzed cross-sectional baseline data from 575 homeless adults with serious mental health problems participating in the Toronto site of the At Home/Chez Soi randomized controlled trial. Chronic DPs (lasting at least 6 months) were the primary exposure variable. Presence of self-reported CDs, including heart disease, effect of stroke, hypertension, diabetes, asthma, chronic bronchitis/emphysema, stomach or intestinal ulcer, inflammatory bowel disease, migraine, thyroid problems, arthritis, kidney/bladder problems, liver disease (other than hepatitis), and iron-deficiency anemia, were the primary outcomes. The total number of CDs was also analyzed as a secondary outcome. Logistic regression models were used to assess the association between DPs with each of the studied CDs, and negative binomial regression was used to test the association between DPs with the number of CDs. RESULTS: In our 575 homeless participants (68.5% males) with mean age 40.3 (11.8) years, a high proportion had DPs (42.5%). The presence of DPs was positively associated with heart disease (adjusted odds ratio (AOR):4.19,1.67-10.52), diabetes (AOR:2.17,1.13-4.17), chronic bronchitis (AOR:2.34,1.28-4.29), stomach or intestinal ulcer (AOR:3.48,1.80-6.73), inflammatory bowel disease (AOR:2.52,1.38-4.60), migraine (AOR:1.80,1.20-2.72), arthritis (AOR:2.71,1.71-4.29), kidney/bladder problems (AOR:2.43,1.30-4.54), and iron-deficiency anemia (AOR:3.28,1.90-5.65). DPs were also associated with a higher number of CDs (IRR: 1.62,1.38-1.90). CONCLUSION: Dental health problems in homeless individuals with serious mental disorders are associated with several CDs. Dental care should be better integrated into existing social and health programs serving this population to improve their overall health status. The AH/CS study is registered with the International Standard Randomized Control Trial Number Register (ISRCTN42520374).
Entities:
Keywords:
Chronic diseases; Dental health services; Homeless persons; Inflammation; Mouth diseases; Multiple chronic conditions; Oral health; Preventive health service
Authors: Cilia Mejia-Lancheros; Samira Alfayumi-Zeadna; James Lachaud; Patricia O'Campo; Evie Gogosis; George Da Silva; Vicky Stergiopoulos; Stephen W Hwang; Naomi Thulien Journal: Health Soc Care Community Date: 2022-05-06