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Oral health and related risk indicators in north‐central Appalachia differ by rurality
Author(s) -
Zhou Yuqiao,
Cuddy Richard,
McNeil Daniel W.,
Wright Casey D.,
Crout Richard J.,
Feingold Eleanor,
Neiswanger Katherine,
Marazita Mary L.,
Shaffer John R.
Publication year - 2021
Publication title -
community dentistry and oral epidemiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.061
H-Index - 101
eISSN - 1600-0528
pISSN - 0301-5661
DOI - 10.1111/cdoe.12618
Subject(s) - medicine , rurality , edentulism , appalachia , socioeconomic status , environmental health , population , rural area , educational attainment , rural health , demography , gerontology , oral health , family medicine , paleontology , pathology , sociology , economics , biology , economic growth
Objectives This cross‐sectional study assessed differences in oral health and related behaviours and risk indicators by rurality in a north‐central Appalachian population using the Andersen behavioural model as a conceptual framework. Methods Participants were residents aged 18‐59 years (n = 1311) from the Center for Oral Health Research in Appalachia, selected according to a household‐based sampling strategy. Rural‐Urban Continuum codes (RUC) corresponding to the participants’ residences were used to classify participants as rural or urban. Mixed models were used to test rural‐urban differences in measures of oral health, related behaviours, and need, enabling, and predisposing risk indicators. Models were adjusted for sociodemographic variables: age, sex, race, income, perceived socioeconomic status, educational attainment and dental insurance. Results Rural residents had poorer oral health overall, with fewer sound teeth ( β = −1.79), more dental caries ( β = 0.27) and higher rates of edentulism (5.2% vs 2.8%). Differences also were observed for dental care utilization and perceived barriers to care. Rural residents were less likely to attend dental visits as often as needed (26.9% vs 42.8%) and were more prone to seek care only after experiencing a dental problem (64.3% vs 43.9%). Rural residents also were more likely to report high costs (89% vs 62.6%) as a major reason for not having dental visits. Rural‐urban differences for some oral health characteristics and behaviours could be explained by sociodemographic characteristics, whereas others could not. Conclusions This study revealed rural‐urban differences in risk indicators and oral health outcomes in north‐central Appalachia. Many of these differences were explained, completely or partly, by sociodemographic factors.