Adverse childhood experiences, dental insurance, and developmental disability: Association with unmet dental needs in Ohio

IF 1.8 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry Pub Date : 2024-03-22 DOI:10.1111/jphd.12605

Lili Horter BS, Carson Richardson BS, Marika Paul PhD, Beau D. Meyer DDS, MPH

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引用次数: 0

Abstract

Objective

This study investigated whether insurance status and/or developmental disability moderated the association between adverse childhood experiences (ACE) and unmet dental needs among children aged 0 to 17 in Ohio.

Methods

We utilized cross-sectional data from the 2021 Ohio Medicaid Assessment Survey to assess the dental needs of children. ACE scores, dental insurance status, and developmental disability status were analyzed using multivariable logistic regression to identify their potential association with parental-reported unmet dental needs.

Results

The weighted sample represented 2,752,222 children in Ohio. Over half reported zero ACEs (55.8%) and no dental needs (56.1%). Approximately 1 in 9 lacked dental insurance (11.1%), and 1 in 10 had a developmental disability (9.9%). Children with one to three ACEs had three times the odds of unmet dental needs compared to children with zero ACEs (OR = 3.20; 95%CI [2.10, 4.89]), and children with four or more ACEs had eight times the odds of unmet dental needs (OR = 8.78; 95%CI [5.26, 14.67]). Children lacking dental insurance had over six times higher odds of unmet dental needs compared to children with dental insurance (OR = 6.10; 95%CI [3.92, 9.49]). The presence of developmental disability status did not moderate the presence of unmet dental needs; however, the lack of dental insurance status significantly moderated the association between ACEs and unmet dental needs.

Conclusion

Insurance status, not developmental disability, moderated the association between ACEs and unmet dental needs among children in Ohio. Efforts to ensure continuous access to dental insurance are warranted.

Abstract Image

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不良童年经历、牙科保险和发育障碍：俄亥俄州未满足的牙科需求的关联。

目的本研究调查了保险状况和/或发育障碍是否会调节俄亥俄州0至17岁儿童的不良童年经历（ACE）与未满足的牙科需求之间的关系：我们利用 2021 年俄亥俄州医疗补助评估调查的横截面数据来评估儿童的牙科需求。我们使用多变量逻辑回归分析了ACE评分、牙科保险状况和发育障碍状况，以确定它们与父母报告的未满足牙科需求之间的潜在关联：加权样本代表了俄亥俄州的 2,752,222 名儿童。超过半数的儿童报告说他们没有遭遇过 ACE（55.8%），也没有牙科需求（56.1%）。大约九分之一的儿童没有牙科保险（11.1%），十分一的儿童有发育障碍（9.9%）。有一到三次 ACE 的儿童未满足牙科需求的几率是没有 ACE 儿童的三倍（OR = 3.20；95%CI [2.10，4.89]），有四次或四次以上 ACE 的儿童未满足牙科需求的几率是没有 ACE 儿童的八倍（OR = 8.78；95%CI [5.26，14.67]）。与有牙科保险的儿童相比，没有牙科保险的儿童未满足牙科需求的几率要高出六倍多（OR = 6.10；95%CI [3.92，9.49]）。发育障碍的存在并不影响未满足的牙科需求的存在；然而，缺乏牙科保险的状况却显著地影响了ACE与未满足的牙科需求之间的关联：保险状况，而非发育障碍，调节了俄亥俄州儿童中的ACE与未满足的牙科需求之间的关系。确保持续获得牙科保险的努力是有必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of public health dentistry 医学-公共卫生、环境卫生与职业卫生

CiteScore

3.80

自引率

4.30%

发文量

审稿时长

6-12 weeks

期刊介绍： The Journal of Public Health Dentistry is devoted to the advancement of public health dentistry through the exploration of related research, practice, and policy developments. Three main types of articles are published: original research articles that provide a significant contribution to knowledge in the breadth of dental public health, including oral epidemiology, dental health services, the behavioral sciences, and the public health practice areas of assessment, policy development, and assurance; methods articles that report the development and testing of new approaches to research design, data collection and analysis, or the delivery of public health services; and review articles that synthesize previous research in the discipline and provide guidance to others conducting research as well as to policy makers, managers, and other dental public health practitioners.