Substance Use, General Health and Health Literacy as Predictors of Oral Health in Emerging Adult Sexual Minority Men of Color: A Secondary Data Analysis

S Raquel Ramos, David T Lardier Jr, Rueben C Warren, Melba Cherian, Sarwat Siddiqui, Trace Kershaw, S Raquel Ramos, David T Lardier Jr, Rueben C Warren, Melba Cherian, Sarwat Siddiqui, Trace Kershaw

Abstract

There is limited evidence surrounding oral health in emerging adult, sexual minority men of color. This study examined the association between sociodemographic factors, health literacy, cigarette, e-cigarette, and alcohol use on oral health outcomes. Secondary data analysis was conducted with 322 sexual minority men ages 18-34 in the United States. Between-group, mean-level, and multivariable logistic regression analyses examined differences on oral health outcomes. Increased cigarette (aOR = 1.84, p = 0.03), e-cigarette (aOR = 1.40, p = 0.03), and alcohol use (aOR = 2.07, p = 0.05) were associated with extended time away from the dentist. Health literacy (aOR = 0.93, p = 0.05) was negatively associated. Increased cigarette (aOR = 1.17, p = 0.04) and cigarette use (aOR = 1.26, p = 0.04) were associated with tooth loss. Health literacy was negatively associated (aOR = 0.65, p = 0.03). Increased e-cigarette (aOR = 1.74, p = 0.04) and cigarette use (aOR = 4.37, p < 0.001) were associated with dental affordability issues. Lower health literacy and racial identification as Black were associated with dental affordability issues; demonstrating an urgent need to address these factors to improve oral health in emerging adult sexual minority men of color.

Trial registration: ClinicalTrials.gov NCT04061915.

Keywords: electronic cigarette; health literacy; oral health; sexual minority men; substance use; systemic health; tooth loss; young adult.

Conflict of interest statement

The authors declare no conflict of interest.

References

    1. CDC . HIV Surveillance Report, 2018 (Updated) CDC; Atlanta, GA, USA: 2020.
    1. Warren R. Enhancing oral and systemic health. Compend. Contin. Educ. Dent. 2001;22:4.
    1. CDC . Oral Health in America: A Report of the Surgeon General. NIH publication; Bethesda, MD, USA: 2000. pp. 155–188.
    1. Petersen P.E. The World Oral Health Report 2003: Continuous improvement of oral health in the 21st century—The approach of the WHO Global Oral Health Programme. Community Dent. Oral Epidemiol. 2003;31:3–24. doi: 10.1046/j..2003.com122.x.
    1. NIDCR HIV/AIDS & Oral Health. [(accessed on 10 December 2020)];2018 Available online: .
    1. ADA Oral-Systemic Health. [(accessed on 10 November 2020)];2019 Available online: .
    1. Hafeez H., Zeshan M., Tahir M.A., Jahan N., Naveed S. Health Care Disparities Among Lesbian, Gay, Bisexual, and Transgender Youth: A Literature Review. Cureus. 2017;9:e1184. doi: 10.7759/cureus.1184.
    1. Kates J., Ranji U., Beamesderfer A., Salganicoff A., Daws L. Health and Access to care and Coverage for Lesbian, Gay, Bisexual and Transgender (LGBT) Individuals in the US. Kaiser Family Foundation; San Francisco, CA, USA: 2015. Retrieved 16 February 2020.
    1. Schwartz S.B., Sanders A.E., Lee J.Y., Divaris K. Sexual orientation-related oral health disparities in the United States. J. Public Health Dent. 2019;79:18–24. doi: 10.1111/jphd.12290.
    1. CDC What Is Health Literacy? [(accessed on 17 September 2020)];2020 Available online: .
    1. Firmino R.T., Ferreira F.M., Paiva S.M., Granville-Garcia A.F., Fraiz F.C., Martins C.C. Oral health literacy and associated oral conditions. J. Am. Dent. Assoc. 2017;148:604–613. doi: 10.1016/j.adaj.2017.04.012.
    1. Holtzman J.S., Atchison K.A., Macek M.D., Markovic D. Oral Health Literacy and Measures of Periodontal Disease. J. Periodontol. 2017;88:78–88. doi: 10.1902/jop.2016.160203.
    1. Baskaradoss J.K. The association between oral health literacy and missed dental appointments. J. Am. Dent. Assoc. 2016;147:867–874. doi: 10.1016/j.adaj.2016.05.011.
    1. Salfas B., Rendina H.J., Parsons J.T. What is the role of the community? Examining minority stress processes among gay and bisexual men. Stigma Health. 2019;4:300–309. doi: 10.1037/sah0000143.
    1. Meyer I.H. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychol. Bull. 2003;129:674–697. doi: 10.1037/0033-2909.129.5.674.
    1. Bariola E., Lyons A., Leonard W. Gender-specific health implications of minority stress among lesbians and gay men. Aust. N. Z. J. Public Health. 2016;40:506–512. doi: 10.1111/1753-6405.12539.
    1. Mereish E.H., Kuerbis A., Morgenstern J. A daily diary study of stressful and positive events, alcohol use, and addiction severity among heavy drinking sexual minority men. Drug Alcohol Depend. 2018;187:149–154. doi: 10.1016/j.drugalcdep.2018.03.003.
    1. McConnell E.A., Janulis P., Phillips G., Truong R., Birkett M. Multiple minority stress and LGBT community resilience among sexual minority men. Psychol. Sex. Orientat. Gend. Divers. 2018;5:1–12. doi: 10.1037/sgd0000265.
    1. WHO Oral Health. [(accessed on 10 November 2020)];2020 Available online: .
    1. NCCDPHP . The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. US Department of Health and Human Services, Centers for Disease Control and Prevention; Atlanta, GA, USA: 2014.
    1. McCabe S.E., Matthews A.K., Lee J.G., Veliz P., Hughes T.L., Boyd C.J. Tobacco Use and Sexual Orientation in a National Cross-sectional Study: Age, Race/Ethnicity, and Sexual Identity–Attraction Differences. Am. J. Prev. Med. 2018;54:736–745. doi: 10.1016/j.amepre.2018.03.009.
    1. Johnson S.E., Holder-Hayes E., Tessman G.K., King B.A., Alexander T., Zhao X. Tobacco Product Use Among Sexual Minority Adults: Findings from the 2012−2013 national adult tobacco survey. Am. J. Prev. Med. 2016;50:e91–e100. doi: 10.1016/j.amepre.2015.07.041.
    1. Fallin-Bennett A., Lisha N.E., Ling P.M. Other Tobacco Product Use Among Sexual Minority Young Adult Bar Patrons. Am. J. Prev. Med. 2017;53:327–334. doi: 10.1016/j.amepre.2017.03.006.
    1. Loschiavo C., Acuna N., Halkitis P.N. Evidence for the Confluence of Cigarette Smoking, Other Substance Use, and Psychosocial and Mental Health in a Sample of Urban Sexual Minority Young Adults: The P18 Cohort Study. Ann. Behav. Med. 2020 doi: 10.1093/abm/kaaa052.
    1. Bagnardi V., Blangiardo M., La Vecchia C., Corrao G. Alcohol consumption and the risk of cancer: A meta-analysis. Alcohol Res. Health. 2001;25:263.
    1. Meurman J.H., Suuronen R. Comprehensive Handbook of Alcohol Related Pathology. Elsevier Academic cop; Amsterdam, The Netherlands: 2005. Oral health and alcohol; pp. 551–555.
    1. Perkins T.M., Perkins I. Chronic alcoholism: A common risk factor in oral cancer and alcoholic cirrhosis. Compend. Contin. Educ. Dent. 2001;22:49–51.
    1. Peralta R.L., Victory E., Thompson C.L. Alcohol use disorder in sexual minority adults: Age- and sex- specific prevalence estimates from a national survey, 2015–2017. Drug Alcohol Depend. 2019;205:107673. doi: 10.1016/j.drugalcdep.2019.107673.
    1. Kamen C., Palesh O., Gerry A.A., Andrykowski M.A., Heckler C., Mohile S., Morrow G.R., Bowen D., Mustian K. Disparities in Health Risk Behavior and Psychological Distress Among Gay Versus Heterosexual Male Cancer Survivors. LGBT Health. 2014;1:86–92. doi: 10.1089/lgbt.2013.0022.
    1. Priyanka K., Sudhir K.M., Reddy V.C.S., Kumar R.K., Srinivasulu G. Impact of Alcohol Dependency on Oral Health—A Cross-sectional Comparative Study. JCDR. 2017;11:ZC43–ZC46. doi: 10.7860/JCDR/2017/26380.10058.
    1. Zarkin G.A., Bray J.W., Babor T.F., Higgins-Biddle J.C. Alcohol Drinking Patterns and Health Care Utilization in a Managed Care Organization. Health Serv. Res. 2004;39:553–570. doi: 10.1111/j.1475-6773.2004.00244.x.
    1. Miquel L., Manthey J., Rehm J., Vela E., Bustins M., Segura L., Vieta E., Colom J., Anderson P., Gual A. Risky Alcohol Use: The Impact on Health Service Use. Eur. Addict. Res. 2018;24:234–244. doi: 10.1159/000493884.
    1. CDC . Behavioral Risk Factor Surveillance System Survey Questionnaire. Department of Health and Human Services, Centers for Disease Control and Prevention; Atlanta, GA, USA: 2001. pp. 22–23.
    1. Lee S.-Y.D., Stucky B.D., Lee J.Y., Rozier R.G., Bender D.E. Short Assessment of Health Literacy-Spanish and English: A Comparable Test of Health Literacy for Spanish and English Speakers. Health Serv. Res. 2010;45:1105–1120. doi: 10.1111/j.1475-6773.2010.01119.x.
    1. SAMHSA . 2015 National Survey on Drug Use and Health: Summary of the Effects of the 2015 NSDUH Questionnaire Redesign: Implications for Data Users [Internet] SAMHSA; Rockville, MD, USA: 2016.
    1. Bursac Z., Gauss C.H., Williams D.K., Hosmer D.W. Purposeful selection of variables in logistic regression. Source Code Biol. Med. 2008;3:1–8. doi: 10.1186/1751-0473-3-17.
    1. Aneshensel C.S. Theory-Based Data Analysis for the Social Sciences. Sage Publications; Newbury Park, CA, USA: 2012.
    1. Vora M.V., Chaffee B.W. Tobacco-use patterns and self-reported oral health outcomes: A cross-sectional assessment of the Population Assessment of Tobacco and Health study, 2013–2014. J. Am. Dent. Assoc. 2019;150:332–344.e2. doi: 10.1016/j.adaj.2018.12.004.
    1. Souto M.L.S., Rovai E.S., Villar C.C., Braga M.M., Pannuti C.M. Effect of smoking cessation on tooth loss: A systematic review with meta-analysis. BMC Oral Health. 2019;19:1–16. doi: 10.1186/s12903-019-0930-2.
    1. Bahdila D., Aldosari M., Abdullah A., Nelson J.L., Hegazi F., Badamia R., Alhazmi H., Chandel T., Odani S., Vardavas C.I., et al. Cocaine, polysubstance abuse, and oral health outcomes, NHANES 2009 to 2014. J. Periodontol. 2020;91:1039–1048. doi: 10.1002/JPER.19-0509.
    1. Chaffee B.W. Electronic Cigarettes: Trends, Health Effects and Advising Patients Amid Uncertainty. J. Calif. Dent. Assoc. 2019;47:85.
    1. Miech R., Johnston L., O’Malley P.M., Bachman J.G., Patrick M.E. Trends in Adolescent Vaping, 2017–2019. N. Engl. J. Med. 2019;381:1490–1491. doi: 10.1056/NEJMc1910739.
    1. Truth Initiative E-Cigarettes: Facts, Stats and Regulations. [(accessed on 11 November 2020)];2020 Available online: .
    1. Leigh W. Factors Affecting the Health of Men of Color in the United States. Joint Center for Political and Economic Studies; Washington, DC, USA: 2004.
    1. CDC Disparities in Oral Health. [(accessed on 10 November 2020)];2020 Available online: .
    1. Assari S. Socioeconomic Status and Self-Rated Oral Health; Diminished Return among Hispanic Whites. Dent. J. 2018;6:11. doi: 10.3390/dj6020011.
    1. Satcher D., Nottingham J.H. Revisiting Oral Health in America: A Report of the Surgeon General. American Public Health Association; Washington, DC, USA: 2017.
    1. Adekugbe O.C. Ph.D. Thesis. The University of Iowa; Iowa City, IA, USA: 2020. Oral Health Status and Dental Service Utilization of Persons Who Identify as Lesbian, Gay, Bisexual, Transgender, and Queer in Iowa City.
    1. Lehavot K., Blosnich J.R., Glass J.E., Williams E.C. Alcohol use and receipt of alcohol screening and brief intervention in a representative sample of sexual minority and heterosexual adults receiving health care. Drug Alcohol Depend. 2017;179:240–246. doi: 10.1016/j.drugalcdep.2017.07.003.
    1. Halkitis P.N., Valera P., Loschiavo C.E., Goldstone S.E., Kanztanou M., Maiolatesi A.J., Ompad D.C., Greene R.E., Kapadia F. Human Papillomavirus Vaccination and Infection in Young Sexual Minority Men: The P18 Cohort Study. Aids Patient Care STDs. 2019;33:149–156. doi: 10.1089/apc.2018.0276.
    1. Meites E., Gorbach P.M., Gratzer B., Panicker G., Steinau M., Collins T., Parrish A., Randel C., McGrath M., Carrasco S., et al. Monitoring for Human Papillomavirus Vaccine Impact Among Gay, Bisexual, and Other Men Who Have Sex with Men—United States, 2012–2014. J. Infect. Dis. 2016;214:689–696. doi: 10.1093/infdis/jiw232.
    1. Horowitz A.M., Kleinman D.V. Oral Health Literacy: The New Imperative to Better Oral Health. Dent. Clin. N. Am. 2008;52:333–344. doi: 10.1016/j.cden.2007.12.001.
    1. Doak C.C., Doak L.G., Root J.H. Teaching Patients with Low Literacy Skills. AJN. 1996;96:16M. doi: 10.1097/00000446-199612000-00022.
    1. Greene M.Z., France K., Kreider E.F., Wolfe-Roubatis E., Chen K.D., Wu A., Yehia B.R. Comparing medical, dental, and nursing students’ preparedness to address lesbian, gay, bisexual, transgender, and queer health. PLoS ONE. 2018;13:e0204104. doi: 10.1371/journal.pone.0204104.
    1. Aguilar E., Fried J. Enhancing dental and dental hygiene student awareness of the lesbian, gay, bisexual and transgender population. Am. Dent. Hyg. Assoc. 2015;89:11–16.
    1. Macdonald D.W., Grossoehme D.H., Mazzola A., Pestian T., Schwartz S.B. “I just want to be treated like a normal person.” Oral health care experiences of transgender adolescents and young adults. J. Am. Dent. Assoc. 2019;150:748–754. doi: 10.1016/j.adaj.2019.03.025.
    1. Estrich C.G., Mikkelsen M., Morrissey R., Geisinger M.L., Ioannidou E., Vujicic M., Araujo M.W. Estimating COVID-19 prevalence and infection control practices among US dentists. J. Am. Dent. Assoc. 2020;151:815–824. doi: 10.1016/j.adaj.2020.09.005.
    1. Carey M. Dental Practices Continue to Recover, According to HPI Poll. [(accessed on 22 June 2020)];2020 Available online: .

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