DETERMINANTS OF ORAL HEALTH IN OLDER PERSONS

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The long-term objectives of this project are to describe and better understand the oral health status of older health status of the older persons in general as well as specific subgroups of this population with special problems. These objectives will be obtained by employing a generic model of health service use and health status as well as findings from the gerontological and dental care literature. The relative influences on oral health status of socioenvironmental, delivery system and personal/lifestyle factors will be studies in multiple communities. The data are being collected through the International Collaborative Study of Oral Health Outcomes (ICS II) conducted by the World Health Organization and the University of Chicago. Participating are communities in the United States (Baltimore, San Antonio, Indian Health Service) and other countries (New Zealand, Poland, Germany, Latvia). Data sources include: 1) clinical examinations of 1000 residents 65-74 as well as 2000 younger persons 35-44 and 12-13 in each community; 2) personal interviews of these same residents to obtain socioeconomic characteristics, health beliefs and knowledge and dental behavior; and 3) interviews of dental providers and administrators to obtain data on delivery system structure and socioenvironmental factors, and 4) secondary data sources. This proposal requires necessary supplementary resources to collect, organize and analyze the data on older persons. Specific aims include: 1) description of the oral health of older Americans with special attention paid to differences among Hispanics, native American, blacks and whites; 2) identification of risk factors and correlates of oral health status of older Americans; and 3) comparison of the results in 1) and 2) with those for younger cohorts 35-44 in the United States and those for older persons from other countries in ICS II. The analyses will employ descriptive statistics as well as multivariate techniques to examine the relative effects of the individual level variables (e.g., education, health beliefs, dental insurance, oral hygiene and dental service use) on oral health status of the aged. The structural relationships between oral health status, delivery system and environment will be inferred with individual variables controlled.