Determining the Social Determinants of Health That Influence Self-Reported Dysphagia: A Cross-Sectional Study.

IF 2.5 3区医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

American Journal of Speech-Language Pathology Pub Date : 2025-09-09 DOI:10.1044/2025_AJSLP-25-00122

Anittha Mappanasingam, Paul Stratford, Ashwini Namasivayam-MacDonald

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Abstract

Introduction: The prevalence of dysphagia has been increasing over the years, with some individuals at a greater risk. Social determinants of health (SDOH) can affect some individual's access to care and their health more than others. The objective of this study is to explore the role of SDOH on self-reported dysphagia in older adults (aged 65 years and older) living in the United States.

Method: The 2022 National Health Interview Survey (NHIS) is a database that collects health information of over 35,000 individuals across the United States. A secondary cross-sectional data analysis determined the SDOH that influence self-reported dysphagia in older adults. Demographic data were represented as mean and standard deviation for continuous data and as frequency and percentage for categorical data. Two parallel analyses were performed, a stepwise logistic regression analysis to unweighted data and a manual backward elimination to data applying the NHIS sampling weights for both a statistically driven model and a theory-driven model.

Results: For stepwise logistic regression analysis, employment, race, food insecurity, and housing were found to influence self-reported dysphagia in the statistically driven model, while all but housing were significant in theory-driven model. For the manual backward elimination analysis, employment and race were significant in both models. Older adults who were unemployed due to health/disability, or retirement, reported sometimes worrying about food affordability, and those who rented a house/apartment were more likely to report swallowing difficulties. Older adults who identified as Black/African American or Asian were less likely to report swallowing difficulties.

Conclusion: More research needs to be done to examine the role of SDOH on dysphagia. Identifying these SDOH can allow clinicians to advocate for vulnerable populations to have accessible access to dysphagia screening and care.

查看原文本刊更多论文

确定影响自我报告的吞咽困难的健康社会决定因素：一项横断面研究。

导读：近年来，吞咽困难的患病率一直在上升，一些个体的风险更高。健康的社会决定因素（SDOH）可能比其他人更能影响某些人获得保健和健康的机会。本研究的目的是探讨SDOH在美国老年人（65岁及以上）自我报告的吞咽困难中的作用。方法：2022年全国健康访谈调查（NHIS）是一个数据库，收集了美国35000多人的健康信息。二次横断面数据分析确定了影响老年人自我报告的吞咽困难的SDOH。对于连续数据，人口统计数据用均值和标准差表示；对于分类数据，用频率和百分比表示。对统计驱动模型和理论驱动模型进行了两次并行分析，对未加权数据进行了逐步逻辑回归分析，并对应用NHIS采样权的数据进行了手动反向消去。结果：通过逐步logistic回归分析，在统计驱动模型中，就业、种族、食物不安全和住房对自我报告的吞咽困难有影响，而在理论驱动模型中，除住房外，其他因素都有显著影响。对于人工逆向消去分析，就业和种族在两个模型中都是显著的。由于健康/残疾或退休而失业的老年人有时会担心食物的负担能力，而那些租了房子/公寓的人更有可能报告吞咽困难。被认为是黑人/非裔美国人或亚洲人的老年人不太可能报告吞咽困难。结论：SDOH在吞咽困难中的作用有待进一步研究。确定这些SDOH可以让临床医生倡导弱势群体有机会获得吞咽困难筛查和护理。

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来源期刊

American Journal of Speech-Language Pathology AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY-REHABILITATION

CiteScore

4.30

自引率

11.50%

发文量

353

审稿时长

>12 weeks

期刊介绍： Mission: AJSLP publishes peer-reviewed research and other scholarly articles on all aspects of clinical practice in speech-language pathology. The journal is an international outlet for clinical research pertaining to screening, detection, diagnosis, management, and outcomes of communication and swallowing disorders across the lifespan as well as the etiologies and characteristics of these disorders. Because of its clinical orientation, the journal disseminates research findings applicable to diverse aspects of clinical practice in speech-language pathology. AJSLP seeks to advance evidence-based practice by disseminating the results of new studies as well as providing a forum for critical reviews and meta-analyses of previously published work. Scope: The broad field of speech-language pathology, including aphasia; apraxia of speech and childhood apraxia of speech; aural rehabilitation; augmentative and alternative communication; cognitive impairment; craniofacial disorders; dysarthria; fluency disorders; language disorders in children; speech sound disorders; swallowing, dysphagia, and feeding disorders; and voice disorders.