One of the primary goals of Healthy People 2010 is to eliminate health disparities among different segments of the population, with substantial emphasis given to disparities associated with race and ethnicity. The recent, first-ever Surgeon General's Report on Oral Health addresses the inequities and disparities among those least able to achieve optimal oral health, and relates the consequences as leading to needless pain and suffering. Studies show that pain is the most commonly reported impact of oral disease and is more strongly associated with perceived need for care, actual dental care, and diminished quality of life than other subjective signs or symptoms. We have conducted community-based studies that provide evidence that US minority adults are at increased risk for orofacial pain and are less likely to use oral health services in response to pain. However, there is little known about the interplay between race and ethnicity with individual, social, and economic characteristics as determinants of taking therapeutic action for orofacial pain. This project proposes to examine common and unique mechanisms underlying decisions to seek care or self-manage orofacial pain with a sampling strategy that will allow for comparisons among race and ethnic subgroups. Along with African- Americans, we have targeted Hispanic adults, a group that is particularly understudied regarding painful oral symptoms, given that they represent the fastest growing ethnic group in America.
The aims of this study are to test hypothesis regarding: 1) Differences in the action taken to manage orofacial pain between minority Americans and non-Hispanic Whites; 2) That race and ethnicity interact with the sensory, emotional, and temporal characteristics of pain, behavioral and emotional impacts, and attitudes and beliefs about care as predictors of visiting a health care professional, engaging in pain self-management, or talking to others about pain. The study design will be a cross-sectional baseline study with a prospective longitudinal panel. We will conduct telephone interviews with a representative probability sample of community-dwelling adults, which will include oversampling of Hispanics and African-Americans within Miami-Dade, Broward, and Palm Beach counties in the state of Florida. Florida's population is rapidly increasing in both size and ethnic diversity and offers a unique opportunity to examine the interethnic differences in the actions taken to manage oral pain. This study proposes to use the Andersen Behavioral Model of Health to account for predisposing, enabling, and need characteristics as predictors of the targeted health enhancing behaviors. Unique contributions of this project will be the use of a validated model of health care use, the inclusion of a broad range of health behaviors (health care visits across multiple disciplines, self-care behaviors, and communicating with others), and the inclusion of Hispanic Americans. As culture can have a significant impact on the subjective experience of illness, differences in response to painful symptoms may help explain differences in behavioral options considered (or not considered) in response to oral disease. This information has important health policy implications for reducing the race and ethnic disparities in oral health through interventions that facilitate access to care and utilization of appropriate services.
| Rahim-Williams, Bridgett; Tomar, Scott; Blanchard, Shirley et al. (2010) Influences of adult-onset diabetes on orofacial pain and related health behaviors. J Public Health Dent 70:85-92 |
| Riley 3rd, Joseph L; King, Christopher (2009) Self-report of alcohol use for pain in a multi-ethnic community sample. J Pain 10:944-52 |
| Riley 3rd, Joseph L; Gibson, Erica; Zsembik, Barbara A et al. (2008) Acculturation and orofacial pain among Hispanic adults. J Pain 9:750-8 |
