Census tract geospatial analysis comparing social determinants of health with tooth loss in California seniors: An ecologic study.

Autor: Chong GTF; Division of Oral Epidemiology and Dental Public Health, School of Dentistry, University of California San Francisco (UCSF), San Francisco, California, USA.; HQ Singapore Armed Forces Medical Corps, Singapore, Singapore., Gansky SA; Division of Oral Epidemiology and Dental Public Health, School of Dentistry, University of California San Francisco (UCSF), San Francisco, California, USA.; Center to Address Disparities in Children's Oral Health, UCSF, San Francisco, California, USA.; Philip R. Lee Institute for Health Policy Studies, UCSF, San Francisco, California, USA.; Research Coordinating Center to Reduce Disparities in Multiple Chronic Diseases, UCSF, San Francisco, California, USA.; Multiethnic Health Equity Research Center, UCSF, San Francisco, California, USA.
Jazyk: angličtina
Zdroj: Community dentistry and oral epidemiology [Community Dent Oral Epidemiol] 2024 Dec; Vol. 52 (6), pp. 889-899. Date of Electronic Publication: 2024 Jul 19.
DOI: 10.1111/cdoe.12995
Abstrakt: Objectives: Individual-level social determinant of health (SDOH) measures alone may insufficiently explain disparities in edentulism among seniors. Therefore, the authors examined the correlation of census tract-level SDOH and residential racial segregation measures with edentulism in Californian adults aged ≥65 years old.
Methods: Explanatory variables were obtained from Healthy Places Index (HPI), the National Cancer Institute and diversitydatakids.org. The edentulism outcome variable was obtained from CDC's PLACES small area estimates from the 2018 Behavioral Risk Factor Surveillance System data. Pearson and Spearman rank correlations were estimated. Multiple linear regression and multi-collinearity evaluations were performed. The Global Moran's I statistic assessed partial autocorrelation within census tracts.
Results: Pearson and Spearman correlations were similar, supporting robustness. HPI, an area measure of advantage, strongly negatively correlated with edentulism prevalence [correlation coefficient: -0.87; 95% confidence interval (CI): -0.87, -0.86]. A change of 1.0 in HPI corresponded to an estimated decrease in edentulism prevalence of 5.9% (linear model adjusted R 2  = 0.78). Racially segregated census tracts with Hispanics or Blacks alone were positively correlated with edentulism prevalence [0.60, 95% CI: 0.58, 0.62; and 0.33, 95% CI: 0.31, 0.35, respectively]. The converse was seen in census tracts with non-Hispanic Whites alone [-0.57, 95% CI: -0.58, -0.55]. Global Moran's I statistic for edentulism (0.13) and HPI scores (0.19) were significant (both p < .001) indicating geospatial autocorrelation.
Conclusions: Higher disadvantage and minority racial segregation within census tracts were positively correlated with edentulism prevalence. Future research and policy should consider possible interventions improving SDOH to reduce oral health inequities.
(© 2024 The Author(s). Community Dentistry and Oral Epidemiology published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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