Master of Science, The Ohio State University, 2016, Dentistry
Purpose: To determine the relationship between toxic stress from negative social determinants of health and behavior of children at the initial dental visit.
Methods: Using a 17-state sample of children 4-5 years-old, behavior ratings, using a 4-point scale, applied by trained dental professionals at initial dental visits were analyzed using bivariate and multivariate logistic regression models as well as Naive Bayes classification and chi-squared tests. Each child's behavior rating was correlated with social determinants using geographic mapping for racial/ethnic status, violence, education level, income, living conditions and other factors known to influence health.
Results: Behavior ratings for 4-year-old (n=17,486) and 5-year-old (n=19,613) children were obtained for first dental visit over a five year period (2009-2013). Behavior was good (n=11,999) and not good (n=25,100). The odds ratio correlating individual socioeconomic factors to behavior showed that children with more negative behavior were more likely to experience violent crime (P=.0004), parental unemployment (P=.0002), less parental education (P=.0006), high expense on food and transportation per capita income (P=.0005), living in a more densely populated area (P=.028), non-homeowner (P=.0001), with a greater amount spend on housing per capita income (P=.0009), African-American (P=.0008), and a lower median household age (P=.0003).
Children with good behavior rating were more likely to be of Latino or white ethnicity (P=.0002), come from homes owned by parents (P=.007), having a male to female ratio closer to 1:1 (P=.031), spent a greater amount on health related expenses (P=.015), and a larger average home size (P=.0002).
Conclusion: This study of 37,099 4-and-5-year-old children, found poorer behavior at initial dental examination for children exposed to violence crime, parental unemployment, less parental education, high expense on food and transportation per capita income, non-homeo (open full item for complete abstract)
Committee: Paul Casamassimo (Advisor); Dennis McTigue (Advisor); Nowak Arthur (Advisor)
Subjects: Dentistry