Perception of general and oral health in White and African American adults: assessing the effect of neighborhood socioeconomic conditions
Perception of general and oral health in White and African American adults: assessing the effect of neighborhood socioeconomic conditions
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DOI：
10.1111/j.1600-0528.2004.00177.x
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发表时间：
2004-10-01
影响因子：
2.3
通讯作者：
Nyquist, LV
中科院分区：
文献类型：
--
作者：
Borrell, LN;Taylor, GW;Nyquist, LV
目的：本研究以居住在密歇根州底特律三县地区的18岁以上成年人为研究对象，研究在控制传统危险因素前后，家庭收入和邻里社会经济地位对一般健康和口腔健康的独立和联合影响。方法：个人资料通过访谈获得，邻里关系资料来自1990年美国人口普查。SUDAAN被用来适应相同社区内复杂的抽样设计和结果的相关性。结果：贫困社区的白人认为自己的口腔健康一般或差的可能性是优势社区的白人的四倍[优势比(OR)：4.0；95%可信区间(CI)：1.6-10.3]。当评估家庭收入和社区SES的联合影响时，贫困社区的低收入白人给他们的口腔健康评级为一般或差的可能性是优势社区高收入白人的六倍(OR：6.4；95%CI：1.6-26.5)。在贫困社区的低收入非裔美国人(OR：6.1；95%CI：1.6-23.8)中，将一般健康评级为一般或较差的几率是优势社区高收入非裔美国人的6倍。同样，生活在贫困社区的低收入非裔美国人给他们的口腔健康评级为一般/差的可能性几乎是优势社区高收入非裔美国人的三倍(OR：2.8；95%CI：1.0-8.1)。结论：在评估自测口腔健康的种族/民族差异时，邻里层面的自发性口腔健康状况，独立或与个人水平的收入相结合，似乎是很重要的。社区条件可能会利用个人水平变量没有捕捉到的关于自我评估口腔健康的结构。
Objectives: This study investigates the independent and joint effects of family income and neighborhood socioeconomic status (SES) on general health and oral health before and after controlling for traditional risk factors in a representative sample of adults aged 18+ years residing in the Detroit tri-county area, Michigan. Methods: Individuals data were obtained through interviews, while neighborhood data came from the 1990 US Census. SUDAAN was used to accommodate the complex sampling design and correlation of outcomes within the same neighborhoods. Results: Whites in disadvantaged neighborhoods were four times more likely to rate their oral health as fair or poor [odds ratio (OR): 4.0; 95% confidence intervals (CI): 1.6-10.3] than their counterparts in advantaged neighborhoods. When evaluating the joint effects of family income and neighborhood SES, low-income Whites in disadvantaged neighborhoods were six times more likely to rate their oral health as fair or poor (OR: 6.4; 95% CI: 1.6-26.5) than their high-income counterparts in advantaged neighborhoods. The odds of rating general health as fair or poor was six times greater in low-income African Americans in disadvantaged neighborhoods (OR: 6.1; 95% CI: 1.6-23.8) than high-income African Americans in advantaged neighborhoods. Similarly, low-income African Americans in disadvantaged neighborhoods were almost three times (OR: 2.8; 95% CI: 1.0-8.1) more likely to rate their oral health as fair/poor than high-income African Americans in advantaged neighborhoods. Conclusions: SES conditions at the neighborhood-level, independently or jointly with individual-level income, appear to be important in evaluating racial/ethnic differences in self-rated oral health. Neighborhood conditions could tap into constructs not captured by individual-level variables on self-rated oral health.