Self-rated general and oral health in New York City adults: Assessing the effect of individual and neighborhood social factors

Objectives: This study investigates the independent and joint effects of individual and neighborhood socioeconomic characteristics on self-rated general and oral health before and after controlling for traditional risk factors in a representative sample of adults 18+ years in New York City. Methods: Individuals' data were obtained from telephone interviews of the 2004 Social Indicators Survey; neighborhood data was gleaned from the 2000 US Census. Logistic regression was used to calculate prevalence ratios. SUDAAN was used to accommodate the complex sampling design and correlation of outcomes within the same neighborhoods. Results: After adjusting for important confounders, survey participants with 12 years of education or less were almost twice more likely to rate their general health as fair/poor than counterparts with 12+ years of education (PRs 1.96 [95% confidence intervals (CI):1.24,3.11] and 1.85 [95% CI:1.21,2.81]). Participants earning less than $20,000 or between $20,000 to $39,999 yearly were more than twice as likely to rate their general health as fair/poor compared to their counterparts earning over $40,000 yearly (PRs 2.31 [95%CI: 1.23,4.31] and 2.30 [95%CI:1.15,4.60]). The probability of rating oral health as fair/poor was at least 50% greater in participants with less than 12 years of education and in participants earning an annual income of less than $20,000 (PR:1.61 [95%CI:1.34,2=.29], PR:1.54 [95%CI:1.09,2.17]). No association was found between neighborhood characteristics and self-rated general and oral health. Conclusions: Individual socioeconomic characteristics may be important for both self-rated general and oral health by affecting individuals' behaviors and access to resources.