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Arnold School of Public Health

Children living in safe, supportive neighborhoods have better oral health

February 27, 2023 | Erin Bluvas, bluvase@sc.edu

A study led by Elizabeth Crouch, associate professor of health services policy and management, has found a connection between children’s living conditions and their oral health. Working with other investigators from the Rural and Minority Health Research Center, where she serves as director, and the Medical University of South Carolina, Crouch and her co-authors published their findings in the Journal of Public Dentistry.

Addressing oral health involves child, family, community, and policy/culture considerations...It is vital that we do not overlook safe and supportive neighborhoods as true determinants of health outcomes, specifically oral health.

Elizabeth Crouch, associate professor of health services policy and management
Elizabeth Crouch

Crouch and her team have investigated multiple areas related to children’s oral health, including rural vs urban settings, the impact of adverse childhood experiences, and opportunities for policy change. These studies and others have found oral health disparities based on race, poverty, rurality, and higher incidence rates of adverse childhood experiences (e.g., emotional/physical/sexual abuse, neglect, household dysfunction).

“Despite numerous clinical advancements over the past 20 years, significant challenges remain for oral health at the population level,” Crouch says. “There has been limited examination, however, of how community-level supports may influence oral health.”

The present study used data from the 2018–2019 National Survey of Children's Health, with the researchers analyzing information concerning more than 40,000 children (ages 6 to 17). They looked at access to oral health services, distinguishing between preventive (e.g., check-ups, cleanings, fluoride treatment) vs reactive care (e.g., tooth decay/cavities) as well as environmental factors, such as whether the participant resided in a safe, supportive neighborhood.

The authors found that children living in a supportive neighborhood are more likely to have had preventive dental visits. Further, children who live in a safe neighborhood are less likely to have tooth decay compared to their counterparts.

“Addressing oral health involves child, family, community, and policy/culture considerations, and our findings from this study support previous research related to the child and family levels while elevating the importance of community and neighborhood contexts,” Crouch says. “Community- and neighborhood-based interventions may be highly effective for children, and community-level advocacy efforts are also needed. It is vital that we do not overlook safe and supportive neighborhoods as true determinants of health outcomes, specifically oral health.”


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