Testa Alexander, Mijares Luis, Fu Karyn, Jackson Dylan, Gutierrez Carmen, DeAngelis Reed, Ganson Kyle, Nagata Jason, Mungia Rahma
Department of Management, Policy and Community Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA
Department of Management, Policy and Community Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
J Epidemiol Community Health. 2025 May 9;79(6):404-409. doi: 10.1136/jech-2024-223202.
This study examines the longitudinal patterns of dental care use from adolescence to middle adulthood (ages 11-43) and investigates racial and ethnic disparities in these patterns.
Data from Waves I through V of the National Longitudinal Study of Adolescent to Adult Health (1993-2018; ages 11-43). Semiparametric group-based trajectory model identified distinct dental care use trajectories. Multinomial logistic regression was used to estimate membership in these trajectory groups by race/ethnicity while accounting for covariates, including socioeconomic status, biological sex, nativity and unmet healthcare needs.
The analysis identified four distinct dental care use trajectories (1): Intermittent decreasing dental care use (37.9%), (2) intermittent increasing dental care use (22.5%), (3) high dental care use (22.5%) and (4) low dental care use (17.0%). Non-Hispanic black and Hispanic respondents were more likely than non-Hispanic white respondents to belong to low dental care use and intermittent decreasing dental care use groups relative to high dental care use. Additionally, non-Hispanic black respondents were more likely than non-Hispanic white respondents to belong to the Intermittent Increasing Dental Use group. Higher socioeconomic status was inversely associated with low and intermittent use group membership. Males and those with unmet healthcare needs at Wave I were also more likely to belong to trajectories with low and intermittent dental care use.
Findings reveal persistent racial disparities in dental care use from adolescence into adulthood. Further research is needed to understand the individual and structural factors perpetuating racial disparities in dental care use over the life course.
本研究考察了从青春期到中年（11 - 43岁）期间牙科护理使用的纵向模式，并调查了这些模式中的种族和民族差异。
来自青少年到成人健康全国纵向研究第一波至第五波的数据（1993 - 2018年；11 - 43岁）。基于半参数分组的轨迹模型确定了不同的牙科护理使用轨迹。多项逻辑回归用于估计按种族/民族划分的这些轨迹组的成员资格，同时考虑协变量，包括社会经济地位、生物性别、出生地和未满足的医疗保健需求。
分析确定了四种不同的牙科护理使用轨迹：（1）间歇性减少牙科护理使用（37.9%），（2）间歇性增加牙科护理使用（22.5%），（3）高牙科护理使用（22.5%）和（4）低牙科护理使用（17.0%）。与高牙科护理使用组相比，非西班牙裔黑人和西班牙裔受访者比非西班牙裔白人受访者更有可能属于低牙科护理使用组和间歇性减少牙科护理使用组。此外，非西班牙裔黑人受访者比非西班牙裔白人受访者更有可能属于间歇性增加牙科护理使用组。较高的社会经济地位与低使用组和间歇性使用组成员资格呈负相关。在第一波中，男性和有未满足医疗保健需求的人也更有可能属于牙科护理使用低和间歇性的轨迹组。
研究结果揭示了从青春期到成年期牙科护理使用中持续存在的种族差异。需要进一步研究以了解在整个生命过程中使牙科护理使用中的种族差异持续存在的个体和结构因素。
