The Determinants of Oral Health for Mexican-Americans

Abstract

The long term objective of this project is improved effectiveness and efficiency of oral health care systems in the South-West, and the United States generally. This will be achieved by (1) providing policy markers and researchers with detailed, reliable and valid data on the state of oral health in San Antonio by (2) describing the relationship of oral health to systems of personal and community oral health care by (3) comparison with other communities in the region, the United States and elsewhere. Mexican-Americans have the lowest dental attendance of an minority, significantly more caries and less treatment. Their periodontal status is assumed to be in jeopardy by the high rate of type II diabetes. Though low education and income are common, this fastest growing minority has strong family support systems, which if appreciated cross-culturally could positively influence oral health. The applicants have planned, sampled, listed, enrolled, interviewed, and dentally examined, a sample of San Antonio citizens. The sample consists of 1000 adults aged 35-44 and 65-74, 700 adolescents, and professionals in 100 dental practices and clinics. Because the complex sample design was clustered for efficiency, SUDAAN-PC software will be used to calculate weighted group means and standard errors. This grant application is for the analysis, interpretation and reporting phases of a major epidemiologic and psycho-social project. Descriptive analysis (1) will be made of the socio-environmental context, the personal and community oral health care systems, provider characteristics, and quality and appropriateness of care. (2) Predisposing and enabling variables including oral health beliefs, acculturation, attitudes, knowledge and self-care practices, and utilization of dental care will be analyzed as univariates for significant effect on oral health status (morbidity, social functioning, symptoms, and satisfaction). (3) The kinds and mix of oral health resources used, as well as total expenditures involved, will also be assessed against oral health status. Analytical Analysis (4) will consist of uni- and multivariate analysis between independent variables (personal characteristics, health behaviors, provider characteristics) and dependent variables (oral status, consumer and provider satisfaction) (5) analysis will be made of health status for life residents of San Antonio, diabetics, those of contrasting acculturation, those who had oral education and prevention in school, by dental practice characteristics and by ethnicity, controlling for socio- economics.