Abstract: Exploring the Causal Effects of Food Insecurity on Oral Health Outcomes of Adults in the United States (Society for Social Work and Research 28th Annual Conference - Recentering & Democratizing Knowledge: The Next 30 Years of Social Work Science)
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Exploring the Causal Effects of Food Insecurity on Oral Health Outcomes of Adults in the United States

Schedule:
Saturday, January 13, 2024
Marquis BR Salon 13, ML 2 (Marriott Marquis Washington DC)
* noted as presenting author
Melanie Morris, MSSW, Doctoral Student, Boston University, Boston, MA
Daniel Miller, PhD, Associate Professor, Boston University, Boston, MA
Thomas Byrne, PhD, Assistant Professor, Boston University, Boston, MA
Background: Poor oral health and food insecurity are both markers of health vulnerability and social inequity. Oral diseases are impacted by diet and nutrition, as well as material hardship and so food insecurity may be a potential risk factor for adverse oral health outcomes. However, the relationship between the two is poorly understood, especially among adults. This study aims to address the current gaps in research by exploring the causal effects of food insecurity and clinical and utilization-based oral health outcomes through propensity scoring methods among adults in the United States.

Methods: This study used nationally representative data from the National Health and Nutrition Examination Survey (NHANES) (N=9,747). Our sample included adults aged 18 and older who completed the food security questionnaire and dental examination between 2015-2018. Using inverse probability of treatment weighting, a propensity scoring method, we examine the effects of food insecurity on clinical and utilization-based oral health outcomes, accounting for a comprehensive set of potential confounders.

Results: Food insecurity was related to statistically significant worse clinical and utilization-based oral health outcomes. Those who were food insecure had 2.03 times (95% CI: 1.89-2.17) increased odds of needing dental care but not getting it and 0.64 times (95% CI: 0.60-0.68) decreased odds of last visiting the dentist within the past 6 months. Likewise, those who were food insecure had 1.50 times (95% CI: 1.41-1.59) increased odds of being recommended to seek dental care, 1.42 times (95% CI: 1.33-1.51) increased odds of having a cavity, and 1.21 times (95% CI: 1.12-1.31) increased odds of having a missing tooth.

Conclusion and Implications: These findings underscore the harmful impacts of food insecurity and the need to reduce food insecurity to improve the oral health of American adults. Future research that clarifies the nature of this causal relationship will inform the structural interventions required to promote and maintain the overall health of adults.

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