Association of oral health-related productivity loss and wealth among working-age adults from 2011-2018

Date
2023
DOI
Authors
Williams, Jessica Clarke
Version
OA Version
Citation
Abstract
OBJECTIVES: To examine the association of oral health-related productivity loss (OHRPL) with wealth in 10,908 working-age adults (30-64 years old) using 2011-2018 National Health and Nutrition Examination Survey (NHANES) data. METHODS: This study measured the association of oral health-related productivity loss with wealth. The outcome, OHRPL, was categorized into “Never,” “Sometimes” (“Hardly ever” / “Somewhat often”) and “Always” (“Often” / “Always”). The exposure, wealth, used existing methodology: categorizing NHANES’ homeownership and family monthly income variables into low (<$2900 /not homeowners), middle (≥$2900 /not homeowners or homeowners/<$2900), and high-wealth (≥$2900/homeowners). Using masked variance pseudo-primary sampling units and variables with a full sample 2-year mobile examination center exam weight for the 2011-2018 cycles, descriptive statistical analysis and multinomial logistic regression was used. Regression outputs were converted to average probabilities of OHRPL by financial and education variables for Black participants. RESULTS: Between 2011-2018, 13,223,810 (weighted) US working-age adults experienced OHRPL and those with low-wealth had 1.5 times the odds (95% CI=1.2-1.8) of reporting OHRPL “sometimes” and 2.9 times the odds (95% CI=1.8-4.8) of reporting OHRPL “always” compared to their high-wealth counterparts. Black (95% CI=1.2-2.1) and Multi-Racial/Other (95% CI=1.4-2.9) groups had the strongest, significant positive associations with experiencing OHRPL “sometimes.” Black men with financial barriers to care were 26% more likely to experience OHRPL “sometimes,” and if they had low-wealth, 34% more likely. CONCLUSIONS: Including economic factors that represent resources and generational wealth can enhance understanding of these dynamics as drivers of oral health outcome disparities.
Description
License
Attribution 4.0 International