Abstract
BackgroundOral diseases negatively impact general health, affecting physical, psychological, social and emotional wellbeing, and ability to give back to community. The relationship between poor oral health, and general health and wellbeing among Indigenous Australians has not been documented. Working in partnership with seven Indigenous communities in South Australia, this study aimed to: 1) quantify self-rated oral health and health-related quality of life and; 2) investigate associations between poor self-rated oral health and general health among Indigenous Australian adults.MethodsData was collected from a large convenience sample of Indigenous Australians aged 18+ years from Feb 2018 to Jan 2019. General health-related quality of life, as the main outcome variable, was measured by calculating disutility scores with the five individual EQ-5D dimensions (EuroQol instrument: EQ-5D-5L), then classified as ‘no problem’ and ‘at least one problem’. Self-reported oral health, as the main explanatory, was dichotomised into ‘fair or poor’ and ‘excellent, very good or good’. Multivariable log-Poisson regression models were used to estimate associations between poor self-rated oral health and general health by calculating mean rate ratios (MRR) for disutility scores and prevalence ratios (PR) for individual dimensions, after adjusting for social-demographic characteristics and health-related behaviours.ResultsData were available for 1011 Indigenous South Australian adults. The prevalence of ‘fair or poor’ self-rated oral health was 33.5%. The mean utility score was 0.82 (95% CI: 0.81–0.83). Compared with those rating their oral health as ‘excellent or very good or good’, those who rated their oral health as ‘fair or poor’ had a mean disutility score that was 1.6 (95% CI: 1.1–2.2) times higher, and the prevalence of at least one problem ranged from 90 to 160% higher for individual EQ-5D dimensions.ConclusionsFair or poor self-rated oral health among Indigenous persons in South Australia was associated with poor general health as measured by EQ-5D-5L disutility. The relationship was especially evident with respect to mobility, self-care and anxiety/depression. The findings emphasise the importance of oral health as predictors of general health among Indigenous Australians.
Highlights
Oral diseases negatively impact general health, affecting physical, psychological, social and emotional wellbeing, and ability to give back to community
Data were available for 1011 Indigenous South Australians aged 18+ years who completed the self-rated oral health and EQ-5 dimensions (5D)-5L items
Higher disutility scores were observed among those rated their oral health as ‘fair or poor’ (0.25, 95% Confidence intervals (CI): 0.22–0.27), in the older age group (0.26, 95% confidence intervals (95% CI): 0.26–0.29), who relied on welfare for income (0.19, 95%CI: 0.18–0.21), owned a health care card (0.19, 95%CI: 0.18–0.21), were current drug users (0.21, 95% CI: 0.18–0.23), comparing with their counterparts. (Table 1)
Summary
Oral diseases negatively impact general health, affecting physical, psychological, social and emotional wellbeing, and ability to give back to community. The relationship between poor oral health, and general health and wellbeing among Indigenous Australians has not been documented. Working in partnership with seven Indigenous communities in South Australia, this study aimed to: 1) quantify self-rated oral health and health-related quality of life and; 2) investigate associations between poor self-rated oral health and general health among Indigenous Australian adults. Prior to European settlement in the 1780s, the health and wellbeing of Indigenous Australians was characterised by physical strength and agility, diets free of refined carbohydrates, and environmental practises which had been sustained for approximately 65,000 years [2]. The rapid changes in lifestyle and diet, and sustained government policies of assimilation, discrimination and land dispossession, has had grave consequences on the health and wellbeing of contemporary Indigenous Australians [3]. Global self-ratings of oral health provide a useful insight into how patients view their oral health in a holistic sense, one which is unique and distinct from clinical diagnoses [11]
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