Do Socioeconomic Conditions Explain Ethnic Inequalities in Tooth Loss among US Adults?

Abstract

To assess whether there are ethnic differences in tooth loss among adult Americans aged <40 years and whether socioeconomic position attenuates these differences if they exist. Data were from the 2014 Behavioral Risk Factor Surveillance System, a health-related telephone cross-sectional survey of a nationally representative sample of US adults. Tooth loss (one tooth or more) was used as the outcome variable. Ethnicity was the main explanatory variable. Family income, education and health insurance were also used in the analysis. Logistic regression models for tooth loss were constructed adjusting for demographic (age, sex, and ethnicity), socioeconomic indicators (income and education), health insurance, dental visits, smoking and diabetes. A total of 76,273 participants were included in the analysis. The prevalence of tooth loss was highest among Blacks (33.7%). Hispanics and other ethnic groups had a higher prevalence of tooth loss than Whites, 29.1% (95%CI: 27.7-30.6), 22.0% (95%CI: 20.3-23.8), and 20.8% (95%CI: 20.2-21.4), respectively. Blacks had odds ratios (OR) 1.98 (95%CI: 1.81-2.16) for tooth loss compared with Whites. After adjusting for socioeconomic positions (SEP), the relationship attenuated but remained significant with OR 1.71 (95%CI: 1.55-1.90). Despite recent changes in the health care system in the United States, ethnic inequalities in tooth loss still exist. Income and education partially explained ethnic differences in tooth loss among Americans aged <40 years.