scholarly journals Do Socioeconomic Conditions Explain Ethnic Inequalities in Tooth Loss among US Adults?

2018 ◽  
Vol 28 (3) ◽  
pp. 201
Author(s):  
Fatma W. Nazer ◽  
Wael Sabbah

<p class="Pa7"><strong>Objective: </strong>To assess whether there are ethnic differences in tooth loss among adult Americans aged &lt;40 years and whether socioeconomic position attenuates these differences if they exist.</p><p class="Pa7"><strong>Methods: </strong>Data were from the 2014 Behavioral Risk Factor Surveillance System, a health-related telephone cross-sectional survey of a nationally representative sample of US adults. Tooth loss (one tooth or more) was used as the outcome variable. Ethnicity was the main explanatory variable. Family income, education and health insurance were also used in the analysis. Logistic regression models for tooth loss were constructed adjusting for demographic (age, sex, and ethnicity), socioeconomic indica­tors (income and education), health insur­ance, dental visits, smoking and diabetes.</p><p class="Pa7"><strong>Results: </strong>A total of 76,273 participants were included in the analysis. The prevalence of tooth loss was highest among Blacks (33.7%). Hispanics and other ethnic groups had a higher prevalence of tooth loss than Whites, 29.1% (95%CI: 27.7-30.6), 22.0% (95%CI: 20.3-23.8), and 20.8% (95%CI: 20.2-21.4), respectively. Blacks had odds ra­tios (OR) 1.98 (95%CI: 1.81-2.16) for tooth loss compared with Whites. After adjusting for socioeconomic positions (SEP), the rela­tionship attenuated but remained significant with OR 1.71 (95%CI: 1.55-1.90).</p><p class="Default"><strong>Conclusions: </strong>Despite recent changes in the health care system in the United States, ethnic inequalities in tooth loss still exist. Income and education partially explained ethnic differences in tooth loss among Americans aged &lt;40 years.</p><p class="Default"><em>Ethn Dis. </em>2018;28(3):201-206; doi:10.18865/ ed.28.3.201</p>

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wei Chen ◽  
Hongfu Ren ◽  
Na Wang ◽  
Yaqing Xiong ◽  
Fei Xu

Abstract Background To examine associations of socioeconomic position (SEP), separately indicated by education, monthly family average income (FAI) and occupation, with health literacy (HL) among adults in regional China. Methods A cross-sectional survey was conducted among urban and rural adults (aged 25–69 years) who were randomly selected, using the probability proportionate to size sampling approach, from Nanjing municipality of China during October and December of 2016. HL, the outcome variable, was assessed using the Chinese Resident Health Literacy Scale. SEP, our independent variable, was separately measured with educational attainment, monthly family average income and occupation. Logistic regression models were introduced to examine SEP-HL association with odds ratio (OR) and 95% confidence interval (CI). Results Totally, 8698 participants completed the survey. The proportion of participants with unweighted and weighted adequate HL was 18.0% (95%CI = 17.2, 18.8%) and 19.9% (95%CI = 16.6, 23.6%), respectively, in this study. After adjustment for possible confounding factors, each SEP indicator was in significantly positive relation to both unweighted and weight HL level. Participants who obtained 13+ and 10–12 years educational attainment, respectively, had 2.41 (95%CI = 1.60, 3.64) and 1.68 (95%CI = 1.23, 2.29) times odds to record weighted adequate HL compared to their counterparts who were with 0–9 years education. Subjects within upper (OR = 1.92, 95%CI = 1.24, 2.98) and middle FAI tertile (OR = 1.59, 95%CI = 1.19, 2.13), respectively, were more likely to report weighted adequate HL relative to those who were within lower FAI tertile. White collars were more likely to have weighted adequate HL (OR = 1.33, 95%CI = 1.09, 1.61) than blue collars. Conclusions Each of education, FAI and occupation was positively associated with health literacy among urban and rural adults in China. The findings have important implications that different SEP indicators can be used to identify vulnerable residents in population-based health literacy promotion campaigns.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anna Schotthoefer ◽  
Kathryn Stinebaugh ◽  
Michael Martin ◽  
Claudia Munoz-Zanzi

Abstract Background People with occupations that require them to spend time working outdoors in suitable tick habitats are predicted to be at an increased risk for tick-borne diseases (TBDs). However, few studies have assessed the risks of outdoor employees in the United States. Methods We conducted a cross-sectional survey to collect data on exposure to ticks and TBD infections among U.S. Forest Service employees in a high TBD incidence region of northern Wisconsin, and to examine employee knowledge, attitudes, and practices (KAPs) regarding TBDs to help guide future education and prevention programs. Chi-square contingency tables, calculations of odds ratios, and logistic regression models were used to identify associations among self-reported employee factors, the proportion of correctly answered knowledge questions, their ranked concern for TBDs, adherence to practicing preventive behaviors, and willingness to pay for protective measures. Results Ninety-five employees completed the survey. Nearly all respondents (97%) reported recent tick exposure, with 27% reporting encountering 10 or more ticks per week during peak tick season. Employee knowledge of TBD was high (median score: 80% correct). Fifty-nine percent of respondents had high concern for TBDs, and there was high adherence to conducting body checks for ticks (83% reported always doing them), but only moderate use of tick repellents (24% reported always and 60% reported occasionally using). High concern for TBD (adjusted odds ratio (aOR) = 6.32 [95% confidence intervals, 1.97–20.28]), a history of TBD diagnosis (aOR = 5.88 [1.41–24.55]), and older age (≥ 46 years) (aOR = 3.29 [1.00–10.84]) were positively associated with high practice adherence. Respondents suggested they would be willing to pay for personal protective methods and get a hypothetical vaccine for Lyme disease, but not community-wide efforts to control ticks. Conclusions Our study provides evidence that U.S. Forest Service employees in Wisconsin represent a high risk group for TBD, and despite relatively high TBD knowledge and engagement in tick protection activities, efforts are needed to reduce their risks for tick bites. More generally, our findings suggest that studies to better understand the factors related to the adoption and effectiveness of public health interventions are needed.


Author(s):  
Malini Muralikrishnan ◽  
Wael Sabbah

Abstract Objective The objectives of this study are to assess the association of racial discrimination with tooth loss among American adults and whether this relationship, if existed, explains ethnic differences in tooth loss. Methods Data is from the Behavioural Risk Factor Surveillance System (BRFSS) 2014, a cross-sectional survey of a nationally representative sample of American adults. The survey included data on sociodemographic characteristics, behaviour, health insurance and number of missing teeth. The survey also included questions on whether a person was treated differently because of his/her race. Logistic regression analysis was conducted to assess the relationship between tooth loss and indicators of discrimination. We also examined the relation between ethnicity and indicators of discrimination. Results The analysis included 4858 participants aged 18 to 44 years. Tooth loss (> one tooth) was reported by 26% of participants. Among those reporting discrimination at healthcare facility, there was 141% increase in tooth loss compared to those not reporting discrimination. Discrimination at work and emotional impact of discrimination were both significantly associated with tooth loss in the partially adjusted models. Accounting for discrimination slightly attenuated ethnic differences in too loss. Black Americans had significantly higher odds for reporting all types of discrimination used here. Conclusion This study demonstrated a potential role for discrimination in tooth loss among American adults. Discrimination could also explain part of ethnic inequalities in oral health.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24064-e24064
Author(s):  
Min Jee Lee ◽  
Eric Adjei Boakye

e24064 Background: The number of cancer survivors in the United States (U.S.) is projected to exceed 20 million by 2024. More and more U.S. states are legalizing marijuana use for both recreational and medicinal purposes. This study estimated the prevalence of marijuana use by state among adult cancer survivors. Methods: U.S nationally representative, cross-sectional data from the 2018-2019 Behavioral Risk Factor Surveillance System Survey (BRFSS) Marijuana Use module were used. A total of 13,174 cancer survivors in 17 states was included. Analyses were weighted to account for BRFSS’s complex survey design with results generalizable to 5.7 million cancer survivors. The outcome variable was marijuana use in the past 30 days. Weighted prevalence estimates were computed. Weighted, multivariable logistic regression model estimated the association between state and marijuana use, adjusting for sociodemographic, health, and healthcare factors. Analyses were performed in January 2021. Results: The prevalence of past-month marijuana use among adult cancer survivors in these states was 9.2%. States varied widely in terms of the prevalence of marijuana use. Marijuana use was higher among those who resided in Guam (15.9%), followed by New Hampshire (13.1%), and lowest for those in Puerto Rico (3.3%) ( p< 0.0001). In the adjusted models, compared with the adult cancer survivors residing in California, those living in Maryland, Minnesota, North Dakota, Ohio, South Carolina, Tennessee, Utah, West Virginia, and Wyoming were significantly less likely to use marijuana. Conclusions: Nearly 9% of adult cancer survivors used marijuana, and those who resided in Guam, New Hampshire, Florida, and California are at higher risk for marijuana use. Given the increasing number of cancer survivors and the proliferation of marijuana legalization, identifying high-risk cancer survivors for marijuana use and informing physicians and patients about safe uses and doses and the potential adverse effects of marijuana use is critical.


Author(s):  
Wael Sabbah ◽  
Aswathikutty Gireesh ◽  
Malini Chari ◽  
Elsa K. Delgado-Angulo ◽  
Eduardo Bernabé

This study examined the relationship between racial discrimination and use of dental services among American adults. We used data from the 2014 Behavioral Risk Factor Surveillance System, a health-related telephone cross-sectional survey of a nationally representative sample of adults in the United States. Racial discrimination was indicated by two items, namely perception of discrimination while seeking healthcare within the past 12 months and emotional impact of discrimination within the past 30 days. Their association with dental visits in the past year was tested in logistic regression models adjusting for predisposing (age, gender, race/ethnicity, income, education, smoking status), enabling (health insurance), and need (missing teeth) factors. Approximately 3% of participants reported being discriminated when seeking healthcare in the past year, whereas 5% of participants reported the emotional impact of discrimination in the past month. Participants who experienced emotional impact of discrimination were less likely to have visited the dentist during the past year (Odds Ratios (OR): 0.57; 95% CI 0.44–0.73) than those who reported no emotional impact in a crude model. The association was attenuated but remained significant after adjustments for confounders (OR: 0.76, 95% CI 0.58–0.99). There was no association between healthcare discrimination and last year dental visit in the fully adjusted model. Emotional impact of racial discrimination was an important predictor of use of dental services. The provision of dental health services should be carefully assessed after taking account of racial discrimination and its emotional impacts within the larger context of social inequalities.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 956-956
Author(s):  
Yanfeng Xu ◽  
Merav Jedwab ◽  
Qi Wu ◽  
Sue Levkoff ◽  
Ling Xu

Abstract The fear and anxiety of COVID-19 and its related policy measures have increased individuals’ psychological distress. The objective of this study was to examine relationships between material hardship, parenting stress, social support, and resilience and custodial grandparents’ psychological distress during the COVID-19 pandemic and further investigate the moderating role of kinship license status. A cross-sectional survey was administered to collect data from custodial grandparents (N = 362) in the United States. T-tests, chi-square tests, and logistic regression models were conducted using STATA 15.0. Results indicated that material hardship (OR = 1.77, p &lt; 0.001) was associated with higher odds of psychological distress, whereas custodial grandparents’ resilience (OR = 0.08, p &lt; 0.001) and social support (OR = 0.39, p &lt; 0.001) were associated with lower odds of experiencing psychological distress. Increased parenting stress in COVID-19 was not significantly associated with psychological distress. Kinship license status moderated the relationships between social support (OR = 0.23, p &lt; 0.05), resilience (OR = 5.06, p &lt; 0.05) and psychological distress. To address custodial grandparents’ psychological distress, more allocated emergency funds and tailored financial services should be provided to meet material needs, and interventions with a focus on resilience and social support are particularly needed. Although licensed custodial grandparents were more likely to experience psychological distress due to their pre-existing vulnerability than unlicensed counterparts, parallel services should be provided to all kinship caregivers.


2020 ◽  
Vol 33 ◽  
Author(s):  
Claudia SOAR ◽  
Cristine Garcia GABRIEL ◽  
Janaina das NEVES ◽  
Liliana Paula BRICARELLO ◽  
Mick Lennon MACHADO ◽  
...  

ABSTRACT Objective Perform comparative analysis of adequate consumption of fruits and vegetables and their associated factors in schoolchildren. Methods Probabilistic samples representative of students of both sexes, 7 to 14 years old, from public and private schools in Florianópolis, SC were investigated in cross-sectional studies in 2007 (n=2,836) and 2012 (n=2,506). The exposure variables were: sex, age, family income per capita, mother’s education and school system. The outcome variable (fruit and vegetable consumption) was collected using the third validated version of the previous day’s food questionnaire. Using the Chi-Square test, exposure variables with a p-value <0.20 were eligible for analysis using crude and adjusted multiple logistic regression models. Exposure variables with p<0.05 were considered to be associated with the consumption of fruits and vegetables. Results There were no significant differences in the adequate consumption between 2007 and 2012. While in 2007 the per capita family income was the only exposure variable associated, in 2012 only a mother with complete higher education was a protective factor for the adequate consumption of fruits and vegetables Conclusion Despite governmental strategies to stimulate the consumption of fruits and vegetables in Brazil, their results are still not perceptible, requiring more time for an evaluation of effectiveness


2020 ◽  
Author(s):  
Anna Schotthoefer ◽  
Kathryn Stinebaugh ◽  
Michael Martin ◽  
Claudia Munoz-Zanzi

Abstract Background: People with occupations that require them to spend time working outdoors in suitable tick habitats are predicted to be at an increased risk for tick-borne diseases (TBDs). However, few studies have assessed the risks of outdoor employees in the United States.Methods: We conducted a cross-sectional survey to collect data on exposure to ticks and TBD infections among U.S. Forest Service employees in a high TBD incidence region of northern Wisconsin, and to examine employee knowledge, attitudes, and practices (KAPs) regarding TBDs to help guide future education and prevention programs. Chi-square contingency tables, calculations of odds ratios, and logistic regression models were used to identify associations among self-reported employee factors, the proportion of correctly answered knowledge questions, their ranked concern for TBDs, practicing preventive behaviors, and willingness to pay for protective measures. Results: Ninety-five employees completed the survey. Nearly all respondents (97%) reported recent tick exposure, with 27% reporting encountering 10 or more ticks per week during peak tick season. Employee knowledge of TBD was high (median score: 80% correct). Fifty-nine percent of respondents had high concern for TBDs, and there was high adherence to conducting body checks for ticks (83% reported always doing them), but only moderate use of tick repellents (24% reported always and 60% reported occasionally using). High concern for TBD (adjusted odds ratio (aOR) = 6.32 [95% confidence intervals: 1.97 – 20.28]), a history of TBD diagnosis (aOR = 5.88 [1.41-24.55]), and older age (≥ 46 years) (aOR = 3.29 [1.00 – 10.84]) were positively associated with high practice adherence. Respondents suggested they would be willing to pay for personal protective methods and get a hypothetical vaccine for Lyme disease, but not community-wide efforts to control ticks. Conclusions: Our study provides evidence that U.S. Forest Service employees in Wisconsin represent a high risk group for TBD, and despite relatively high TBD knowledge and engagement in tick protection activities, efforts are needed to reduce their risks for tick bites. More generally, our findings suggest that studies to better understand the factors related to the adoption and effectiveness of public health interventions are needed.


Author(s):  
Murti Devi ◽  
Vinod Chayal

Background: Intestinal parasitic infestation is one of the commonest causes of chronic infection in humans in developing countries and is responsible for considerable morbidity and mortality. Despite the improved socio-economic conditions and elevated living standards, surprisingly it is still a public health problem even in developed countries, like the United States. Objectives of the study were to determine the association of factors associated with parasitic infestation among children of 6-12 years age.Methods:  A cross sectional survey approach was adopted to collect the data and 200 children (6-12 years) and their parents were finally included as per research criteria. Data was collected by interviewing the parents and children using structured interview schedule. Microscopic examinations of stool samples were also done for detection of ova and cysts of intestinal parasites.Results:  Out of 200 study subjects 65 (32.5%) were found to be positive for parasitic infestation namely Giardia lamblia (18.0%) E. histolytica (8.5%), Taenia (4.5%) and H. nana (1.5%). Majority of parasitic infestation i.e. (58.7%) was found among the children of illiterate mothers, (44.6%) in case of joint families and (44.8%) belonging to families having a monthly income less than Rs. 5,000.Conclusions: In this study, it was found that mother’s education, family income, type of family are significantly associated factors with parasitic infestation. The present study opens an area for the further planning such as improving the low socio-economic status, regular deworming of the children, promotion of usages of toilets and up gradation of water supply system as preventive measures in this setting.


2020 ◽  
Author(s):  
Anna Schotthoefer ◽  
Kathryn Stinebaugh ◽  
Michael Martin ◽  
Claudia Munoz-Zanzi

Abstract Background: People with occupations that require them to spend time working outdoors in suitable tick habitats are predicted to be at an increased risk for tick-borne diseases (TBDs). However, few studies have assessed the risks of outdoor employees in the United States.Methods: We conducted a cross-sectional survey to collect data on exposure to ticks and TBD infections among U.S. Forest Service employees in a high TBD incidence region of northern Wisconsin, and to examine employee knowledge, attitudes, and practices (KAPs) regarding TBDs to help guide future education and prevention programs. Chi-square contingency tables, calculations of odds ratios, and logistic regression models were used to identify associations among self-reported employee factors, the proportion of correctly answered knowledge questions, their ranked concern for TBDs, adherence to practicing preventive behaviors, and willingness to pay for protective measures. Results: Ninety-five employees completed the survey. Nearly all respondents (97%) reported recent tick exposure, with 27% reporting encountering 10 or more ticks per week during peak tick season. Employee knowledge of TBD was high (median score: 80% correct). Fifty-nine percent of respondents had high concern for TBDs, and there was high adherence to conducting body checks for ticks (83% reported always doing them), but only moderate use of tick repellents (24% reported always and 60% reported occasionally using). High concern for TBD (adjusted odds ratio (aOR) = 6.32 [95% confidence intervals: 1.97 – 20.28]), a history of TBD diagnosis (aOR = 5.88 [1.41-24.55]), and older age (≥ 46 years) (aOR = 3.29 [1.00 – 10.84]) were positively associated with high practice adherence. Respondents suggested they would be willing to pay for personal protective methods and get a hypothetical vaccine for Lyme disease, but not community-wide efforts to control ticks. Conclusions: Our study provides evidence that U.S. Forest Service employees in Wisconsin represent a high risk group for TBD, and despite relatively high TBD knowledge and engagement in tick protection activities, efforts are needed to reduce their risks for tick bites. More generally, our findings suggest that studies to better understand the factors related to the adoption and effectiveness of public health interventions are needed.


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