Evidence map›Paper›PMID 26995567›Full record

Observational studyPublic health2016

Geography matters: state-level variation in children's oral health care access and oral health status.

S A Fisher-Owens, M J Soobader, S A Gansky, I A Isong, J A Weintraub, L J Platt, P W Newacheck

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Public health, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed.

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  13. Factors Affecting Preventive Dental Treatment of Adolescents in Korea.International journal of environmental research and public health · 2020
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

S A Fisher-OwensUniversity of California, San Francisco School of Medicine, Department of Pediatrics, San Francisco, CA, USA; Division of Oral Epidemiology & Dental Public Health, UCSF School of Dentistry, Department of Preventive & Restorative Dental Sciences, San Francisco, CA, USA. Electronic address: fisherowens@peds.ucsf.edu.
M J SoobaderStatworks, Boston, MA, USA.
S A GanskyDivision of Oral Epidemiology & Dental Public Health, UCSF School of Dentistry, Department of Preventive & Restorative Dental Sciences, San Francisco, CA, USA; Center to Address Disparities in Children's Oral Health (CAN-DO), University of California, UCSF School of Dentistry, Department of Preventive & Restorative Dental Sciences, San Francisco, CA, USA.
I A IsongMGH Center for Child and Adolescent Health Policy, Boston, MA, USA.
J A WeintraubCenter to Address Disparities in Children's Oral Health (CAN-DO), University of California, UCSF School of Dentistry, Department of Preventive & Restorative Dental Sciences, San Francisco, CA, USA.
L J PlattPhilip R. Lee Institute for Health Policy Studies, UCSF School of Medicine, San Francisco, CA, USA.
P W NewacheckUniversity of California, San Francisco School of Medicine, Department of Pediatrics, San Francisco, CA, USA; Philip R. Lee Institute for Health Policy Studies, San Francisco, CA, USA.

Funding

Vision Awards for GM Lead Users GroupU54DE014251 · NIDCR · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI GANSKY, STUART A · 2001 to 2007
$10.9M
Understanding Sources of Children's Oral Health DisparitiesR21DE018523 · NIDCR · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI NEWACHECK, PAUL · 2008 to 2009
$425k
Disparities in Child &Family Health Care ExpendituresR01HS011662 · AHRQ · UNIVERSITY OF CALIFORNIA SAN FRANCISCO · PI NEWACHECK, PAUL · 2002 to 2003
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AHRQ HHS R01 HS011662NIDCR NIH HHS R21 DE018523NIDCR NIH HHS U54 DE014251
6 · The paper itself

Abstract

objectivesTo ascertain differences across states in children's oral health care access and oral health status and the factors that contribute to those differences. STUDY

designObservational study using cross-sectional surveys.

methodsUsing the 2007 National Survey of Children's Health, we examined state variation in parents' report of children's oral health care access (absence of a preventive dental visit) and oral health status. We assessed the unadjusted prevalences of these outcomes, then adjusted with child-, family-, and neighbourhood-level variables using logistic regression; these results are presented directly and graphically. Using multilevel analysis, we then calculated the degree to which child-, family-, and community-level variables explained state variation. Finally, we quantified the influence of state-level variables on state variation.

resultsUnadjusted rates of no preventive dental care ranged 9.0-26.8% (mean 17.5%), with little impact of adjusting (10.3-26.7%). Almost 9% of the population had fair/poor oral health; unadjusted range 4.1-14.5%. Adjusting analyses affected fair/poor oral health more than access (5.7-10.7%). Child, family and community factors explained ∼¼ of the state variation in no preventive visit and ∼½ of fair/poor oral health. State-level factors further contributed to explaining up to a third of residual state variation.

conclusionGeography matters: where a child lives has a large impact on his or her access to oral health care and oral health status, even after adjusting for child, family, community, and state variables. As state-level variation persists, other factors and richer data are needed to clarify the variation and drive changes for more egalitarian and overall improved oral health.

Indexed as

Health Status DisparitiesAdolescentChildChild, PreschoolCross-Sectional StudiesDental CareHealth Services AccessibilityHealth SurveysHumansMultilevel AnalysisOral HealthResidence CharacteristicsUnited StatesChildren's oral healthState variation

Identifiers

PMID26995567
PMCPMC4884054

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.