Factors associated with dental service use of older Korean Americans

Objectives: Based on Andersen\u27s healthcare utilization model, the present study examined factors associated with dental service use in older Korean Americans. Focus was on predisposing characteristics (age, gender, marital status, education and region), oral health needs (problems with teeth or gums and self-rated oral health) and enabling factors (dental health insurance, length of stay in the United States, acculturation and family network). Methods: Using data from surveys with Korean Americans aged 60 or older (N = 2128), a Poisson regression model examined predictors of dental visit in the past 12 months. Findings: More than 21% of the sample reported having a problem with teeth or gums, and over half rated their oral health as either fair or poor. Approximately 71% lacked dental health insurance. The number of dental visits in the past 12 months averaged 1.40 (SD = 1.74), with about 38% having no dental visits at all. Multivariate analyses showed that higher levels of education, the presence of a problem with teeth or gums, dental health insurance coverage, longer length of stay in the United States, and larger family networks were associated with 1.01-1.35 times higher number of dental visits. Conclusion: The findings not only confirmed the critical role of dental health insurance as a service enabler but also highlighted the importance of considering older ethnic immigrants’ oral health and dental care from the perspectives of culture and family

Relationship between Physical Disability and Depression by Gender: A Panel Regression Model

Background Depression in persons with physical disabilities may be more common than in the general population. The purpose of this study was to examine the relationship between physical disability and depression by gender among adults, using a large, nationally representative sample. Methods This study used data from the Korean Longitudinal Study of Aging, Wave one through four, and ran a series of random effect panel regression models to test the relationship between physical disability status and depression by gender. We tested the moderating effect of gender on the relationship between disability status and depression level by examining the significance of the cross-product term between disability status and gender. Results After controlling for self-rated health, marital status, employment status, education, and age, subjects who were female or diagnosed as having any disability presented higher levels of depression scores. Further, the difference in terms of their depression level measured by Center for Epidemiologic Studies Short Depression Scale (CES-D 10) scores between those who were diagnosed as having any disability and those who were not was greater for females than for their male counterparts. Conclusion This study reaffirmed that disability is the risk factor of depression, using longitudinal data. In addition, female gender is the effect modifier rather than the risk factor. The effect of gender in the non-disability group, mostly composed of older persons, is limited. On the contrary, the female disability group showed more depressive symptoms than the male disability group. The gender difference in the disability group and the role of culture on these differences need further research