Background: Poor dental health is a common chronic condition among youth. Appalachian versus metropolitan residence, socioeconomic status, and health behaviors contribute to poor dental health. Limited research has directly compared dental health and risk factors for poor dental health among Appalachian and metropolitan youth. We examined the association between dental health and residence among adolescent boys and explored socioeconomic and behavioral factors that may contribute to differences in dental health.
Methods: Adolescent males from metropolitan and rural Appalachian Ohio (n = 1220, age 11-16 years) reported their diet and tobacco use. Parents or guardians reported when boys had last visited the dentist and rated their dental health (excellent/very good/good versus fair/poor). Unadjusted logistic regression modeled the association between fair/poor dental health and residence (metropolitan versus Appalachian). Adjusted analyses controlled for race, household income, dental visits, diet, and tobacco use.
Results: Appalachian (versus metropolitan) boys were more likely to have used tobacco in the past 30 days and consumed fewer fruit and vegetables, more added sugar, and more sugary beverages. The relation between dental health and Appalachian versus metropolitan residence did not reach statistical significance, and adjusting for behavioral factors did little to change the observed association.
Conclusion: Our findings suggest that some of the urban/rural disparities in dental health observed in other studies may be related to behavioral factors like tobacco use and diet, but much remains unexplained. We provide support for behavioral interventions to address these issues in the Appalachian community.
Background: Human papillomavirus (HPV) vaccine has been recommended for males in the United States since 2011, yet little is known about vaccine coverage among adolescent males in Ohio. Our longitudinal study examined HPV vaccine coverage among adolescent males in Ohio and identified predictors of vaccination.
Methods: The Buckeye Teen Health Study recruited adolescent males ages 11-16 and their parents from one urban county and nine rural counties in Ohio. We report longitudinal vaccination data on 1126 adolescent males, with baseline data from 2015-2016 and follow-up data from 2017-2018. We used multivariable Poisson regression to identify predictors of HPV vaccine initiation that occurred between baseline and follow-up.
Results: At baseline, 42.4% of parents reported their sons had initiated the HPV vaccine series. Among parents whose sons were unvaccinated at baseline, 36.3% indicated initiation at follow-up. Initiation at follow-up was more common among sons who had received influenza vaccine (RR = 1.54, 95% CI = 1.08-2.18) or whose parents indicated lack of a recent visit to a doctor as the main reason for not yet vaccinating at baseline (RR = 1.41, 95% CI = 1.02-1.95). Initiation was less common among sons whose parents had an associate's degree or some college education (RR = 0.28, 95% CI = 0.46-0.99). Main reasons for not vaccinating changed from baseline to follow-up among parents of unvaccinated sons.
Conclusions: Although HPV vaccine initiation increased over time, many adolescent males in Ohio remain unvaccinated. Findings can help guide future strategies for increasing HPV vaccine coverage among this population.
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