Severe periodontal disease is more frequent among socioeconomically disadvantaged individuals

Socioeconomic disadvantage at the individual and neighborhood level is associated with severe periodontitis among African-Americans and Whites, according to research conducted at the Mailman School of Public Health and reported in the American Journal of Public Health.

The study was based on a sample of individuals aged 45 to 64 years, who participated in the Dental Atherosclerosis Risk in Communities Study, selected from four U.S. communities in North Carolina, Mississippi, Minnesota, and Maryland. Findings confirmed the associations between individual socioeconomic indicators and the prevalence of severe periodontitis among African Americans and Whites. Low income was associated with the prevalence of severe periodontitis among Whites, and both low education and income levels were associated with severe periodontitis among African-Americans.

"These associations remained significant after adjustment for age, gender, recruitment center, and neighborhood socioeconomic conditions," according to Luisa N. Borrell, DDS, PhD, MPH, lead author, and assistant professor of Epidemiology at the Mailman School of Public Health and assistant professor of Dentistry, School of Dental and Oral Surgery, Columbia University. "Specifically, the odds of having severe periodontitis were twice as high among African Americans without a high-school diploma than among their peers with a college degree or postgraduate education. Moreover, low income African Americans and Whites were at least 50% more likely to have severe periodontitis than their high-income counterparts," observed Dr. Borrell.

Although there was no association between neighborhood socioeconomic conditions and severe periodontitis, the study shows that low-income Whites residing in disadvantaged neighborhoods had almost twice the odds of experiencing severe periodontitis than high-income Whites living in high-socioeconomic status neighborhoods.

This is the first study of its kind to investigate neighborhood effects on periodontal disease, although it had been postulated that area of residence influences an individual's health behaviors and health-related norms. "In the case of periodontal disease, social contexts could promote or prevent behaviors that may affect periodontal health such as smoking, regardless of individual socioeconomic status," notes Dr. Borrell.

"Our study confirms that individual income and education are important factors in periodontal health independent of neighborhood socioeconomic circumstances for African Americans and Whites. Most importantly, this study shows that being poor and living in a disadvantaged neighborhood increases the odds of periodontal disease among Whites only" says Dr. Borrell.

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This work was supported by the National Heart, Lung and Blood Institute, the National Institute of Dental and Craniofacial Research, and the Robert Wood Johnson Health and Society Scholars Program.

To view the findings online, access: www.ajph.org. A copy of the complete study will be published in the February 2006 issue of the American Journal of Public Health, Vol 96, No.2.

About the Mailman School of Public Health
The only accredited school of public health in New York City, and among the first in the nation Columbia University's Mailman School of Public Health provides instruction and research opportunities to more than 850 graduate students in pursuit of masters and doctoral degrees. Its students and more than 250 multi-disciplinary faculty engage in research and service in the city, nation, and around the world, concentrating on biostatistics, environmental health sciences, epidemiology, health policy and management, population and family health, and sociomedical sciences. www.mailman.hs.columbia.edu


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