Journal of Urban Health

, Volume 91, Issue 4, pp 809–821 | Cite as

Oral Health among Residents of Publicly Supported Housing in Boston

  • Nancy Irwin Maxwell
  • Snehal Shah
  • Daniel Dooley
  • Michelle Henshaw
  • Deborah J. Bowen


Tooth loss in adults diminishes quality of daily life, affecting eating, speaking, appearance, and social interactions. Tooth loss is linked to severe periodontitis and caries; and to risk of stroke, cardiovascular disease, rheumatoid arthritis, and dementia. At the national (USA) level, poverty and African-American race have been linked to lower utilization of dental services, suggesting that the 7.5 million residents of publicly supported housing may be at risk of tooth loss and poor overall oral health. We assessed whether residence in publicly supported housing in Boston was associated with four oral health-related indicators. Compared to residents of nonpublicly supported housing, after adjusting for covariates residents of both public housing developments (PHDs) and rental assistance units (RAUs) had significantly lower odds of having had a dental cleaning in the past year (PHD, OR = 0.64 (95 % CI, 0.44–0.93); RAU, OR = 0.67 (95 % CI, 0.45–0.99))—despite parity in having had a past year dental visit. Further, residents of RAUs had double the odds of having had six or more teeth removed (OR = 2.20 (95 % CI, 1.39–3.50)). Associations of race/ethnicity and housing type with dental insurance were interrelated. Unadjusted results document a deficit in oral health-related indicators among public housing residents, taken as a group, giving a clear picture of an oral health care gap and identifying a defined real-world population that could benefit from services. Existing public housing infrastructure could provide both a venue and a foundation for interventions to reduce oral health disparities on a broad scale.


Oral health Tooth loss Public housing Behavioral Risk Factor Surveillance System 



This journal article is a product of a Prevention Research Center and was supported by Cooperative Agreement Number 5 U48 DP0019-22 from the Centers for Disease Control and Prevention. The findings and conclusions in this journal article are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention.


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Copyright information

© The New York Academy of Medicine 2013

Authors and Affiliations

  • Nancy Irwin Maxwell
    • 1
  • Snehal Shah
    • 2
  • Daniel Dooley
    • 3
  • Michelle Henshaw
    • 4
  • Deborah J. Bowen
    • 5
  1. 1.Department of Environmental HealthBoston University School of Public HealthBostonUSA
  2. 2.Research and Evaluation Office and Department of PediatricsBoston Public Health Commission and Boston University School of MedicineBostonUSA
  3. 3.Research and Evaluation OfficeBoston Public Health CommissionBostonUSA
  4. 4.Department of Health Policy and Health Services ResearchBoston University Henry M. Goldman School of Dental MedicineBostonUSA
  5. 5.Department of Community Health SciencesBoston University School of Public HealthBostonUSA

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