Health Policy Manag.  2021 Mar;31(1):74-90. 10.4332/KJHPA.2021.31.1.74.

Oral Health Status and Behavior Factors Associated with Self-Rated Health Status among the Elderly in South Korea: The 7th Korea National Health and Nutrition Examination Survey (2016–2018)

Affiliations
  • 1Seoul National University Dental Hospital, Seoul, Korea
  • 2Departments of Health Policy and Management, Graduate School of Public Health, Yonsei University, Seoul, Korea
  • 3Departments of Healthcare Management, Graduate School of Public Health, Yonsei University, Seoul, Korea
  • 4Labor Welfare Research Institute, Korea Worker’s Compensation & Welfare Service, Seoul, Korea
  • 5Institute of Health Services Research, Yonsei University, Seoul, Korea

Abstract

Background
It is getting important to improve the oral health status of the elderly because oral health status may affect their health status of the whole body. In this respect, we aimed to explore the association of oral health status and behavior factors with self-rated health status by sex.
Methods
Using the data from the 7th Korea National Health and Nutrition Examination Survey for health surveys and oral examinations (2016–2018), we analyzed a total of 3,070 people aged 65 or older (men: 1,329; women: 1,741). Our dependent variable, self-rated health status, was divided into two groups: not good (bad and very bad) and good (very good, good, and fair), whereas our independent variables of interest were oral health status and behavior factors. In addition to descriptive analysis and the Rao-Scott chi-square test, reflecting survey characteristics, we conducted hierarchical multivariable logistic regression analyses adjusted for socio-demographics and health status and behavior factors. All analyses were stratified by sex.
Results
The proportion of people having ‘not good’ self-rated health was 36.5% in women but 24.5% in men. In a model adjusted for all covariates, the self-rated health status showed significant association with the self-rated oral health status. For example, in men, the risk of having ‘not good’ self-rated health was high in people having ‘poor’ (odds ratio [OR], 5.31; 95% confidence interval [CI], 2.34–12.03) self-rated oral health status and in those having ‘fair’ (OR, 4.03; 95% CI, 1.68–9.70) in comparison with those having ‘good’ self-rated oral health status. Dental status regarding speaking difficulty seemed to be very important in influencing self-rated health status. For instance, in women, compared to people having ‘no discomfort’ speaking difficulty, the risk of having ‘not good’ self-rated health was high in people having ‘not bad’ (OR, 1.60; 95% CI, 1.14–2.24) and ‘discomfort’ (OR, 1.79; 95% CI, 1.30–2.47) speaking difficulty. The covariates significantly associated with the risk of having ‘not good’ self-rated health were: physical activity, chronic disease, stress, and body mass index in both sexes; health insurance type and drinking only in men; and economic activity only in women.
Conclusion
Oral health status and behavioral factors were associated with self-rated health status among the elderly, differently by sex. This suggests that public health policies toward better health in the elderly should take their oral health status and oral health behaviors into account in a sex-specific way

Keyword

Oral health status and behavior factor; Self-rated health status; Elderly; 7th Korea National Health and Nutrition Examination Survey; Republic of Korea
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