A Comparative Analysis of Oral Health and Self-Rated Health: ‘All of Us Research Program’ vs. ‘Health and Retirement Study’
Abstract
:1. Introduction
2. Methods
2.1. Data Sources
2.1.1. The Health and Retirement Study (HRS) and the All of Us (AoU) Research Program
2.1.2. Eligibility Criteria
2.2. Measurements
2.3. Statistical Analysis
3. Results
3.1. Participants
Cohort | AoU 1 N | HRS N |
---|---|---|
Entire Cohort | 407,333 | 16,319 |
Age 51+ | 248,970 | 16,318 |
Dentate Status (dentate or edentulous) | 19,206 | 16,290 |
Dentist visit | 6080 | 16,178 |
Self-Rated Health | 6075 | 16,173 |
Race: Non-Hispanic Black, Non-Hispanic White Ethnicity: Hispanic | 5669 | 15,282 |
Sex at Birth, Female or Male | 5618 | 15,282 |
Education Level | 5561 | 15,282 |
Smoking (ever or never) | 5480 | 15,282 |
Cognition 1 | 5480 | 14,691 |
Diabetes 1 | 5480 | 14,504 |
CHD/Stroke 1 | 5480 | 14,358 |
3.2. Descriptive Characteristics of Participants
3.3. Self-Rated Health
4. Discussion
4.1. Study Strengths
4.2. Limitations and Recommendations for Improvement
4.2.1. Timing and Geography
4.2.2. Information from Electronic Health Records
4.2.3. Survey Questions
5. Conclusions and Recommendations
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
a. Regression Coeficients (Standard Errors) | ||||||
Non-Hispanic Black 51–64 N = 568 | Non-Hispanic Black 65+ N = 442 | Non-Hispanic White 51–64 N = 1297 | Non-Hispanic White 65+ N = 2241 | Hispanic 51–64 N = 469 | Hispanic 65+ N = 463 | |
Male | 0.03 (0.09) | −0.06 (0.11) | −0.10 (0.07) | 0.00 (0.05) | 0.07 (0.12) | −0.29 (0.11) |
No Recent Dentist Contact | 0.13 (0.09) | 0.16 (0.10) | 0.36 (0.07) | 0.22 (0.06) | 0.16 (0.10) | −0.08 (0.10) |
Edentulous | −0.38 (0.23) | 0.07 (0.23) | 0.24 (0.20) | 0.14 (0.14) | −0.02 (0.26) | −0.04 (0.22) |
Less Education | 0.08 (0.09) | 0.30 (0.10) | 0.28 (0.08) | 0.15 (0.07) | 0.27 (0.10) | 0.23 (0.11) |
Ever Smoker | 0.23 (0.09) | 0.20 (0.11) | 0.38 (0.06) | 0.32 (0.06) | 0.20 (0.11) | 0.35 (0.11) |
Diabetes | 0.61 (0.20) | 0.92 (0.22) | 0.88 (0.17) | 0.87 (0.13) | 0.81 (0.22) | 0.54 (0.21) |
Cardiovascular Disease | 0.88 (0.56) | 0.91 (0.47) | 0.95 (0.39) | 0.20 (0.21) | −0.08 (0.59) | 0.42 (0.79) |
Impaired Cognition | 1.22 (0.60) | 0.69 (0.53) | 0.93 (0.30) | 0.35 (0.18) | 0.19 (0.70) | 1.67 (0.84) |
b. Odds Ratio (95% Confidence Interval) | ||||||
Non-Hispanic Black 51–64 (N = 568) | Non-Hispanic Black 65+ (N = 442) | Non-Hispanic White 51–64 (N = 1297) | Non-Hispanic White 65+ (N = 2241) | Hispanic 51–64 (N = 469) | Hispanic 65+ (N = 463) | |
Male | 1.07 (0.75–1.53) | 0.89 (0.58–1.37) | 0.82 (0.63–1.07) | 1.00 (0.81–1.24) | 1.14 (0.73–1.80) | 0.56 (0.36–0.88) |
No Recent Dentist Contact | 1.32 (0.92–1.85) | 1.39 (0.93–2.08) | 2.06 (1.58–2.69) | 1.56 (1.23–1.98) | 1.39 (0.94–2.04) | 0.85 (0.57–1.27) |
Edentulous | 0.68 (0.43–1.08) | 1.08 (0.68–1.70) | 1.28 (0.86–1.90) | 1.15 (0.87–1.53) | 0.98 (0.59–1.63) | 0.96 (0.63–1.47) |
Less Education | 1.19 (0.83–1.69) | 1.81 (1.20–2.71) | 1.75 (1.30–2.36) | 1.35 (1.03–1.78) | 1.73 (1.16–2.58) | 1.58 (1.04–2.40) |
Ever Smoker | 1.59 (1.12–2.26) | 1.49 (0.98–2.25) | 2.15 (1.67–2.77) | 1.88 (1.52–2.34) | 1.49 (0.97–2.29) | 2.02 (1.30–3.13) |
Diabetes | 1.86 (1.26–2.72) | 2.50 (1.63–3.84) | 2.42 (1.72–3.41) | 2.39 (1.86–3.07) | 2.25 (1.47–3.46) | 1.72 (1.13–2.61) |
Cardiovascular Disease | 2.42 (0.80–7.29) | 2.48 (0.98–6.27) | 2.59 (1.20–5.62) | 1.22 (0.80–1.84) | 0.92 (0.29–2.91) | 1.52 (0.33–7.08) |
Impaired Cognition | 3.40 (1.04–11.0) | 2.00 (0.70–5.69) | 2.53 (1.41–4.56) | 1.42 (0.99–2.03) | 1.21 (0.30–4.82) | 5.33 (1.02–27.9) |
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Race/Ethnicity | AoU (N = 5480) | HRS Unweighted (N = 14,358) | HRS Weighted 1 (N = 14,358) | |||
---|---|---|---|---|---|---|
51–64 | 65+ | 51–64 | 65+ | 51–64 | 65+ | |
Non-Hispanic Black | 568 (10.3%) | 442 (8.1%) | 1847 (12.9%) | 1414 (9.9%) | 894 (6.2%) | 675 (4.7%) |
Non-Hispanic White | 1297 (23.7%) | 2241 (40.9%) | 3203 (22.3%) | 5535 (38.6%) | 5301 (36.9%) | 5975 (41.6%) |
Hispanic | 469 (8.6%) | 463 (8.5%) | 1357 (9.5%) | 1002 (7.0%) | 905 (6.3%) | 608 (4.2%) |
All Race/Ethnicity Groups | 2334 (42.6%) | 3146 (57.4%) | 6407 (44.6%) | 7951 (55.4%) | 7100 (49.5%) | 7258 (50.5%) |
Variables | AoU (Column %) | HRS Unweighted (Column %) | HRS Weighted (Column % 1) |
---|---|---|---|
Race/Ethnicity Non-Hispanic Black Non-Hispanic White Hispanic | 1010 (18.4%) 3538 (64.6%) 932 (17.0%) | 3261 (22.7%) 8738 (60.9%) 2359 (16.4%) | 1569 (10.9%) 11,275 (78.5%) 1512 (10.5%) |
Sex Female Male | 3385 (61.8%) 2095 (38.2%) | 8416 (58.6%) 5942 (41.4%) | 7783 (54.2%) 6574 (45.8%) |
Age (years) 51–64 65+ | 2334 (42.6%) 3146 (57.4%) | 6407 (44.6%) 7951 (55.4%) | 7100 (49.5%) 7257 (50.6%) |
Self-Rated Health Excellent/Very Good/Good Fair/Poor | 3696 (67.5%) 1784 (32.6%) | 10,255 (71.4%) 4103 (28.6%) | 10,967 (76.4%) 3390 (23.6%) |
Recent Dentist Contact Yes No | 3793 (69.2%) 1687 (30.8%) | 9156 (63.8%) 5202 (36.2%) | 9937 (69.2%) 4420 (30.8%) |
Dentate Status Edentulous Dentate | 885 (16.1%) 4595 (83.9%) | 2300 (16.0%) 12,059 (84.0%) | 1845 (12.9%) 12,511 (87.2%) |
Education HS or Less Some College or More | 1632 (29.8%) 3848 (70.2%) | 4569 (31.8%) 9789 (68.2%) | 5573 (38.8%) 8784 (61.2%) |
Ever Smoker Yes No | 2577 (47.0%) 2903 (53.0%) | 4825 (33.6%) 9533 (66.4%) | 4870 (33.9%) 9487 (66.1%) |
Diabetes Yes No | 1105 (20.2%) 4375 (79.8%) | 3989 (27.8%) 10,369 (72.1%) | 3435 (23.9%) 10,922 (76.1%) |
CVD Yes No | 223 (4.1%) 5257 (95.9%) | 4007 (27.9%) 10,351 (72.1%) | 3681 (25.6%) 10,676 (74.4%) |
Impaired Cognition Yes No | 279 (5.1%) 5201 (94.9%) | 704 (4.9%) 13,654 (95.1%) | 969 (6.8%) 13,388 (93.3%) |
AoU | Weighted HRS | |||||
---|---|---|---|---|---|---|
Excellent Very Good Good N = 3269 | Fair Poor N = 1832 | p-Value * | Excellent Very Good Good N * = 10,967 | Fair Poor N * = 3390 | p-Value * | |
Race/Ethnicity Non-Hispanic Black Non-Hispanic White Hispanic | 570 (56.4%) 2616 (73.9%) 510 (54.7%) | 440 (43.6%) 992 (26.1%) 422 (45.3%) | <0.001 | 1039 (66.2%) 9044 (80.2%) 884 (58.5%) | 530 (33.8%) 2232 (19.8%) 628 (41.6%) | <0.001 |
Sex Female Male | 2263 (66.9%) 1433 (68.4%) | 1122 (33.2%) 662 (31.6%) | 0.23 | 5912 (76.0%) 5054 (76.9%) | 1871 (24.0%) 1519 (23.1%) | 0.19 |
Age (years) 51–64 65+ | 1435 (61.5%) 2261 (71.9%) | 899 (38.5%) 885 (28.1%) | <0.001 | 5487 (77.3%) 5480 (75.5%) | 1613 (22.7%) 1777 (24.5%) | 0.01 |
Recent Dentist Contact Yes No | 2743 (72.3%) 953 (56.5%) | 1050 (27.7%) 734 (43.5%) | <0.001 | 8207 (82.6%) 2760 (62.4%) | 1730 (17.4%) 1661 (37.6%) | <0.001 |
Dentate Status Edentulous Dentate | 560 (63.3%) 3136 (68.3%) | 325 (36.7%) 1459 (31.8%) | 0.004 | 1083 (58.7%) 9883 (79.0%) | 762 (41.3%) 2628 (21.0%) | <0.001 |
Education HS or Less ** Some College *** | 886 (54.3%) 2810 (73.0%) | 746 (45.7%) 1038 (27.0%) | <0.001 | 6132 (69.8%) 4835 (86.8%) | 2652 (30.2%) 738 (13.2%) | <0.001 |
Ever Smoker Yes No | 1588 (61.6%) 2108 (72.6%) | 989 (38.4%) 795 (27.4%) | <0.001 | 3384 (69.5%) 7582 (79.9%) | 1486 (30.5%) 1904 (20.1%) | <0.001 |
Diabetes Yes No | 544 (49.2%) 3152 (72.1%) | 561 (50.8%) 1223 (28.0%) | <0.001 | 2104 (61.3%) 8862 (81.1%) | 1331 (38.7%) 2060 (18.9%) | <0.001 |
CVD Yes No | 126 (56.5%) 3570 (67.9%) | 97 (43.5%) 1687 (32.1%) | <0.001 | 2256 (61.3%) 8711 (81.6%) | 1426 (38.7%) 1964 (18.4%) | <0.001 |
Impaired Cognition Yes No | 166 (59.5%) 3530 (67.9%) | 113 (40.5%) 1671 (32.1%) | <0.001 | 872 (90.0%) 10,095 (75.4%) | 97 (10.0%) 3294 (24.6%) | <0.001 |
Characteristic | AoU Fair/Poor S-RH OR (95% CI) | HRS Fair/Poor S-RH OR (95% CI) |
---|---|---|
Male | 0.96 (0.83–1.10) | 0.94 (0.70–1.25) |
No Recent Dentist Contact | 1.28 (1.11–1.48) | 1.45 (1.09–1.94) |
Edentulous | 1.14 (0.78–1.65) | 1.57 (0.69–3.57) |
Less Education | 1.24 (1.06–1.45) | 1.42 (1.03–1.94) |
Ever Smoker | 1.38 (1.20–1.59) | 1.89 (1.43–2.51) |
Diabetes | 2.33 (1.68–3.22) | 2.23 (1.60–3.09) |
Cardiovascular disease | 1.72 (0.80–3.72) | 1.33 (0.65–2.75) |
Impaired Cognition | 1.97 (0.94–4.16) | 1.99 (0.87–4.59) |
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Weintraub, J.A.; Moss, K.L.; Finlayson, T.L.; Jones, J.A.; Preisser, J.S. A Comparative Analysis of Oral Health and Self-Rated Health: ‘All of Us Research Program’ vs. ‘Health and Retirement Study’. Int. J. Environ. Res. Public Health 2024, 21, 1210. https://doi.org/10.3390/ijerph21091210
Weintraub JA, Moss KL, Finlayson TL, Jones JA, Preisser JS. A Comparative Analysis of Oral Health and Self-Rated Health: ‘All of Us Research Program’ vs. ‘Health and Retirement Study’. International Journal of Environmental Research and Public Health. 2024; 21(9):1210. https://doi.org/10.3390/ijerph21091210
Chicago/Turabian StyleWeintraub, Jane A., Kevin L. Moss, Tracy L. Finlayson, Judith A. Jones, and John S. Preisser. 2024. "A Comparative Analysis of Oral Health and Self-Rated Health: ‘All of Us Research Program’ vs. ‘Health and Retirement Study’" International Journal of Environmental Research and Public Health 21, no. 9: 1210. https://doi.org/10.3390/ijerph21091210