Self-rated general and oral health in New York City adults: assessing the effect of individual and neighborhood social factors

Abstract

This study investigates the independent and joint effects of individual and neighborhood socioeconomic characteristics on self-rated general and oral health before and after controlling for selected characteristics in adults aged 18 years and older in New York City. Data for 1168 individuals who participated in the 2004 Social Indicators Survey were linked to neighborhood data from the 2000 US Census. Log-binomial regression models fitted using generalized estimating equations were used to calculate prevalence ratios (PR) and 95% confidence intervals (CI). sudaan was used to accommodate the complex sampling design of the survey and the intra-neighborhood correlation of outcomes of individuals residing within the same neighborhoods. After adjusting for selected characteristics, survey participants with 12 years of education or less were almost twice more likely to rate their general health as fair/poor than counterparts with more than 12 years of education [PRs 1.86 (95%CI: 1.16, 3.00) and 1.82 (95%CI: 1.18, 2.82)]. Participants earning <$20,000 (PR: 2.29; 95%CI: 1.23, 4.29) or between $20,000 to $39,999 yearly (PR: 2.24; 95%CI: 1.11, 4.53) were more than twice as likely to rate their general health as fair/poor compared to their counterparts earning over $40,000 yearly. When compared to participants with more than 12 years of education and those reporting an annual income ≥$40,000, the probability of rating oral health as fair/poor was at least 50% greater in participants with <12 years of education (PR: 1.58; 95%CI: 1.11, 2.26) and in participants earning an annual income of <$20,000 (PR: 1.55; 95%CI: 1.10, 2.19). No association was found between neighborhood characteristics for either self-rated general or oral health. Individual socioeconomic characteristics may be important for both self-rated general and oral health by affecting individuals' behaviors and access to resources.