Yuqiao Zhou1,2, Richard Cuddy3, Daniel W McNeil4,5, Casey D Wright4, Richard J Crout6, Eleanor Feingold1,3, Katherine Neiswanger2, Mary L Marazita1,2,7,8, John R Shaffer1,2. 1. Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA. 2. Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA. 3. Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA. 4. Department of Psychology, West Virginia University, Morgantown, WV, USA. 5. Department of Dental Practice and Rural Health, School of Dentistry, West Virginia University, Morgantown, WV, USA. 6. Department of Periodontics, School of Dentistry, West Virginia University, Morgantown, WV, USA. 7. Clinical and Translational Science, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA. 8. Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Abstract
OBJECTIVES: This cross-sectional study assessed differences in oral health and related behaviours and risk indicators by rurality in a north-central Appalachian population using the Andersen behavioural model as a conceptual framework. METHODS: Participants were residents aged 18-59 years (n = 1311) from the Center for Oral Health Research in Appalachia, selected according to a household-based sampling strategy. Rural-Urban Continuum codes (RUC) corresponding to the participants' residences were used to classify participants as rural or urban. Mixed models were used to test rural-urban differences in measures of oral health, related behaviours, and need, enabling, and predisposing risk indicators. Models were adjusted for sociodemographic variables: age, sex, race, income, perceived socioeconomic status, educational attainment and dental insurance. RESULTS: Rural residents had poorer oral health overall, with fewer sound teeth (β = -1.79), more dental caries (β = 0.27) and higher rates of edentulism (5.2% vs 2.8%). Differences also were observed for dental care utilization and perceived barriers to care. Rural residents were less likely to attend dental visits as often as needed (26.9% vs 42.8%) and were more prone to seek care only after experiencing a dental problem (64.3% vs 43.9%). Rural residents also were more likely to report high costs (89% vs 62.6%) as a major reason for not having dental visits. Rural-urban differences for some oral health characteristics and behaviours could be explained by sociodemographic characteristics, whereas others could not. CONCLUSIONS: This study revealed rural-urban differences in risk indicators and oral health outcomes in north-central Appalachia. Many of these differences were explained, completely or partly, by sociodemographic factors.
OBJECTIVES: This cross-sectional study assessed differences in oral health and related behaviours and risk indicators by rurality in a north-central Appalachian population using the Andersen behavioural model as a conceptual framework. METHODS: Participants were residents aged 18-59 years (n = 1311) from the Center for Oral Health Research in Appalachia, selected according to a household-based sampling strategy. Rural-Urban Continuum codes (RUC) corresponding to the participants' residences were used to classify participants as rural or urban. Mixed models were used to test rural-urban differences in measures of oral health, related behaviours, and need, enabling, and predisposing risk indicators. Models were adjusted for sociodemographic variables: age, sex, race, income, perceived socioeconomic status, educational attainment and dental insurance. RESULTS: Rural residents had poorer oral health overall, with fewer sound teeth (β = -1.79), more dental caries (β = 0.27) and higher rates of edentulism (5.2% vs 2.8%). Differences also were observed for dental care utilization and perceived barriers to care. Rural residents were less likely to attend dental visits as often as needed (26.9% vs 42.8%) and were more prone to seek care only after experiencing a dental problem (64.3% vs 43.9%). Rural residents also were more likely to report high costs (89% vs 62.6%) as a major reason for not having dental visits. Rural-urban differences for some oral health characteristics and behaviours could be explained by sociodemographic characteristics, whereas others could not. CONCLUSIONS: This study revealed rural-urban differences in risk indicators and oral health outcomes in north-central Appalachia. Many of these differences were explained, completely or partly, by sociodemographic factors.
Authors: Chris A Martin; Daniel W McNeil; Richard J Crout; Peter W Ngan; Robert J Weyant; Hilda R Heady; Mary L Marazita Journal: J Am Dent Assoc Date: 2008-05 Impact factor: 3.634
Authors: Katherine Neiswanger; Daniel W McNeil; Betsy Foxman; Manika Govil; Margaret E Cooper; Robert J Weyant; John R Shaffer; Richard J Crout; Hyagriv N Simhan; Scott R Beach; Stella Chapman; Jayme G Zovko; Linda J Brown; Stephen J Strotmeyer; Jennifer L Maurer; Mary L Marazita Journal: Int J Dent Date: 2015-05-18
Authors: John R Shaffer; Elizabeth J Leslie; Eleanor Feingold; Manika Govil; Daniel W McNeil; Richard J Crout; Robert J Weyant; Mary L Marazita Journal: Int J Dent Date: 2015-05-27
Authors: Daniel W McNeil; Sarah E Hayes; Cameron L Randall; Deborah E Polk; Kathy Neiswanger; John R Shaffer; Robert J Weyant; Betsy Foxman; Elizabeth Kao; Richard J Crout; Stella Chapman; Linda J Brown; Jennifer L Maurer; Mary L Marazita Journal: Behav Modif Date: 2015-12-07