The main aim of this study is to compare the prevalence of diabetes-related complications in white to the prevalence in other racial and ethnic groups in United States using 2009 Behavioral Risk Factor Surveillance System (BRFSS). By constructing the logistic regression model, odds ratios (OR) were calculated to compare the prevalence of diabetes complications in white and other groups. Compared to white, the prevalence of hypertension and stroke in African Americans were higher, while the prevalence of heart attack and coronary heart disease were lower. The Asian Americans or Pacific Islanders, African Americans and Hispanics were more likely to develop retinopathy compared to white. The prevalence of hypertension, hypercholesterolemia, heart attack, coronary heart disease, Stroke in Native Americans and “other” group were not significantly different from the prevalence in white. Asian or Pacific Islanders were less likely to experience stroke.

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.