Mental Health, Socioeconomic Position, and Oral Health: A Path Analysis

Mental health conditions and poor oral health outcomes share bidirectional links, and both are linked to factors related to socioeconomic position (SEP). We used nationally representative survey data to describe the complex interplay of SEP, mental health, oral health behaviors, dental treatment see...

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Bibliographic Details
Published in:Preventing chronic disease 2024-10, Vol.21, p.E76, Article 240097
Main Authors: Heaton, Lisa J, Santoro, Morgan, Tiwari, Tamanna, Preston, Rebecca, Schroeder, Kelly, Randall, Cameron L, Sonnek, Adrianna, Tranby, Eric P
Format: Article
Language:English
Subjects:
Adult
Aged
Dental caries
Dental insurance
Dentists
Depression - epidemiology
Education
Female
Females
Health Behavior
Health disparities
Home ownership
Humans
Male
Males
Mental depression
Mental disorders
Mental health
Mental Health - statistics & numerical data
Middle Aged
Oral Health
Oral hygiene
Polls & surveys
Quality of life
Social Class
Socioeconomic Factors
Teeth
Transgender persons
United States - epidemiology
Young Adult
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Summary:Mental health conditions and poor oral health outcomes share bidirectional links, and both are linked to factors related to socioeconomic position (SEP). We used nationally representative survey data to describe the complex interplay of SEP, mental health, oral health behaviors, dental treatment seeking, and oral health. We used data from the 2022 State of Oral Health Equity in America survey, which collects data from US adults on prior depression diagnosis and current depressive symptoms via the Patient Health Questionnaire-9 and demographic characteristics (age, sex/gender, race, ethnicity), SEP (education, income, employment, home ownership, dental insurance), oral health behaviors (brushing and flossing frequency), dental treatment seeking (time since last visit, plans for visit in the coming year), and self-rated oral health (feeling self-conscious due to poor oral health, having symptoms of poor oral health). We used structural equation modeling to identify latent variables and fit the path analytic models. In the total sample (N = 5,682), SEP was significantly associated with dental treatment seeking (standardized parameter estimate [SE] = 0.55 [0.05]), oral health behaviors (standardized parameter estimate [SE] = 0.34 [0.04]), and mental health (standardized parameter estimate [SE] = 0.59 [0.05]). These factors, in turn, were significantly associated with self-rated oral health (estimates ranging from 0.20 to 0.54, SEs ranging from 0.04 to 0.05). SEP, which involves several major social determinants of health, is directly associated with mental health and indirectly associated with self-rated oral health status, with mental health modifying the relationship between SEP and self-rated oral health. Findings emphasize the need to integrate medical, dental, and behavioral health with the goal of providing comprehensive person-centered care.
ISSN:1545-1151
1545-1151
DOI:10.5888/pcd21.240097