The purpose of this application is to empirically examine the influence of individual, family, community and state level characteristics on racial/ethnic and socioeconomic disparities in children's oral health and health care. The data will come primarily from the 2003 National Survey of Children's Health (NSCH), conducted by the Centers for Disease Control and Prevention. This is a population-based survey of approximately 102,000 children ages 0-17 years nationwide, including independent, representative samples of approximately 2,000 children from each state and the District of Columbia (DC). It will be augmented with state-level contextual variables derived from other sources. Multilevel modeling methods will be used in the empirical analysis. The three specific aims of this project are to: 1) Identify and quantify the relative contributions of individual, family, community, and state-level factors that explain disparities in children's oral health status and oral health care using the NSCH, thus furthering our understanding of oral health disparities, their sources and potential remedies; 2) Identify differences across states in children's oral health status and oral health care and the factors that contribute to those differences. Our goal under this specific aim is to identify mutable state-level factors (e.g., water fluoridation policies, state dental public health infrastructure, and availability of dental health professionals) that can lead to improvements in children's oral health and reduce disparities in oral health status and oral health care, and; 3) Establish a web based system using the NSCH database that augments existing systems and can be used by policy makers, researchers and advocates to compare and track children's oral health and oral health care disparities, including baseline data for each state and DC from 2003 and comparison data from the 2007 NSCH when it becomes available. We have established a working relationship with the federal MCH Bureau-CDC supported Data Resource Center to include our results on their website devoted to the 2003 NSCH (www.nschdata.org). This frequently used web resource will provide an excellent home for the data developed under this study. Accomplishing these specific aims will provide helpful information for dental care practitioners, families, federal and state health policymakers, and dental health services researchers concerning child, family and community level influences on oral health and oral health disparities. Our overarching goal in this project is to identify significant and modifiable factors that influence children's oral health disparities nationally and across states. This information can then be used to help guide federal and state policies to reduce disparities in oral health status and oral health care. Project Narrative: An overarching goal for HP 2010 is the elimination or reduction of health disparities in the US population. This proposal is responsive to that priority. It is also responsive to several components of the NIDCR Strategic Plan, including Goal 6 (eliminating health disparities in oral, dental and craniofacial diseases and conditions among underserved populations and groups) and Goal 7 (ensuring the adequacy of systems to document and monitor the extent and impact of oral, dental and craniofacial diseases, disorders and conditions). The diverse and cross-disciplinary study team proposed for this project is responsive to Goal 4 (supporting research infrastructure and enhancing the development of new approaches for conducting inter- and cross-disciplinary research). ? ? ?
| Fisher-Owens, S A; Soobader, M J; Gansky, S A et al. (2016) Geography matters: state-level variation in children's oral health care access and oral health status. Public Health 134:54-63 |
| Fisher-Owens, Susan A; Isong, Inyang A; Soobader, Mah-J et al. (2013) An examination of racial/ethnic disparities in children's oral health in the United States. J Public Health Dent 73:166-74 |
| Isong, Inyang A; Soobader, Mah-J; Fisher-Owens, Susan A et al. (2012) Racial disparity trends in children's dental visits: US National Health Interview Survey, 1964-2010. Pediatrics 130:306-14 |
