Gill, C. (2016). The Association between Income Disparities and Prenatal Oral Health: Results from the 2009-2011 North Carolina Pregnancy Risk Assessment Monitoring System. Unc Charlotte Electronic Theses And Dissertations.
Access to adequate dental care is a problem in the U.S., particularly for economically disadvantaged individuals. During pregnancy, women are at increased risk of developing adverse oral health conditions, such as periodontitis, which can potentially lead to negative birth outcomes. Prior studies have examined racial disparities in oral health, but few have examined the association between household income and prenatal oral health outcomes and access to oral health care. The purpose of this study was to examine further the effect of health disparities, measured through self-reported income, on prenatal oral health and access to oral health care services. This study was a secondary data analysis of 3,111 women between 18 and 45 years of age who participated in the 2009-2011 North Carolina Pregnancy Risk Assessment Monitoring System (PRAMS). Annual household income was self-reported by participants and classified as low (<$50,000) or high income (≥$50,000). Information on the two outcomes, negative prenatal oral health outcomes and access to oral health during pregnancy, were also self-reported. Logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs). After adjusting for maternal education, marital status, and maternal age, women of lower income had twice the odds of having negative oral health outcomes during pregnancy compared to women of higher income (OR=2.22, 95% CI: 1.44 – 3.43). After adjusting for maternal education, marital status, and maternal race/ethnicity, women of lower income had over four times the odds of being unable to access oral health care compared to women of higher income (OR=4.21, 95% CI: 2.81 – 6.30). While race/ethnicity may be an effect modifier of the income-negative oral health outcomes association, it was not an effect modifier of the income-access to oral health care association. Findings may inform the development of interventions designed to reduce the impact of health disparities on prenatal oral health and access to oral health care. However, additional studies examining household income and negative prenatal oral health outcomes and access to oral health care during pregnancy are needed to confirm these findings.