Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai'i, 677 Ala Moana Blvd, 1016-B, Honolulu, HI 96816. Email:
Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawai'i.
Prev Chronic Dis. 2017 Nov 16;14:E115. doi: 10.5888/pcd14.170214.
Tooth preservation in adults and children is one of the Healthy People 2020 goals for oral health. Although the overall prevalence of tooth loss has been declining in the United States, substantial racial/ethnic differences in preventable tooth loss persist as a public health problem. We examined the strength of the association of health risk factors and tooth loss in Hawai'i.
We used data from the Hawai'i Behavioral Risk Factor Surveillance System survey collected from 2011 through 2014. Participant responses were included if they self-identified as Native Hawaiian, white, Japanese, or Filipino. Differences in excess tooth loss (6 or more teeth) and known risk factors (demographics, diabetes, and dental visits) were analyzed by using univariate analyses and adjusted stepwise, logistic regression models.
We identified oral health inequity among the 4 ethnic groups studied; among the groups, Native Hawaiians had the largest proportion of excess tooth loss. The univariate analyses found differences in the strength of these associations among the 4 racial/ethnic groups. The stepwise analyses found that the associations of excess tooth loss and race/ethnicity were not significant after adjusting for demographics, diabetes status, and dental visits.
Findings suggest a need for programs and policies that improve access to oral health care in Hawai'i for those with low levels of income and education and those with diabetes.
保护成年人和儿童的牙齿是 2020 年“健康人民”口腔健康目标之一。尽管美国的整体失牙率一直在下降,但作为一个公共卫生问题,可预防的失牙在不同种族/民族之间仍存在着巨大差异。我们研究了夏威夷健康风险因素与失牙之间的关联强度。
我们使用了 2011 年至 2014 年期间收集的夏威夷行为风险因素监测系统调查的数据。如果参与者自我认定为夏威夷原住民、白种人、日本人或菲律宾人,则将其纳入研究。通过单变量分析和调整逐步逻辑回归模型,分析了多余牙齿缺失(6 颗或更多牙齿)和已知风险因素(人口统计学、糖尿病和牙科就诊情况)的差异。
我们发现了 4 个研究种族/民族群体之间的口腔健康不平等现象;在这些群体中,夏威夷原住民的多余牙齿缺失比例最大。单变量分析发现,在这 4 个种族/民族群体中,这些关联的强度存在差异。逐步分析发现,在调整人口统计学、糖尿病状况和牙科就诊情况后,多余牙齿缺失与种族/民族之间的关联不再显著。
研究结果表明,夏威夷需要制定计划和政策,为收入和教育水平较低以及患有糖尿病的人提供更多的口腔保健服务。