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Oral health status and oral health care use among formerly incarcerated people

https://doi.org/10.1016/j.adaj.2019.10.026Get rights and content

Abstract

Background

Incarceration carries adverse consequences for health, yet there is limited research on the association between incarceration and oral health outcomes. The authors examined the relationship between former incarceration and 2 self-reported oral health outcomes—periodontal disease and oral health care use—and assessed the degree to which postrelease factors mediate the relationship between former incarceration and oral health outcomes.

Methods

The authors analyzed nationally representative observational data from the National Longitudinal Study of Adolescent to Adult Health by using multivariate logistic regression. Karlson-Holm-Breen mediation analysis was used to assess how much former incarceration and oral health outcomes are confounded by material hardship, health insurance coverage, and poor health behaviors.

Results

Incarceration history is associated with periodontal disease (odds ratio [OR], 1.454; 95% confidence interval [CI], 1.042 to 2.029) and oral health care use (OR, 1.433; 95% CI, 1.248 to 1.646) after control variables are taken into account. However, the confounding variables fully mediate the association between incarceration and periodontal disease (OR, 1.143; 95% CI, 0.815 to 1.605) and oral health care use (OR, 1.133; 95% CI, 0.980 to 1.309).

Conclusions

Formerly incarcerated people in the United States have worse oral health outcomes than their never-incarcerated counterparts, and much of this relationship can be explained by socioeconomic status and health behaviors.

Practical Implications

Formerly incarcerated people have scarce resources and lack knowledge about oral health care. Health care professionals should encourage formerly incarcerated people to focus on oral health care. Because modifiable risk behaviors confound much of this relationship, targeted interventions may provide benefits for improving oral health care among this vulnerable population.

Section snippets

Sample

Data for our study are from waves I and IV of the National Longitudinal Study of Adolescent to Adult Health (Add Health), a nationally representative sample of adolescents enrolled in grades 7 through 12 during the 1994 through 1995 academic year and subsequently followed into young adulthood. To date, respondents have been followed through 4 waves of data collection: wave I (1994-1995), wave II (1995-1996), wave III (2001), and wave IV (2008). At wave IV, respondents were between 24 and 34

Results

The summary statistics for the analytic sample are provided in Table 1. Approximately 3% of respondents reported having periodontal disease, and 56% reported not receiving oral health care in the year before the wave IV interview. About 14% of respondents reported being formerly incarcerated. Mean age of the sample was 28 years; 69.1% were non-Hispanic white, 14.5% were non-Hispanic black, and 11.6% were Hispanic.

Table 2 presents the results of the logistic regression of self-reported

Discussion

We examined self-reported periodontal disease and self-reported oral health care use among formerly incarcerated people by using data from a nationally representative sample of young adults in the United States. Several key findings emerged. First, formerly incarcerated people were more likely to experience periodontal disease than their never-incarcerated counterparts. Second, the direct relationship between incarceration history and periodontal disease was diminished to statistical

Conclusions

The results of our study show that formerly incarcerated people in the United States have worse oral health outcomes than do those who have never been incarcerated and that much of this relationship is explained by lower socioeconomic status and worse health behaviors among formerly incarcerated people. The results of our study bolster the need for future research that further identifies pathways through which incarceration history could lead to oral health problems. For example, researchers

Dr. Testa is an assistant professor, Department of Criminology and Criminal Justice, University of Texas at San Antonio, 501 W. Cesar E. Chavez Blvd, San Antonio, TX 78207

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  • Cited by (0)

    Dr. Testa is an assistant professor, Department of Criminology and Criminal Justice, University of Texas at San Antonio, 501 W. Cesar E. Chavez Blvd, San Antonio, TX 78207

    Dr. Fahmy is an assistant professor, Department of Criminology and Criminal Justice, University of Texas at San Antonio, San Antonio, TX.

    Disclosure. Drs. Testa and Fahmy did not report any disclosures.

    This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill, and funded by grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. Information on how to obtain the Add Health data files is available on the Add Health website (http://www.cpc.unc.edu/addhealth). No direct support was received from grant P01-HD31921 for this analysis.

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