Ghaffari Affan, Graves Katelyn Y, Bradbury Russell F, Harman Jeffrey S
Florida State University College of Medicine, Tallahassee, Florida, USA.
J Rural Health. 2025 Mar;41(2):e70022. doi: 10.1111/jrh.70022.
To determine the extent to which there were disparities in access to recommended preventive oral services between US-based children living in rural versus urban areas.
The study used cross-sectional, parent-reported National Survey of Children's Health data from 2022, which is the most current year of publicly available data when analyses were performed. Inclusion criteria included all children from the ages of 2 through 17. The US Census Bureau definition of rural was used to guide the analyses. Survey procedures within Stata were used to build the multiple regression models. To test the association between the main predictor variable (i.e., rural-urban designation) and outcome variable (i.e., percentage of those receiving five recommended preventive dental services), five sets of multiple logistic regressions were used, which controlled for the effects of all the other covariates. The STROBE checklist for cross-sectional studies was used for reporting purposes in this manuscript.
Controlling for the effects of covariates, there was no association of living in an urban area (as opposed to a rural area) and children receiving any of the five recommended services, including comprehensive oral examination, prophylaxis, sealants, radiographs, and fluoride treatments (p > 0.01).
Our study demonstrated the lack of disparities in utilization of preventive dental procedures among US-based children, which may be attributable to factors such as innovative service delivery models integrating telehealth and community-based management in rural communities, COVID-19, and public insurance expansion. Future studies should be conducted to track whether the trend of eroding disparities remains consistent.
确定居住在美国农村和城市地区的儿童在获得推荐的预防性口腔服务方面的差异程度。
该研究使用了2022年横断面的、家长报告的全国儿童健康调查数据，这是进行分析时可公开获取数据的最新年份。纳入标准包括所有2至17岁的儿童。美国人口普查局对农村的定义用于指导分析。在Stata软件中使用调查程序构建多元回归模型。为了检验主要预测变量（即城乡划分）与结果变量（即接受五项推荐预防性牙科服务的儿童百分比）之间的关联，使用了五组多元逻辑回归，以控制所有其他协变量的影响。本手稿使用横断面研究的STROBE清单进行报告。
在控制协变量的影响后，居住在城市地区（与农村地区相对）与儿童接受五项推荐服务中的任何一项之间没有关联，这五项服务包括全面口腔检查、预防治疗、窝沟封闭、X光检查和氟化物治疗（p>0.01）。
我们的研究表明，美国儿童在预防性牙科程序的使用上不存在差异，这可能归因于多种因素，如农村社区整合远程医疗和社区管理的创新服务提供模式、新冠疫情以及公共保险的扩大。未来应开展研究，以追踪差距缩小的趋势是否持续一致。
