Background: Oral health disparities exist in the USA. However, little is known of the relationship between oral health disparity and citizenship. The aims of this study were: (i) to describe the differences in self-rated oral health (SROH) between adult American citizens and non-citizens (>20 years of age); and (ii) to test whether factors such as frequency of dentist visits and socio-economic status (SES) are differently associated with SROH in these two groups. Methods: The data used in this study were drawn from the National Health and Nutrition Examination Survey conducted in 2011–2012. Weighted logistic regression models were used to detect the strengths of the association between a series of predictors and SROH. Results: More non-citizens (59.54%) than their citizen peers (26.24%) rated their oral health as fair/bad. All factors analysed in this study were differently associated with SROH based on citizenship. More specifically, natural characteristics, such as ethnicity and age, were significantly associated with SROH among non-citizens, and SES was significantly associated with American citizens. Among non-citizens, Hispanic, Non-Hispanic Black and Asian subjects were more likely than Non-Hispanic White subjects to report their oral health as being ‘good’. Family poverty level, education and the frequency of dentist visits were significantly associated with SROH among citizens. Conclusion: The findings of this study indicate that American immigrants report their oral health across most dimensions as being worse than do American citizens. Each explanatory factor may have a different strength of association with SROH in immigrants and citizens, which implies that different steps should be taken within these groups to reduce disparities in oral health.

Background : Studies of self-rated oral health are always done at either the individual level or the aggregate level. Partitioning individual and neighbourhood sources of variation also enables explorations of the influences of people’s social context on their self-rated oral health. Objective : The main objective of the study was to examine the influence of the social context in which people live on their self-rating of their oral health, independent of individual indicators of good oral health. Method : This study used a secondary analysis of data on a nationally representative sample of 2 907 South African adults (aged ≥ 16 years) who had participated in the 2007 annual South African Social Attitude Survey (SASAS). The 2007 SASAS used a multi-stage probability sampling strategy, with census enumeration areas as the primary sampling unit. Using an interviewer-administered questionnaire, the information obtained included socio-demographic data, the respondents’ level of trust in people (a proxy measure for social capital), oral health behaviours and self-rated oral health. Using the 2005 General Household Survey (GHS) (persons’ n=107 987; households’ n=28 129), the living environment characteristics of participants of the SASAS were obtained, including sources of water and energy supply and household cell phone ownership as a proxy measure for social networking. A mixed-effects model was then constructed to determine factors associated with a self-rating of oral health as ‘very good/good’. Results : Of the respondents, 51.7% were female. Among the respondents, 76.3% self-rated their oral health as good. There was a significant gender modifying effect, thus analyses was stratified by gender. The odds of self-rating oral health as good was significantly higher only among females living in areas with higher household cell phone ownership density, even after controlling for potential confounders. At the individual level, trust was positively associated with good self-rated oral health only among males, and higher social ranking in the society was positively associated with good self-rated oral health only among females. Overall, 55% of the total variance in self-rated oral health was explained by factors operating at the individual level, whereas 18% of the total variance was explained by factors operating at the community level. Self-report of recent oral health problems such as toothache and oral malodour were significantly associated with lower odds of self-rating their oral health as good, as was with reporting less frequent brushing. Conclusion : Good self-rated oral health may be positively associated with indicators of higher levels of social capital both at the level of the individual and the community and with less physical impairments of oral functioning. Furthermore, the findings indicate that unlike men’s oral health ratings, women’s oral health ratings are more likely to be influenced by women’s social relationships with others in the society. Copyright / Dissertation (MSc)--University of Pretoria, 2011. / School of Health Systems and Public Health (SHSPH) / Unrestricted

Indiana University-Purdue University Indianapolis (IUPUI) / Although complex phenomena such as oral diseases can be studied using generalizable conceptual frameworks, the differences in the underlying influences across countries necessitate adaptation of existing oral health frameworks to the specific conditions in each country. The aim of this dissertation was to investigate distal (indirect) and proximal (direct) influences of oral health and their interactions with both self-reported oral pain (OP) and self-rated oral health status (SROH) in Saudi Arabia (SA). Two secondary data analyses were conducted utilizing data from the national demographic and health survey (DHS) of SA in 2017. The objective of the first study was to describe the study design, and the distal and proximal influences reported in the 2017 SA DHS. The objective of second study was to explore associations between proximal and distal factors that affect OP and SROH, using the adapted framework. Path analysis modeling was used to estimate direct, indirect, and total effects. The 2017 SA DHS used an innovative multistage stratified random-sampling technique to select the population sample by using primary health care centers’ catchment areas as the primary sampling unit. The final analysis included 29,274 adults, 9910 adolescents, and 11653 children. OP in the past year was experienced in 39% in children and, 48.5% for the adolescents, and 47.1% in adults. The proportion of respondents who reported good, very good, or excellent self-rated oral health status was 92.9 % in children, 87.1% in both adolescents and adults. In children group, OP was linked to less tooth brushing, more dental visits and less dental routine examination, while less favorable SROH was linked to less tooth brushing, more dental visits and sweets consumption. In adolescents and adults groups, OP and less favorable SROH were linked to more dental visits, complaint dental visits, less tooth brushing. Many distal influences showed significant effects (direct, indirect, and total) on OP and SROH; however, differences existed among the three age groups. The studies suggest that future investigations should focus on why Saudi residents perceive their oral health positively while the prevalence of negative oral health influences and OP was high.

Orientador: Anita Liberalesso Neri / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-16T19:36:47Z (GMT). No. of bitstreams: 1 White_HarrietJane_M.pdf: 1085400 bytes, checksum: e369eff02a7b34fb4c09790e4f1664ff (MD5) Previous issue date: 2010 / Resumo: Objetivos: investigar relações entre estado nutricional indicado pelo IMC, perda de peso não-intencional, condições funcionais para a alimentação e autoavaliações de saúde bucal e de saúde global em mulheres e homens idosos recrutados na comunidade. Métodos: participaram 689 idosos (470 mulheres; 65 a 90 anos, M = 72,28 + 5,40; renda familiar mensal de < 1 > 10 salários mínimos, M = 4,72 + 5,27), selecionados da amostra probabilística do Estudo FIBRA Campinas. Foram feitas medidas de peso, altura e IMC e aplicadas questões de autorrelato para medida das demais variáveis. Resultados: Vinte e oito por cento pontuaram para obesidade, 14,39% para pré-obesidade e 14,83% para baixo peso; 24,86% tinham perdido peso no ano anterior; 30% da amostra tinham problemas de mastigação; 20% tinham pelo menos 3 problemas funcionais para alimentação; 72,41% pontuaram alto em autoavaliação da saúde bucal, 58,86% em autoavaliação da saúde global. Mais mulheres e mais idosos de 65 a 74 anos pontuaram para obesidade; mais idosos de baixa renda perderam peso e tinham problemas funcionais para a alimentação. Piores condições funcionais para a alimentação e renda inferior a 5 SM mostraram-se fortemente associados com autoavaliações negativas de saúde bucal e de saúde global, sendo esta mais afetada do que a primeira. Conclusão: Autoavaliações negativas de saúde tendem a associar-se com autocuidado deficitário, que pode agravar os problemas de mastigação, deglutição e paladar e as comorbidades provavelmente associadas. A pobreza potencializa esses prejuízos, por relacionar-se com problemas de acesso e de qualidade dos serviços de saúde. / Abstract: Objectives: to investigate the relation between nutritional status indicated by BMI, unintentional weight loss, functional conditions of feeding and self-rated oral health and global health in elderly women and men recruited in the community. Methods: 689 elderly participated (470 women; 65 -90 years old, M = 72,28 + 5,40; familiar monthly income from < 1 > 10 minimum wages, M = 4,72 + 5,27), selected from a random sample of Study FIBRA-Campinas about frailty. It was taken weight measurements, height and BMC and applied questions of self report to measure the rest of the variables. Results: Twenty-eight percent scored for obesity, 14,39% for pre-obesity and 14,83% for low weight; 24,86% had lost weight last year; chewing problems were the most frequent (30% of the samples); 20% had at least 3 functional problems for feeding; 72,41% showed high score of self-rated oral health, 58,86% in global health. More women and elderly from 65 to 74 years old scored obesity; more elderly with low incomes lost weight and had functional problems for feeding. The worst functional conditions for feeding and incomes below 5 minimum salaries were strongly associated with negative self-rated oral health and global health, and the last one being more affected than the first one. Conclusion: Negative self-assessments of health tends to associate to low self-care, that can aggravate chewing problems, taste and swallowing, and the probably comorbidities associated. The poverty powers the damage, because it has relations with access problems and health quality services. / Mestrado / Mestre em Gerontologia