Testa Alexander, Mijares Luis, Santos Mateus Renno, Maroufy Vahed, Jackson Dylan B, Samper-Ternent Rafael, Mungia Rahma, Neumann Ana C
Department of Management, Policy and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, United States of America.
Department of Criminology, University of South Florida, Tampa, Florida, United States of America.
PLoS One. 2025 Apr 8;20(4):e0320658. doi: 10.1371/journal.pone.0320658. eCollection 2025.
A growing body of research has documented an association between prior incarceration and lower dental care use, yet the longitudinal impact of prior incarceration on dental care patterns over time among older adults remains unexplored. This study aims to investigate whether prior incarceration is associated with differing trajectories of dental care use among older adults in the United States. Data were drawn from the 2012-2020 waves of the Health and Retirement Study (HRS), a nationally representative longitudinal survey of older adults in the United States (n = 5,893). Group-based trajectory modeling was used to estimate dental care use patterns over time. The findings revealed dental care patterns followed three trajectories: regular dental care use (48.1%), moderate-declining dental care use (27.3%), and low dental care use (24.6%). Multinomial logistic regression was used to examine the relationship between prior incarceration and membership in these trajectory groups. Bivariate analyses revealed that prior incarceration was significantly associated with higher relative risks of being in the moderate-declining (Relative Risk Ratio [RRR] = 2.75, 95% CI = 2.08-3.63) and low dental care use trajectories (RRR = 2.88, 95% CI = 2.10-3.94) compared to the regular dental care use group. After adjusting for sociodemographic, economic, and healthcare-related covariates, formerly incarcerated individuals had a 1.52 times higher relative risk of belonging to the moderate-declining dental care trajectory (RRR = 1.52, 95% CI = 1.16-1.98). The association between prior incarceration and membership in the low dental care trajectory group was not statistically significant. These findings underscore the need for targeted interventions to address dental care disparities among formerly incarcerated individuals, which could lead to improved oral and overall health outcomes for this vulnerable population.
越来越多的研究记录了先前监禁与较低的牙科护理使用率之间的关联，但先前监禁对老年人随时间变化的牙科护理模式的长期影响仍未得到探索。本研究旨在调查先前监禁是否与美国老年人不同的牙科护理使用轨迹相关。数据来自2012 - 2020年健康与退休研究（HRS）的各轮调查，这是一项对美国老年人具有全国代表性的纵向调查（n = 5893）。基于组的轨迹模型用于估计随时间变化的牙科护理使用模式。研究结果显示，牙科护理模式遵循三种轨迹：定期牙科护理使用（48.1%）、中度下降的牙科护理使用（27.3%）和低牙科护理使用（24.6%）。多项逻辑回归用于检验先前监禁与这些轨迹组成员身份之间的关系。双变量分析显示，与定期牙科护理使用组相比，先前监禁与处于中度下降（相对风险比[RRR] = 2.75，95%置信区间 = 2.08 - 3.63）和低牙科护理使用轨迹的较高相对风险显著相关（RRR = 2.88，95%置信区间 = 2.10 - 3.94）。在调整了社会人口统计学、经济和医疗保健相关协变量后，曾被监禁的个体属于中度下降牙科护理轨迹的相对风险高1.52倍（RRR = 1.52，95%置信区间 = 1.16 - 1.98）。先前监禁与低牙科护理轨迹组成员身份之间的关联无统计学意义。这些发现强调了需要有针对性的干预措施来解决曾被监禁个体之间的牙科护理差异，这可能会改善这一弱势群体的口腔和整体健康状况。
