Dissertation
Perceived social status and oral health outcomes: a new determinant of health?
University of Iowa
Doctor of Philosophy (PhD), University of Iowa
Spring 2023
DOI: 10.25820/etd.007105
Abstract
Background: Perceived social status (PSS) is a measure of social status, reflecting cumulative lifetime effects of relative social status based on available resources and life experiences. PSS is hypothesized to better capture social status compared to traditional socioeconomic status (SES) measures (i.e., education, occupation, and income). This dissertation investigated the association of PSS with oral health.
Methods: This dissertation is a series of three studies. Study I and study II analyzed a survey administered to a random sample of low-income adults with Medicaid insurance in the state of Iowa (N=18,000). Study III used a qualitative approach with semi-structured one-on-one interviews of emerging young adults (aged 18-25-years) seeking dental care to evaluated PSS and motivators to seeking dental care.
Results: In study I, PSS was found to be positively associated (ß=.16, p<.0001) with self-reported oral health when controlling for demographic characteristics, as well as with self-reported dental utilization in study II. Additionally, individuals with higher PSS more often mentioned having routine dental care in childhood and strong personal drive to seek dental care in adulthood as determined in study III.
Conclusions: Our research along with previous studies have demonstrated that PSS is associated with oral health outcomes and healthy behaviors. Exploring these factors longitudinally is critical, particularly across the lifespan. We discovered that emerging young adults face additional challenges to obtaining care. Future directions include exploring whether PSS changes as individuals age and if that impacts care-seeking behaviors.
Details
- Title: Subtitle
- Perceived social status and oral health outcomes: a new determinant of health?
- Creators
- Jennifer Michelle Cecelia Sukalski
- Contributors
- Susan C McKernan (Advisor)Natoshia M Askelson (Committee Member)Peter C Damiano (Committee Member)Julie C Reynolds (Committee Member)Xian Jin Xie (Committee Member)
- Resource Type
- Dissertation
- Degree Awarded
- Doctor of Philosophy (PhD), University of Iowa
- Degree in
- Oral Science
- Date degree season
- Spring 2023
- DOI
- 10.25820/etd.007105
- Publisher
- University of Iowa
- Number of pages
- ix, 205 pages
- Copyright
- Copyright 2023 Jennifer Michelle Cecelia Sukalski
- Language
- English
- Date approved
- 06/30/2023
- Description illustrations
- illustrations, tables, graphs
- Description bibliographic
- Includes bibliographical references (pages 185-205).
- Public Abstract (ETD)
- Despite considerable advances over the last 50 years in in the prevention, diagnosis, and treatment of oral diseases in the U.S., disparities persist in segments of the population. Populations most disproportionally impacted are those with low socioeconomic status (SES), racial/ethnic minorities, those living rural areas. Traditional objective SES indicators that are often used in research to measure disparities include education, income, and occupational status. Although objective SES measures are valid and reliable predictors of current life situations, they are contextually inadequate. These measures do not consider the implications of someone’s self-perceived social status relative to others. Further, these measures apply a fixed criterion for all groups and do not consider variability in the importance and value of life experiences collectively. Recent research has explored the relationship between PSS and health, using this more holistic view. Studies have found that PSS is predictive of numerous health outcomes such as: self-rated health, heart disease, diabetes, and mental health. However, little research has been done to explore the role of PSS with oral health. In a series of three studies, this dissertation investigated the association of PSS with oral health outcomes – self-reported oral health and self-reported dental utilization in a Medicaid adult population, and motivators to seeking dental care among emerging young adults (aged 18-25). Perceived social status was found to be associated with self-reported oral health and self-reported dental utilization.
- Academic Unit
- Oral Pathology, Radiology and Medicine
- Record Identifier
- 9984425393102771
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