Race/Ethnicity, Socioeconomic Status and Oral Health

点击翻译按钮获取中文摘要

DESCRIPTION (provided by applicant): Several studies report that that race/ethnicity, socioeconomic status (SES), and neighborhood socioeconomic disadvantage are related to self-reports of general health, but very few studies have examined these relationships for self-rated oral health and other measures of perceived oral health, particularly among low-income and racially and ethnically diverse U.S. populations. The purpose of this study is to estimate composition (differences in people) and context (differences in places where people live) effects on low-income mothers' perceptions of oral health and their children's oral health. Aim 1 will estimate composition effects in a population of children aged 3-6 covered by Medicaid and their low-income mothers by: (a) describing the disparities in perceived oral health by racial/ethnic group and SES among mothers and their children, including the association between mother's perceptions of her oral health and her child's oral health in each group; (b) estimating whether a gradient relationship exists between mother's SES (income, education, and employment status) and her perceived oral health and perceptions of her child's oral health; and (c) estimating the interaction effects of SES and race/ethnicity on perceived oral health. Aim 2 addresses contextual effects: controlling for individual-level characteristics, we will estimate the independent effects of neighborhood socioeconomic disadvantage on the perceived oral health of mothers and their children aged 3-6. We also will test whether our findings are consistent with the general health literature by repeating Aims 1 and 2 for mother ratings of her and her child's general health. Data for this study come from our NIDCR study, Linking Mother and Child Access to Dental Care (NIDCR Grant No. R01 DE014400), a prospective cohorts udy of children aged 3-6 covered by Medicaid and their mothers in Washington state. Building on the biological connection between mother and child oral health, its main purpose is to determine whether having a me ther with a regular source of dental care at baseline is associated with greater dental care for the child af ter 1 year. Baseline survey data exist for 4,373 children and mothers in the following racial/ethnic groups: ,311 Hispanic mothers, 1,385 White mothers, 818 Black mothers, and 719 mothers from other racial/ethnic groups. Measures of perceived oral health include self- rating of oral health, fair/poor oral health, rating of condition of teeth, and number and type of dental problems. Guided by the study's conceptual model, regression equations will be estimated to test hypotheses. In Aim 1 binary and ordinal logistic regression will be used to estimate the effects of race/ethnicity and SES on mothers' perceptions of their and their children's health, controlling for other individual characteristics and risk factors. In Aim 2 mixed-effect multilevel models will be used to estimate the effects of neighborhood socioeconomic disadvantage on perceived oral health controlling for individual-level characteristics.