Spatial Systems Science for Oral Health Promotion among Older Adults

Objectives: This study aims to describe how methods of spatial systems science inform a collaborative research project intended to promote oral health equity among older adults. Specifically, we explore social factors at the community, interpersonal, and individual scales that impact the health needs and preferences of underserved racial/ethnic minority older adults.  Our models are informed by the ElderSmile community-based oral health education and screening program operated by the Columbia University College of Dental Medicine at senior centers in underserved neighborhoods of northern Manhattan.   

Methods: This project takes a multi-method approach to study socially-influenced oral health-seeking behaviors and health outcomes through spatial systems science. The utilized methods include geographic information science, system dynamics, agent-based modeling, and social network analysis. A web-based data visualization tool titled, ElderSmile Time Map, was constructed to visualize participation in the program. Collaboration between multi-disciplinary researchers and ElderSmile practitioners has been facilitated by group model-building activities.

Results: A portfolio of statistical and simulation models has emerged from this collaborative process.  Group model-building activities have led to the refinement and extension of models in our portfolio, such as the ElderSmile Time Map, which was enhanced with user-defined charts so as to better inform program operation. Spatially explicit analysis enables alignment with agent-based models and consideration of how health outcomes are distributed in space.

Conclusions: For the diverse communities in which the ElderSmile program operates, older adults’ health-seeking behaviors, utilization of oral health services, and oral health outcomes vary in part due to where they live.