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Ethnic Disparities in Self-Reported Oral Health Status and Access to Care among Older Adults in NYC

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Abstract

There is a growing burden of oral disease among older adults that is most significantly borne by minorities, the poor, and immigrants. Yet, national attention to oral heath disparities has focused almost exclusively on children, resulting in large gaps in our knowledge about the oral health risks of older adults and their access to care. The projected growth of the minority and immigrant elderly population as a proportion of older adults heightens the urgency of exploring and addressing factors associated with oral health-related disparities. In 2008, the New York City Health Indicators Project (HIP) conducted a survey of a representative sample of 1,870 adults over the age of 60 who attended a random selection of 56 senior centers in New York City. The survey included questions related to oral health status. This study used the HIP database to examine differences in self-reported dental status, dental care utilization, and dental insurance, by race/ethnicity, among community-dwelling older adults. Non-Hispanic White respondents reported better dental health, higher dental care utilization, and higher satisfaction with dental care compared to all other racial/ethnic groups. Among minority older adults, Chinese immigrants were more likely to report poor dental health, were less likely to report dental care utilization and dental insurance, and were less satisfied with their dental care compared to all other racial/ethnic groups. Language fluency was significantly related to access to dental care among Chinese immigrants. Among a diverse community-dwelling population of older adults in New York City, we found significant differences by race/ethnicity in factors related to oral health. Greater attention is needed in enhancing the cultural competency of providers, addressing gaps in oral health literacy, and reducing language barriers that impede access to care.

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Notes

  1. The response rate is calculated in the following manner: \( \left[ {{\hbox{Completed interviews}}/\left( {{\hbox{Completed interviews}} + {\hbox{Incomplete interviews}} + {\hbox{Refused interviews}}} \right)} \right] \times 100 \).

  2. The refusal rate is calculated in the following manner: \( \left[ {{\hbox{Refused interviews}}/\left( {{\hbox{Completed interviews}} + {\hbox{Incomplete interviews}} + {\hbox{Refused Interviews}}} \right)} \right] \times 100 \).

References

  1. National Institute of Dental and Craniofacial Research, US Department of Health and Human Services. Oral Health in America: a Report of the Surgeon General. Rockville, MD: US Public Health Service, Department of Health and Human Services; 2000.

  2. Jones JA, Adelson R, Niessen LC, Gilbert GH. Issues in financing dental care for the elderly. J Public Health Dent. 1990; 50(4): 268–75.

    Article  PubMed  CAS  Google Scholar 

  3. Niessen LC. Extending dental insurance through retirement. Spec Care Dentist. 1984; 4(2): 84–6.

    Article  PubMed  CAS  Google Scholar 

  4. Institute of Medicine. Retooling for an Aging America: building the Health Care Workforce. Washington, DC: The National Academies Press; 2008.

    Google Scholar 

  5. Dolan TA, Atchison K, Huynh TN. Access to dental care among older adults in the United States. J Dent Educ. 2005; 69(9): 961–74.

    PubMed  Google Scholar 

  6. National Center for Health Statistics. Health, United States 2008. Hyattsville, MD. http://www.cdc.gov/nchs/data/hus/hus09.pdf#093. Accessed April 18, 2010.

  7. New York City Department for the Aging. The Older Population in New York City: Changes in Race, Hispanic Origin and Age, 1990 to 2000. http://www.nyc.gov/html/dfta/downloads/pdf/trend_olderpop.pdf. Accessed April 10, 2010.

  8. New York City Center for Economic Opportunity, 2010. http://www.nyc.gov/html/ceo/downloads/pdf/ceo_poverty_measure_v5.pdf. Accessed April 18, 2010.

  9. Gooch BF, Malvitz DM, Griffin SO, Maas WR. Promoting the oral health of older adults through the chronic disease model: CDC’s perspective on what we still need to know. J Dent Educ. 2005; 69(9): 1058–63.

    PubMed  Google Scholar 

  10. Lamster IB. Oral health care services for older adults: a looming crisis. Am J Public Health. 2004; 94(5): 699–702.

    Article  PubMed  Google Scholar 

  11. Kiyak HA, Reichmuth M. Barriers to and enablers of older adults’ use of dental services. J Dent Educ. 2005; 69(9): 975–86.

    PubMed  Google Scholar 

  12. Manski RJ, Goodman HS, Reid BC, Macek MD. Dental insurance visits and expenditures among older adults. Am J Public Health. 2004; 94(5): 759–64.

    Article  PubMed  Google Scholar 

  13. Manski RJ, Macek MD, Moeller JF. Private dental coverage: who has it and how does it influence dental visits and expenditures? J Am Dent Assoc. 2002; 133(11): 1551–9.

    PubMed  Google Scholar 

  14. Garcia RI, Cadoret CA, Henshaw M. Multicultural issues in oral health. Dent Clin North Am. 2008; 52(2): 319–32.

    Article  PubMed  Google Scholar 

  15. Timmins L. The impact of language barriers on the health care of Latinos in the United States: a review of the literature and guidelines for practice. J Midwifery Womens Health. 2002; 47(2): 80–96.

    Article  PubMed  Google Scholar 

  16. Flores G. The impact of medical interpreter services on the quality of health care: a systematic review. Med Care Res Rev. 2005; 62: 255–99.

    Article  PubMed  Google Scholar 

  17. Ku L, Flores G. Pay now or pay later: providing interpreter services in health care. Health Aff. 2005; 24: 435–44.

    Article  Google Scholar 

  18. Pearson WS, Ahluwalia IB, Ford ES, Mokdad AH. Language preference as a predictor of access to and use of healthcare services among Hispanics in the United States. Ethn Dis. 2008; 18(1): 93.

    PubMed  Google Scholar 

  19. Jaramillo F, Eke PI, Thorton-Evans GO, Griffin SO. Acculturation and dental visits among Hispanic adults. Prev Chron Dis. 2009; 6(2).

  20. Mertz E, O’Neil E. The growing challenge of providing oral health care services to all Americans. Health Aff (Millwood). 2002; 21(5): 65–77.

    Article  Google Scholar 

  21. Park DS. Challenges of delivering oral health care to older adults. NY State Dent J. 2009; 75(5): 36–40.

    Google Scholar 

  22. Persson GR, Persson RE, Hollender LG, Kiyak HA. The impact of ethnicity, gender, and marital status on periodontal and systemic health of older subjects in the Trials to Enhance Elders’ Teeth and Oral Health (TEETH). J Periodontol. 2004; 75(6): 817–23.

    Article  PubMed  Google Scholar 

  23. Kiyak HA, Kamoh A, Persson RE, Persson GR. Ethnicity and oral health in community-dwelling older adults. Gen Dent. 2002; 50(6): 513–8.

    PubMed  Google Scholar 

  24. New York State Fee Schedule for Dental Services. http://www.health.state.ny.us/health_care/medicaid/fees/docs/dentalfees03.pdf. Accessed April 8, 2010.

  25. A state of decay: the oral health of older Americans. Chicago, IL: Oral Health America; 2003:1–8.

  26. Manski RJ, Cooper PF. Dental care use: does dental insurance truly make a difference in the US? Community Dent Health. 2007; 24: 205–12.

    PubMed  CAS  Google Scholar 

  27. Pyle MA, Stoller EP. Oral health disparities among the elderly: interdisciplinary challenges for the future. J Dent Educ. 2003; 67(12): 1327–36.

    PubMed  Google Scholar 

  28. Butani Y, Weintraub JA, Barker JC. Oral health-related cultural beliefs for four racial/ethnic groups: assessment of the literature. BMC Oral Health. 2008; 8: 26.

    Article  PubMed  Google Scholar 

  29. Gilbert GH. Racial and socioeconomic disparities in health from population-based research to practice-based research: the example of oral health. J Dent Educ. 2005; 69(9): 1003–14.

    PubMed  Google Scholar 

  30. Marshall S, Northridge ME, De La Cruz LD, Vaughan RD, O’Neil-Dunne J, Lamster IB. ElderSmile: a comprehensive approach to improving oral health for seniors. Am J Public Health. 2009; 99(4): 595–9.

    Article  PubMed  Google Scholar 

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Acknowledgments

This work was supported by the New York City Department for the Aging.

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Authors and Affiliations

  1. New York University College of Dentistry, New York, NY, USA

    Donna Shelley & Stefanie Russell

  2. Brookdale Center for Health Aging and Longevity of Hunter College, New York, NY, USA

    Nina S. Parikh

  3. City University of New York School of Public Health at Hunter College and Graduate Center, New York, NY, USA

    Marianne Fahs

Authors
  1. Donna Shelley
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  2. Stefanie Russell
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  3. Nina S. Parikh
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  4. Marianne Fahs
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Correspondence to Donna Shelley.

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Shelley, D., Russell, S., Parikh, N.S. et al. Ethnic Disparities in Self-Reported Oral Health Status and Access to Care among Older Adults in NYC. J Urban Health 88, 651–662 (2011). https://doi.org/10.1007/s11524-011-9555-8

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