Caruth School of Dental Hygiene, Texas A&M University College of Dentistry, 3302 Gaston Avenue, Suite 136, Dallas, TX, 75246, USA.
Department of Health Behavior and Health Systems; School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA.
BMC Public Health. 2020 Jan 28;20(1):111. doi: 10.1186/s12889-019-8045-x.
Oral disease is a serious public health issue, and Hispanic children in the United States (US) are more likely than children of other racial/ethnic groups to experience dental caries. Although Hispanic children are a growing segment of the US population there is limited research on the association between acculturation and oral health outcomes in this population. This study examined the associations between household acculturation and pediatric oral health in the Hispanic population using a nationally representative sample of children.
Data from the 2011-2012 National Survey of Children's Health were analyzed; analyses included Hispanic children ages 1 to 17. Household acculturation was assessed with a combination of language and parental nativity, while oral health was assessed via parents'/guardians' reports of children's dental caries. Logistic regression was used to examine the association between acculturation and oral health, adjusting for other demographic and social determinants of pediatric oral health. We assessed significance at the p < 0.05 level, and all analyses accounted for the survey's complex sample design.
Analyses included 9143 Hispanic children. In total, 24.9% (95% CI: 22.9-27.0%) experienced dental caries, and there were significant associations between household acculturation and oral health. In unadjusted analyses, 32.0% (95% CI: 28.9-35.4%) of children in low acculturation households, 20.3% (95% CI: 16.0-25.4%) of children in moderate acculturation households, and 16.9% (95% CI: 14.2-20.0%) of children in high acculturation households experienced dental caries (p < 0.001). In adjusted analyses, children in high acculturation households were significantly less likely than those in low acculturation households to experience dental caries (p < 0.001; OR = 0.50; 95% CI: 0.35-0.70). The difference between children in moderate and low acculturation households approached but did not reach statistical significance (p = 0.057; OR = 0.69; 95% CI: 0.48-1.01).
A dose-response relationship was observed between household acculturation and the oral health of Hispanic children in the US. As acculturation increases, the likelihood of a child experiencing dental caries decreases. These findings suggest that public health and community-based interventions intended to reduce oral health disparities in Hispanic children would likely be most impactful if the acculturation levels of the children's households are considered during program development.
口腔疾病是一个严重的公共卫生问题，与其他种族/族裔群体的儿童相比，美国的西班牙裔儿童更容易出现龋齿。尽管西班牙裔儿童是美国人口增长最快的群体之一，但针对这一人群的文化适应与口腔健康结果之间的关联，研究还很有限。本研究使用全国代表性儿童样本，考察了西班牙裔人群中家庭文化适应与儿科口腔健康之间的关联。
对 2011-2012 年全国儿童健康调查的数据进行了分析；分析包括 1 至 17 岁的西班牙裔儿童。家庭文化适应程度通过语言和父母原籍国的组合进行评估，而口腔健康则通过父母/监护人报告的儿童龋齿情况进行评估。使用逻辑回归检验文化适应与口腔健康之间的关联，同时调整其他儿科口腔健康的人口统计学和社会决定因素。我们在 p<0.05 水平上评估了显著性，并对所有分析均考虑了调查的复杂样本设计。
分析纳入了 9143 名西班牙裔儿童。总体而言，24.9%（95%CI：22.9-27.0%）的儿童患有龋齿，家庭文化适应与口腔健康之间存在显著关联。在未经调整的分析中，低文化适应家庭的儿童中有 32.0%（95%CI：28.9-35.4%），中文化适应家庭的儿童中有 20.3%（95%CI：16.0-25.4%），高文化适应家庭的儿童中有 16.9%（95%CI：14.2-20.0%）患有龋齿（p<0.001）。在调整分析中，与低文化适应家庭的儿童相比，高文化适应家庭的儿童发生龋齿的可能性显著降低（p<0.001；OR=0.50；95%CI：0.35-0.70）。中文化适应家庭的儿童与低文化适应家庭的儿童之间的差异接近但未达到统计学显著性（p=0.057；OR=0.69；95%CI：0.48-1.01）。
观察到家庭文化适应与美国西班牙裔儿童口腔健康之间存在剂量反应关系。随着文化适应程度的提高，儿童发生龋齿的可能性降低。这些发现表明，如果在制定计划时考虑儿童家庭的文化适应程度，旨在减少西班牙裔儿童口腔健康差异的公共卫生和社区为基础的干预措施可能最有影响力。
