Oral Health in Appalachia: Regional, State, Sub-State, and National Comparisons

Abstract

Abstract This study compares oral health measures within Appalachia, Appalachian states, and the rest of the United States to determine which geographic areas experienced the poorest oral health. We aggregated oral health indicators from the Behavioral Risk Factor Surveillance System to estimate prevalence of poor oral health indicators between Appalachian and non-Appalachian regions, as well as metropolitan and non-metropolitan differences within regions. Regional, state, sub-state, and national comparisons of oral health indicators and determinants of health are reported. Central and southern Appalachian regions (based on geographical description, not ARC designation) experienced poorer oral health than northern Appalachia. Mississippi and West Virginia scored especially low in oral health indicators. Oral health indicators were significantly worse in non-metropolitan areas of Appalachian states than in metropolitan areas, and all oral health measures were significantly worse in metropolitan areas of Appalachia than in metropolitan areas across the United States. However, Appalachian non-metropolitan residents were no more or less likely to have had a dental visit than non-metropolitan residents across the United States. It is important to emphasize that not all of Appalachia experiences poor oral health outcomes. While areas of Appalachia had some of the poorest oral health outcomes in the nation, other areas had better outcomes than poor rural areas in other states.