CareQuest Institute for Oral Health, 465 Medford St, Ste 500, Boston, MA 02129 (
CareQuest Institute for Oral Health, Boston, Massachusetts.
Prev Chronic Dis. 2024 Oct 3;21:E76. doi: 10.5888/pcd21.240097.
Mental health conditions and poor oral health outcomes share bidirectional links, and both are linked to factors related to socioeconomic position (SEP). We used nationally representative survey data to describe the complex interplay of SEP, mental health, oral health behaviors, dental treatment seeking, and oral health.
We used data from the 2022 State of Oral Health Equity in America survey, which collects data from US adults on prior depression diagnosis and current depressive symptoms via the Patient Health Questionnaire-9 and demographic characteristics (age, sex/gender, race, ethnicity), SEP (education, income, employment, home ownership, dental insurance), oral health behaviors (brushing and flossing frequency), dental treatment seeking (time since last visit, plans for visit in the coming year), and self-rated oral health (feeling self-conscious due to poor oral health, having symptoms of poor oral health). We used structural equation modeling to identify latent variables and fit the path analytic models.
In the total sample (N = 5,682), SEP was significantly associated with dental treatment seeking (standardized parameter estimate [SE] = 0.55 [0.05]), oral health behaviors (standardized parameter estimate [SE] = 0.34 [0.04]), and mental health (standardized parameter estimate [SE] = 0.59 [0.05]). These factors, in turn, were significantly associated with self-rated oral health (estimates ranging from 0.20 to 0.54, SEs ranging from 0.04 to 0.05).
SEP, which involves several major social determinants of health, is directly associated with mental health and indirectly associated with self-rated oral health status, with mental health modifying the relationship between SEP and self-rated oral health. Findings emphasize the need to integrate medical, dental, and behavioral health with the goal of providing comprehensive person-centered care.
心理健康状况和口腔健康不良结局之间存在双向关联，两者都与社会经济地位（SEP）相关因素有关。我们使用具有全国代表性的调查数据来描述 SEP、心理健康、口腔健康行为、寻求牙科治疗和口腔健康之间的复杂相互作用。
我们使用了 2022 年美国口腔健康公平状况调查的数据，该调查通过患者健康问卷-9 收集了美国成年人的先前抑郁诊断和当前抑郁症状的数据，以及人口统计学特征（年龄、性别/性别、种族、族裔）、SEP（教育、收入、就业、房屋所有权、牙科保险）、口腔健康行为（刷牙和使用牙线的频率）、寻求牙科治疗（上次就诊后的时间、未来一年就诊计划）和自我评估的口腔健康（因口腔健康不佳而感到自我意识、有口腔健康不佳的症状）。我们使用结构方程模型来识别潜在变量并拟合路径分析模型。
在总样本（N=5682）中，SEP 与牙科治疗寻求（标准化参数估计[SE]=0.55[0.05]）、口腔健康行为（标准化参数估计[SE]=0.34[0.04]）和心理健康（标准化参数估计[SE]=0.59[0.05]）显著相关。这些因素反过来又与自我评估的口腔健康显著相关（估计值范围从 0.20 到 0.54，SE 范围从 0.04 到 0.05）。
SEP 涉及几个主要的健康决定因素，它与心理健康直接相关，与自我评估的口腔健康状况间接相关，而心理健康则改变了 SEP 与自我评估的口腔健康之间的关系。这些发现强调需要将医疗、牙科和行为健康相结合，以提供全面的以人为本的护理。
