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Associations between health insurance and generalized periodontal disease in a study population of G ullah A frican A mericans with type‐2 diabetes
Author(s) -
Marlow Nicole M.,
Slate Elizabeth H.,
Fernandes Jyotika K.,
Leite Renata S.
Publication year - 2013
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/j.1600-0528.2012.00737.x
Subject(s) - medicaid , medicine , diabetes mellitus , population , logistic regression , demography , health insurance , odds ratio , glycemic , gerontology , environmental health , health care , endocrinology , sociology , economics , economic growth
Objectives To explore the relationship between health insurance status (Medicare, Medicaid, private, and uninsured) and generalized periodontal disease ( GPD ) among a study population ( N = 245) of adult G ullah A frican A mericans with type‐2 diabetes mellitus (T2 DM ) ages <65 years. Methods We used multivariable logistic regression to assess GPD [using three different and increasingly severe clinical assessments: ≥3, ≥4, and ≥5 mm clinical attachment level ( CAL ) at ≥30% of sites] according to health insurance status. Results Prevalence of GPD was 33.06% for ≥3, 18.78% for ≥4, and 9.80% for ≥5 mm CAL . Age ranged 26–64 years (mean = 52.11, SD = 8.53, median = 53). Private insurance was most prevalent (39.59%), followed by uninsured (30.61%), Medicaid (16.33%), and Medicare (13.47%). Results showed increased odds (versus private insurance) for GPD at ≥3 mm among Medicaid ( OR = 1.82, P = 0.2404), Medicare ( OR = 3.34, P = 0.0103), and uninsured ( OR = 1.96, P = 0.0956) groups; GPD at ≥4 mm among Medicaid ( OR = 1.97, P = 0.3303), Medicare ( OR = 5.02, P = 0.0121), and uninsured ( OR = 3.38, P = 0.0319) groups; and GPD at ≥5 mm among Medicaid ( OR = 1.21, P = 0.8507), Medicare ( OR = 12.62, P = 0.0038), and uninsured ( OR = 4.00, P = 0.0763) groups. Conclusions We observed substantial disparities for GPD severity among those without private health insurance even after adjusting for glycemic control, income, dental health behaviors, and other covariates. Improved insurance benefits as well as individualized oral health educational interventions may decrease GPD severity for this study population of younger (ages <65 years) Gullah African Americans with T2 DM , particularly those with Medicare insurance.