Rural and Minority Health Research Center, Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
Department of Stomatology, Division of Population Oral Health, Medical University of South Carolina, Charleston, SC, USA.
J Public Health Dent. 2021 Dec;81(4):251-260. doi: 10.1111/jphd.12444. Epub 2021 Jan 27.
The purpose of our study was to examine the association between rurality and select oral health care metrics: teeth condition, decay, and access measures such as preventive dental care among children in the United States.
We conducted a cross-sectional study with a sample of 20,842 respondents from the 2017 to 2018 National Survey of Children's Health (NSCH), a nationally representative sample of U.S. children. Socio-demographic information, residence, and oral health and healthcare utilization information were used to create study variables. Descriptive statistics, bivariate analyses, and a multivariable regression model were performed.
Rural children were less likely to have a preventive dental visit than urban children (84.9 percent versus 87.5 percent, P = 0.03). Children residing in rural areas were more likely to have their teeth condition reported as fair or poor than children residing in urban areas (7.3 percent versus 6.6 percent, P = 0.02). Compared to their urban counterparts, rural children were also less likely to have received fluoride treatment (46.6 percent versus 52.5 percent, P = 0.0022) and less likely to have received a dental sealant (19.5 percent versus 22.5 percent, P = 0.0147). In adjusted analysis, there was no significant difference in receiving a preventive dental visit for rural children, compared to their urban counterparts.
As preparations are made for the 2020 Surgeon General's report on oral health, the current study provides important evidence to inform future advocacy and legislative priorities. To reduce urban-rural disparities among children, there must be enhanced dental care access, dental workforce expansion, and increased awareness about preventive oral health services.
本研究旨在检验农村和城市儿童在口腔保健指标（牙齿状况、龋齿、预防保健措施）方面的关联。
我们开展了一项横断面研究，使用了来自 2017-2018 年全国儿童健康调查（NSCH）的 20842 名受访者的样本，这是美国儿童的全国代表性样本。使用社会人口统计学信息、居住地、口腔健康和医疗保健使用信息来创建研究变量。进行描述性统计、双变量分析和多变量回归模型分析。
农村儿童接受预防性牙科就诊的可能性低于城市儿童（84.9%比 87.5%，P=0.03）。居住在农村地区的儿童牙齿状况报告为“一般”或“差”的可能性高于居住在城市地区的儿童（7.3%比 6.6%，P=0.02）。与城市儿童相比，农村儿童接受氟化物治疗的可能性也较低（46.6%比 52.5%，P=0.0022），接受牙面封闭的可能性也较低（19.5%比 22.5%，P=0.0147）。在调整分析中，与城市儿童相比，农村儿童接受预防性牙科就诊的可能性没有显著差异。
在为 2020 年卫生总监口腔健康报告做准备时，本研究提供了重要证据，为未来的宣传和立法重点提供了信息。为了减少城乡儿童之间的差异，必须增加牙科保健服务的可及性、扩大牙科劳动力，并提高对预防口腔保健服务的认识。
