Document Type

Article

Language

eng

Format of Original

9 p.

Publication Date

Fall 2015

Publisher

Wiley

Source Publication

Journal of Public Health Dentistry

Source ISSN

1752-7325

Original Item ID

DOI: 10.1111/jphd.12097

Abstract

Objective: To investigate the association between neighborhood level factors and dental visits in young adults in the United States after adjusting for individual level factors.

Methods: The National Longitudinal Study of Adolescent Health Wave 1 (1994-1995) to Wave III (2001-2002) was analyzed. The primary outcome of having had at least one dental visit in the previous 12 months was analyzed via a multilevel random-effects logistic model accounting for geographic clustering in Wave III and survey design clustering from Wave I. Neighborhood level covariates were defined at the census tract level.

Results: Overall rate of dental visits was 57 percent, highest among 18-20 year olds (65 percent) and lowest in 23-26 year olds (52 percent). Increased proportion of African-Americans (≤5 percent to ≥20 percent) and Hispanics (≤5 percent to ≥20 percent) in a neighborhood corresponded with a decrease in dental visits (60 percent versus 52 percent) and (58 percent versus 51 percent), respectively. Neighborhoods with a high proportion of college-educated residents had a higher percentage of dental visits. Similar differences were found when comparing the lowest and highest tertiles defined by poverty level and unemployment with dental visits. Neighborhood education was significantly associated with dental service utilization after adjustment for individual level factors and dental utilization in adolescence (Waves I and II) in the random effects model.

Conclusions: This study demonstrates that the education level of residents within a neighborhood was associated with dental service utilization in young adults in the United States.

Comments

Accepted version. Journal of Public Health Dentistry, Vol 75, No. 4 (Fall 2015): pg. 282-290. DOI. © 2015 American Association of Public Health Dentistry. Used with permission.

This is the peer reviewed version of the following article: "Dental Service Utilization and Neighborhood Characteristics in Young Adults in The United States: A Multilevel Approach, Dental Service Utilization and Neighborhood Characteristics in Young Adults in The United States: A Multilevel Approach," Journal of Public Health Dentistry, Vol 75, No. 4 (Fall 2015): pg. 282-290. which has been published in final form at DOI. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.

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