Exploring the complex relationships between health behaviors, health outcomes, social vulnerability, regional cultures, and oral health.

Colin Woodard, Nicolaas P Pronk, Ross Arena, D Brad Rindal

Journal: Current problems in cardiology 2024;49(12):102835

PMID: 39251118

Full Text on Elsevier Science View on PubMed

Abstract

OBJECTIVES

Health and social factors show large heterogeneity across regional cultural geographies and influence oral health as well. The purpose of this study is to confirm associations between county-level general health, behaviors, social factors, and oral health indicators and to further analyze the patterns of distribution of oral health indicators across dominant regional cultures in the United States (US) as defined by the American Nations model.

METHODS

We calculated a Lifestyle Health Index (LHI) from the 2023 PLACES database using county-level, age-adjusted health data and merged it with (a) 2020 Social Vulnerability Index (SVI) database, (b) dominant regional cultures from Nationhood Lab's American Nations model, (c) dentist visits and teeth lost data from the 2023 PLACES database, and (d) access to dentistry data from the County Health Rankings database.

RESULTS

Correlation coefficients between the LHI (and sub scores), SVI (and sub scores), and dental variables showed strong associations. ANOVA post-hoc test results revealed significant differences for dental visits and teeth lost for LHI, SVI and access to dentists. Prevalence of dental visits and teeth lost showed clear heterogeneity across regional cultures.

CONCLUSIONS

Oral health is strongly linked to lifestyle health factors, social vulnerability, access to dentistry, and cultural norms and belief systems. Within the US, significant heterogeneity exists in the distribution of oral health indicators across dominant regional cultural geographies. Oral health communications and policy solutions focused on health-related behaviors (e.g., tobacco, diet), disease-specific considerations (e.g., diabetes), and the social environment (e.g., poverty, housing) should be tailored to regional cultures rather than a single US-based culture to improve dental care and oral health outcomes.

Address: HealthPartners Institute, Minneapolis, MN 55425, USA; Department of Health Policy and Management, University of Minnesota, Minneapolis, MN 55455, USA; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL 60607, USA. Electronic address: [email protected].; Nationhood Lab, Pell Center for International Relations and Public Policy, Salve Regina University, Newport, RI 02840, USA. Electronic address: [email protected].; HealthPartners Institute, Minneapolis, MN 55425, USA; Center for Oral Health Integration, HealthPartners Institute, Minneapolis, MN 55425, USA. Electronic address: [email protected].; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL 60607, USA; Department of Physical Therapy, College of Applied Science, University of Illinois, Chicago, IL 60607, USA. Electronic address: [email protected].

DOI: 10.1016/j.cpcardiol.2024.102835

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MeSH Terms: Humans, Oral Health, Health Behavior, United States, Vulnerable Populations, Life Style