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Assessment of the Relationship between Neighborhood Characteristics and Dental Caries Severity among Low‐Income African‐Americans: A Multilevel Approach
Author(s) -
Tellez Marisol,
Sohn Woosung,
Burt Brian A.,
Ismail Amid I.
Publication year - 2006
Publication title -
journal of public health dentistry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.64
H-Index - 63
eISSN - 1752-7325
pISSN - 0022-4006
DOI - 10.1111/j.1752-7325.2006.tb02548.x
Subject(s) - socioeconomic status , census , psychological intervention , geocoding , multilevel model , matching (statistics) , cohort , demography , geography , environmental health , african american , gerontology , medicine , population , sociology , statistics , ethnology , remote sensing , pathology , psychiatry , mathematics
Objectives: To assess the relationship between neighborhood effects and the severity of dental caries among low‐income African‐Americans. Methods: A multistage probability sample of African‐American families living in the poorest 39 census tracts in Detroit was drawn. During 2002–03, cross‐sectional data of a cohort that includes 1021 caregivers were collected in the first of three waves of interviews and examinations. Multilevel analyses focused on 27 neighborhood clusters and involved a combination of individual (Level‐1) and neighborhood (Level‐2) data including census and geocoded (address matching to census geographic areas) information. Results: There is significant variation in the severity of caries between low‐income neighborhood clusters. Caries severity decreases with a higher number of churches, while it increases with a higher number of grocery stores in the clusters after accounting for individual characteristics. Only 14% of the inter‐individual variability in caries was explained by classical individual risk factors for this condition. Conclusion: Neighborhoods contribute something unique to caregivers' oral health, beyond socioeconomic position and individual risk factors. Multilevel interventions are necessary to reduce disparities among African‐Americans and churches may offer a promising venue from which to conduct them .