The impact of race/ ethnicity on the oral health food insecurity association among U.S. adults
OA Version
Citation
Abstract
OBJECTIVE: Food insecurity is a significant health concern that limits access to nutritional foods, with some racial and ethnic groups experiencing more food insecurity.
AIM: To examine the impact of race/ethnicity on the relationship between food insecurity and oral health outcomes.
METHODS: This cross-sectional study utilized the 2011- 2012 and 2013- 2014 NHANES cycles. The sample included 7,274 adults (20-65 years) with complete data for food security, oral health outcomes, and race/ethnicity. The primary outcomes were active caries (yes/no) and periodontal disease (none/mild vs moderate/severe). The primary independent variable was adult food security (full/marginal, low/very low); the modifier was self-reported race/ethnicity. Descriptive statistics were stratified by race/ethnicity and food insecurity status. Logistic regression models investigated race/ethnicity modification effects on the food security-oral health relationship. Analyses using SAS V9.4 accounted for NHANES complex sampling design.
RESULTS: Food insecurity was lowest for non-Hispanic Whites (13.1%) and “Other” races (13.9%). Hispanics (27.7%) and non-Hispanic Blacks (24.3%) had the highest prevalence. Food insecurity effects on active caries were elevated across all races/ethnicities; however, no statistically significant interaction was detected between the groups in multivariate models (OR:(95%CI) Hispanic=1.7:(1.2-2.4), non-Hispanic white=2.0:(1.5-2.6), non-Hispanic Blacks=1.4:(1.0-1.8), Other races=1.1:(0.6-2.0)); food security*race/ethnicity interaction p- value=0.22. While race/ethnicity ORs for the food security-periodontal disease relationship differed, the differences were statistically significant (Hispanic=1.2:(0.9-1.5), White=1.6:(1.2-2.1), non-Hispanic Blacks=1.2:(0.95-1.6), Other races=3.1:(1.3-7.4); food security*race/ethnicity interaction p-value=0.025).
CONCLUSION: While there were significant differences in race/ethnicity and food security, we did not detect these differences in food insecurity's impact on oral health when looking at caries interaction. However, there were significant differences in race/ethnicity in terms of periodontal disease.