Diabetes 2013 May-24

 

Associations between health insurance and generalized periodontal disease in a study population of Gullah African Americans with type-2 diabetes.

Community Dent Oral Epidemiol. 2012 Aug 10.

Marlow NM, Slate EH, Fernandes JK, Leite RS.

Division of Biostatistics and Epidemiology, College of Medicine, Medical University of South Carolina, Charleston, SC, USA; Center for Oral Health Research, College of Dental Medicine, Medical University of South Carolina, Charleston, SC, USA.

Abstract

OBJECTIVES: To explore the relationship between health insurance status (Medicare, Medicaid, private, and uninsured) and generalized periodontal disease (GPD) among a study population (N = 245) of adult Gullah African Americans with type-2 diabetes mellitus (T2DM) ages <65 years.

METHODS: We used multivariable logistic regression to assess GPD [using three different and increasingly severe clinical assessments: ≥3, ≥4, and ≥5 mm clinical attachment level (CAL) at ≥30% of sites] according to health insurance status.

RESULTS: Prevalence of GPD was 33.06% for ≥3, 18.78% for ≥4, and 9.80% for ≥5 mm CAL. Age ranged 26-64 years (mean = 52.11, SD = 8.53, median = 53). Private insurance was most prevalent (39.59%), followed by uninsured (30.61%), Medicaid (16.33%), and Medicare (13.47%). Results showed increased odds (versus private insurance) for GPD at ≥3 mm among Medicaid (OR = 1.82, P = 0.2404), Medicare (OR = 3.34, P = 0.0103), and uninsured (OR = 1.96, P = 0.0956) groups; GPD at ≥4 mm among Medicaid (OR = 1.97, P = 0.3303), Medicare (OR = 5.02, P = 0.0121), and uninsured (OR = 3.38, P = 0.0319) groups; and GPD at ≥5 mm among Medicaid (OR = 1.21, P = 0.8507), Medicare (OR = 12.62, P = 0.0038), and uninsured (OR = 4.00, P = 0.0763) groups.

CONCLUSIONS: We observed substantial disparities for GPD severity among those without private health insurance even after adjusting for glycemic control, income, dental health behaviors, and other covariates. Improved insurance benefits as well as individualized oral health educational interventions may decrease GPD severity for this study population of younger (ages <65 years) Gullah African Americans with T2DM, particularly those with Medicare insurance. © 2012 John Wiley & Sons A/S.

PMID: 22882563

 

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