scholarly journals Education-Related Inequalities in Dental Services Use among Older Adults in 23 Countries

2020 ◽  
Vol 99 (12) ◽  
pp. 1341-1347
Author(s):  
F. Bof de Andrade ◽  
J.L.F. Antunes ◽  
F.C.D. Andrade ◽  
M.F.F. Lima-Costa ◽  
J. Macinko

This study aimed to measure the magnitude of education-related inequalities in the use of dental services among older adults (aged 50 y or older) from a sizable multicountry sample of 23 upper-middle- and high-income countries. This study used cross-sectional data from nationally representative surveys of people aged 50 y and over. Countries included in the Health and Retirement Study surveys were the following: Brazil, China, South Korea, Mexico, United States, Austria, Belgium, Croatia, Czech Republic, Denmark, Estonia, France, Germany, Greece, Italy, Israel, Luxembourg, Poland, Portugal, Slovenia, Spain, Sweden, and Switzerland. The dependent variable was the use of dental services, based on the self-report of having had a dental visit within the previous year, except for the United States and South Korea, which used 2-y recall periods. Educational level was used as the measure of socioeconomic position and was standardized across countries. Multivariate logistic regression modeling was used to evaluate the factors associated with the use of dental services, and the magnitude of education inequalities in the use of dental services was assessed using the slope index of inequality (SII) to measure absolute inequalities and the relative index of inequality for relative inequalities. The pooled prevalence of the use of dental services was 31.7% and ranged from 18.7% in China to 81.2% in Sweden. In the overall sample, the absolute difference in the prevalence of use between the lowest and highest educational groups was 20 percentage points. SII was significant for all countries except Portugal. Relative educational inequalities were significant for all countries and ranged from 3.2 in Poland to 1.2 in Sweden. There were significant education-related inequalities in the use of dental care by older adults in all countries. Monitoring these inequalities is critical to the planning and delivery of dental services.

Author(s):  
J.J. Aziz ◽  
K.F. Reid ◽  
J.A. Batsis ◽  
R.A. Fielding

Background: Older adults living in rural areas suffer from health inequities compared to their urban counterparts. These include comorbidity burden, poor diet, and physical inactivity, which are also risk factors for sarcopenia, for which muscle weakness and slow gait speed are domains. To date, no study has examined urban-rural differences in the prevalence of muscle weakness and slow gait speed in older adults living in the United States. Objective: To compare the prevalence of grip strength weakness and slow gait speed between urban and rural older adults living in the United States. Design: A cross-sectional, secondary data analysis of two cohorts from the National Health and Nutrition Examination Survey (NHANES), using gait speed or grip strength data, and urban-rural residency, dietary, examination, questionnaire and demographic data. Participants: 2,923 adults (≥ 60 yrs.). Measures: Grip weakness was defined as either, an absolute grip strength of <35 kg. and <20 kg. or grip strength divided by body mass index (GripBMI) of <1.05 and <0.79 for men and women, respectively. Slow gait speed was defined as a usual gait speed of ≤0.8m/s. Results: The prevalence of GripBMI weakness was significantly higher in urban compared to rural participants (27.4% vs. 19.2%; p=0.001), whereas their absolute grip strength was lower (31.75(±0.45) vs. 33.73(±0.48)). No urban-rural differences in gait speed were observed. Conclusions: Older adults residing in urban regions of the United States were weaker compared to their rural counterparts. This report is the first to describe urban-rural differences in handgrip strength and slow gait speed in older adults living in the United States.


2017 ◽  
Vol 15 (1) ◽  
pp. 51-55 ◽  
Author(s):  
Amanda Harrawood ◽  
Nicole R. Fowler ◽  
Anthony J. Perkins ◽  
Michael A. LaMantia ◽  
Malaz A. Boustani

Objectives: To measure older adults acceptability of dementia screening and assess screening test results of a racially diverse sample of older primary care patients in the United States. Design: Cross-sectional study of primary care patients aged 65 and older. Setting: Urban and suburban primary care clinics in Indianapolis, Indiana, in 2008 to 2009. Participants: Nine hundred fifty-four primary care patients without a documented diagnosis of dementia. Measurements: Community Screening Instrument for Dementia, the Mini-Mental State Examination, and the Telephone Instrument for Cognitive Screening. Results: Of the 954 study participants who consented to participate, 748 agreed to be screened for dementia and 206 refused screening. The overall response rate was 78.4%. The positive screen rate of the sample who agreed to screening was 10.2%. After adjusting for demographic differences the following characteristics were still associated with increased likelihood of screening positive for dementia: age, male sex, and lower education. Patients who believed that they had more memory problems than other people of their age were also more likely to screen positive for dementia. Conclusion: Age and perceived problems with memory are associated with screening positive for dementia in primary care.


2016 ◽  
Vol 37 (1) ◽  
pp. 79-98 ◽  
Author(s):  
Tiffany E. Shubert ◽  
Matthew Lee Smith ◽  
Luohua Jiang ◽  
Marcia G. Ory

The Otago Exercise Program (OEP) is an evidence-based fall prevention program disseminated internationally. Little is known about the implementation or effectiveness of the OEP in the United States. The purposes were to (a) identify characteristics of older adults enrolled in OEP, and (b) examine perceived and actual functional performance changes after participation in 8 weeks of the program. Baseline and 8-week functional and self-report data were collected on 210 older adults from 2013 to 2015. Linear mixed models and general estimating equations logistic regression models adjusted for socio-demographic factors were performed to assess changes. At 8 weeks, scores dramatically improved on self-report and physical performance tests: Timed Up-and-Go ( p < .001), 30-Second Chair Rise ( p < .001), and Four-Stage Balance ( p < .001). Findings support that participation in the U.S. OEP as part of a plan of care can result in significant improvements in objective functional mobility, balance measures, and self-reported ability.


2018 ◽  
Vol 34 (10) ◽  
Author(s):  
Fabiola Bof de Andrade ◽  
Jose Leopoldo Ferreira Antunes

The objective of this research was to evaluate trends in socioeconomic inequalities in the prevalence of functional dentition among community-dwelling older adults in Brazil. This was a cross-sectional study with data from the last two SBBrasil Project surveys conducted in 2003 and 2010. Functional dentition was defined as the presence of 20 or more natural teeth and was assessed during the clinical examination of dentition status. Schooling was used as the socioeconomic position measure. Socioeconomic inequality was measured using two complex measures; the slope index of inequality (SII) and the relative index of inequality (RII). The prevalence of functional dentition was 10.8% (95%CI: 8.1-14.2) in 2003 and 13.6% (95%CI: 11.1-16.5) in 2010. The prevalence of functional dentition increased significantly over the educational rank in both years. Absolute inequalities were significant for both years and remained unaltered between 2003 and 2010. Significant relative inequality in the prevalence of functional dentition was found in both years of the survey. Socioeconomic inequalities in the prevalence of functional dentition among older adults in Brazil persisted significantly between both national oral health surveys.


2021 ◽  
pp. 019459982110621
Author(s):  
Alexander S. Kim ◽  
Joshua F. Betz ◽  
Nicholas S. Reed ◽  
Bryan K. Ward ◽  
Carrie L. Nieman

Tympanic membrane (TM) perforations can occur at any age, but limited population-level data are available. Using data from the National Health and Nutrition Examination Survey, we performed a cross-sectional analysis of the prevalence and population estimates for TM perforations among individuals ≥12 years old in the United States. Overall, TM perforations have a prevalence of 2.1% (95% CI, 1.7%-2.6%), corresponding to 5.8 million Americans. Across the life course, older adults have the highest prevalence of TM perforations at 6.1% (95% CI, 4.7%-7.6%), corresponding to nearly 3 million Americans, as opposed to a prevalence of 0.6% (95% CI, 0.3%-0.9%) in adolescents, which equates to 0.2 million Americans. Males and females have a similar prevalence at 2.3% (95% CI, 1.6%-3.0%) among males and 2.0% (95% CI, 1.4%-2.6%) among females. These prevalence and population estimates provide the first US-based population estimates of the burden of TM perforations over the life course.


2008 ◽  
Vol 22 (4) ◽  
pp. 256-263 ◽  
Author(s):  
Kenneth Jacob Steinman ◽  
Athe Bambakidis

Purpose. Estimate the prevalence of and identify characteristics associated with religious congregations' collaboration with health agencies. Design. Cross-sectional analyses of self-report data from the National Congregations Study, a random sample of religious congregations generated from the 1998 General Social Survey. Setting. United States. Subjects. Key informants from 1236 congregations. Each respondent described a single congregation. Measures. Respondents provided open-ended descriptions of congregational programs. Researchers coded program descriptions by content (e.g., domestic violence) and whether the program involved collaboration with a secular agency. Other congregational characteristics (e.g., denomination) were measured by validated measures and linked census tract data. Results. Overall, 11.1% of congregations participated in faith-health collaboration (FHC). Logistic regression analyses found that FHC was more common among congregations with more members, with a small proportion of congregants under 35 years, and with a senior pastor with a graduate degree. Other effects were conditional; for instance, denominational differences varied depending on urban/suburban/rural location and the proportion of low-income members. Conclusion. This study provides the first national estimates of the prevalence of FHC. Such collaborative efforts may require different approaches in different areas. These results can help practitioners identify congregations that may be more willing to collaborate.


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