Social Inequalities in Periodontal Diseases

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DESCRIPTION (provided by applicant): While some improvements in the health of the United States population have occurred over time, the persistence of disparities between groups, namely racial/ethnic or socioeconomic groups, indicates that such improvement has been uneven. Indeed, this improvement differential has actually contributed toward widening the disparities gap. Furthermore, although the long-standing focus of health comparisons in the US has been race/ethnicity, differences between the "haves" and the "have-nots" have been documented for years and remained pervasive. One such disparity is oral health, and more specifically periodontal disease disparities, which have been reported from national and local surveys for years. Previous studies show differences in periodontal health by race/ethnicity and personal socioeconomic indicators such as income and education. However, race/ethnicity, SES, and traditional risk factors do not fully explain the observed disparities in periodontal health. These findings suggest that the determinants of disparities in periodontal diseases may extend beyond individual characteristics. Therefore, to reduce the gap among groups, multilevel and interdisciplinary research approaches addressing more distant or upstream factors will need to be undertaken in studying periodontal health disparities (i.e., the place where people live and interact could influence and shape their health profiles and behaviors patterns). This career transition award will provide me with a unique opportunity to obtain new and innovative ways for studying not only the social determinants of periodontal diseases and other dental conditions but also health in general. Three areas of training are proposed: Oral Epidemiology, Advanced Epidemiological Methods and Statistical Analysis and Social Epidemiology. My training in these areas will be overseen by five mentors: Brian A. Burr, BDS, MPH, PhD; Rueben C. Warren DDS, DrPH, Ana V. Diez-Roux, MD, PhD; Bruce Link, PhD and Harold W. Neighbors, PhD. My goal is to become an independent investigator that tackles research questions using a social determinant of health approach including individuals as well as their immediate environment. The proposed research will extend our understanding on the determinants of periodontal diseases by: 1) assessing the contribution of both individual and neighborhood-level social factors; 2) examining the contribution of individual risk factors to racial/ethnic and socioeconomic differences in periodontal diseases; 3) investigating interactions across individual and neighborhood-level social factors; and 4) exploring periodontal health disparity trends over time.