Disability and immigration status interaction and the risk of periodontal disease
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Abstract
OBJECTIVE: To evaluate whether disability and immigrant status influence the likelihood of having periodontal disease.
METHODS: This cross-sectional study analyzed data from the 2011-2014 National Health and Nutrition Examination Survey (NHANES). Study selection criteria included: age 30 or older, available periodontal examination data, and documented disability and immigration status. Periodontal disease was coded as none/mild vs moderate/severe.
Participants were categorized into: U.S.-born or U.S. citizens without a disability, U.S. citizens with a disability, immigrants without a disability, and immigrants with a disability. Logistic regression was performed using SAS software 9.4, considering complex sampling.
RESULTS: Of the study participants (n=6954), 61.0% were U.S. citizens without disabilities. Our next largest group, U.S. citizens with a disability, comprised 24.5% of
our participants. Participants who identified as immigrants without disability comprised 11.5%, while individuals with concurrent immigration and a disability accounted for 2.6%. The highest periodontal disease was detected in immigrants with disabilities (65.7%), followed by 48.5% of immigrants without disabilities, and 47.7% of U.S. citizens with disabilities, while periodontal disease was lowest for US citizens without disabilities (32.1%). Logistic regression analysis found that US citizens with a disability had almost twice the odds of periodontal disease compared to US citizens without a disability (OR=1.93, 95% Cl: 1.63, 2.28). Immigrants without disabilities (OR=1.99, 95% Cl:1.61,2.46) had significantly higher odds of periodontal disease compared to non- disabled US citizens, while the strongest relationship was for immigrants with disabilities (OR=4.04, 95% Cl:2.94,5.55). Despite these differences, a multivariate logistic regression analysis assessing the modification effects of disability status on the citizen- periodontal disease association did not detect a statistically significant relationship (p=0.64).
CONCLUSION: Both immigration and disability status were associated with increased odds of periodontal disease, with higher odds of periodontal disease experienced by immigrants with disabilities. Although this group had higher odds than expected from immigration or disability alone, the multivariate analysis did not find significant evidence that disability changed the relationship between citizen and periodontal disease, perhaps due to small sample size.
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2025