Residential rurality and oral health disparities: Influences of contextual and individual factors

Sangnam Ahn, James N. Burdine, Matthew Lee Smith, Marcia G. Ory, Charles D. Phillips

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


The purposes of the study were (a) to identify disparities between urban and rural adults in oral health and (b) to examine contextual (i.e., external environment and access to dental care) and individual (i.e., predisposing, enabling, and lifestyle behavioral) factors associated with oral health problems in a community population. Study data were derived from a two-stage, telephone-mailed survey conducted in 2006. The subjects were 2,591 adults aged 18 years and older. Cochran-Mantel-Haenszel statistics for categorical variables were applied to explore conditional independence between both health access and individual factors and oral health problems after controlling for the urban or rural residence. Logistic regression was used to investigate the simultaneous associations of contextual and individual factors in both rural and urban areas. Approximately one quarter (24.1%) of the study population reported oral health problems. Participants residing in rural areas reported more oral health disparities. Oral health problems were significantly associated with delaying dental care. These problems also were more common among those who were less educated, were African American, skipped breakfast every day, and currently smoked. The study findings suggest that oral health disparities persist for people in rural areas, and improving oral health status is strongly related to better access to oral health care and improved lifestyles in both rural and urban areas.

Original languageEnglish (US)
Pages (from-to)29-41
Number of pages13
JournalJournal of Primary Prevention
Issue number1
StatePublished - Feb 2011


  • Dental care utilization
  • Older adults
  • Oral health
  • Rural health

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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