摘要：Objectives . We assessed the prevalences of periodontitis by education and income levels among US adults with data from the third National Health and Nutrition Examination Survey. Methods . The study was limited to non-Hispanic Blacks, Mexican Americans, and non-Hispanic Whites 50 years of age or older with a complete periodontal assessment during the dental examination. Results . Blacks with higher education and income levels had a significantly higher prevalence of periodontitis than their White and Mexican-American counterparts. The relationship between income level and periodontitis was modified by race/ethnicity. High-income Blacks exhibited a higher prevalence of periodontitis than did low-income Blacks and high-income Whites. Conclusions . Our findings call attention to the importance of recognizing socioeconomic status–related health differences across racial/ethnic groups within the social, political, and historical context. The pervasiveness of health disparities by socioeconomic status (SES) in the United States has been documented for years. 1– 6 Regardless of race or ethnicity, health outcomes for individuals of lower SES continue to be poorer than those of their higher-SES counterparts. 3, 7 This is also true for periodontal health: for years, the data have shown significant SES differences across racial/ethnic groups. 8– 18 Many previous studies documenting differences in periodontal health have included SES indicators (i.e., income and education) in their analyses. Some studies have provided cross-tabulations between periodontitis and categories for each SES indicator, 19– 25 whereas others have included these indicators as covariates in multivariable analysis approaches. 22, 23, 25– 29 The first group of studies has reported higher prevalences and severity of periodontitis for those with lower SES compared with their higher-SES counterparts. The second group has documented the persistence of racial/ethnic differences after adjusting for SES indicators. However, the incommensurability of these indicators across racial/ethnic groups has not been discussed in these studies. To date, SES indicators have not been investigated as the main independent covariates in studies of periodontal health. Therefore, their contribution to the existing racial/ethnic differences or to the disparity in the prevalence of periodontitis in general remains unknown. To address these issues and expand our previous work on racial/ethnic differences in periodontitis, we ascertained prevalences of periodontitis for (1) income and (2) education among non-Hispanic Black, Mexican-American, and non-Hispanic White adults aged 50 years or older using data from the third National Health and Nutrition Examination Survey (NHANES III). In addition, we investigated the combined effect of income and education on the prevalence of periodontitis. Finally, in this article we discuss the pathways by which SES indicators intertwined with race/ethnicity to affect periodontal health.
