The purpose of this study was to evaluate poor/nonpoor comparisons as a basis for sizing economic disparities in a broad array of unmet oral health needs among U.S. adults. NHANES III data for 13,500+ dentate persons 18+ years and 12,560+ dentate persons 18-74 years were analyzed using logistic regression for 7 indicators of unmet oral health needs: untreated coronal and root decay, gingivitis, loss of attachment (LOA) >4mm, advanced (ADV) LOA, one or more restorations and tooth conditions (RTCs) that might benefit from treatment, and 1+RTCs involving pulpal pathology or a retained root (PR). The analysis adjusted for age, gender, and race-ethnicity. For 5 of the 7 indicators, the ratio between the odds for the poor compared to the odds for the nonpoor ranged between 2.0 and 2.5 (p-values < 0.0001). The poor/nonpoor OR was 1.6 (p=.0000) for gingivitis and 1.3 (p=0.003) for 1+RTCs with PR. For 4 indicators, these poor/nonpoor ORs captured between 71 and 81 percent of the ratio between the odds for the poor compared to that for higher income individuals (those with 4 times the income of the poverty threshold). For untreated coronal and root decay and having 1+RTCs with PR, the poor/nonpoor ORs captured only about 40-43 percent of the ORs for poor/higher income comparisons. These results provide evidence that poor/nonpoor comparisons are useful in identifying aspects of unmet oral health needs affected by economic status disparities, but are not useful in sizing these disparities nor in locating the largest disparities.
Learning Objectives: After the presentation the participant will be able to: 1) describe the uses and limitations of poor/nonpoor comparisons as a basis for identifying and sizing economic disparities in unmet oral health needs, and 2) describe the kinds of comparisons between the poor and specific income categories of the nonpoor which are more appropriate for sizing economic disparities in oral health and for locating the largest disparities that need to be addressed programatically
Keywords: Oral Health, Access to Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employment