Perceived Social Status and Oral Health Among Medicaid Insured Adults in Iowa

Purpose: Perceived social status (PSS), a measure of social status, reflects cumulative lifetime effects of an individual’s relative social status based on resources and lived experiences. PSS is hypothesized to better capture social status compared to traditional measures of socioeconomic status (S...

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Main Authors: Jennifer M.C. Sukalski, Natoshia M. Askelson, Julie C. Reynolds, Peter C. Damiano, Wei Shi, Xian Jin Xie, Susan C. McKernan
Format: Article
Language:English
Published: Mary Ann Liebert 2024-12-01
Series:Health Equity
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Online Access:https://www.liebertpub.com/doi/10.1089/heq.2023.0227
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author Jennifer M.C. Sukalski
Natoshia M. Askelson
Julie C. Reynolds
Peter C. Damiano
Wei Shi
Xian Jin Xie
Susan C. McKernan
author_facet Jennifer M.C. Sukalski
Natoshia M. Askelson
Julie C. Reynolds
Peter C. Damiano
Wei Shi
Xian Jin Xie
Susan C. McKernan
author_sort Jennifer M.C. Sukalski
collection DOAJ
description Purpose: Perceived social status (PSS), a measure of social status, reflects cumulative lifetime effects of an individual’s relative social status based on resources and lived experiences. PSS is hypothesized to better capture social status compared to traditional measures of socioeconomic status (SES) (i.e., education, occupation, and income). Although recognized as a predictor of health-related morbidity and mortality, limited research has explored PSS and oral health. This study investigated PSS as a predictor of self-reported oral health among low-income adults. Methods: In spring 2018, a survey was administered to a random sample of low-income adults in the state of Iowa with public dental insurance (N = 18,000). Respondents were asked about PSS, oral health status, and demographics. Multivariable linear regression models examined PSS as a predictor of self-reported oral health and compared the predictive power of PSS and SES indicators. Results: The final adjusted sample size was 2,331. The mean PSS (range 1-10) was 5.3 (standard deviation 2.0). A significant positive association was noted between PSS (ß = 0.16, p < 0.0001) and self-reported oral health status when controlling for demographics. Furthermore, PSS accounted for an additional 3% of variance when controlling for demographic and SES indicators. Conclusions: PSS was associated with self-reported oral health status after adjusting for SES indicators, which reflects the importance of exploring the impact of individuals’ perceptions of their social status in addition to objective measures of SES. Results suggest the need for future dental research to explore cumulative effects of lived experiences on current oral health status.
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spelling doaj-art-81292aedd1bf4a5ab97c873a717deb8e2025-08-20T02:59:07ZengMary Ann LiebertHealth Equity2473-12422024-12-018166767510.1089/heq.2023.0227Perceived Social Status and Oral Health Among Medicaid Insured Adults in IowaJennifer M.C. Sukalski0Natoshia M. Askelson1Julie C. Reynolds2Peter C. Damiano3Wei Shi4Xian Jin Xie5Susan C. McKernan6Department of Preventive and Community Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, USA.Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, Iowa, USA.Department of Preventive and Community Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, USA.Department of Preventive and Community Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, USA.Division of Biostatistics and Computational Biology, Iowa Institute for Oral Health Research, University of Iowa College of Dentistry, Iowa City, Iowa, USA.Department of Preventive and Community Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, USA.Department of Public and Primary Oral Healthcare, University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA.Purpose: Perceived social status (PSS), a measure of social status, reflects cumulative lifetime effects of an individual’s relative social status based on resources and lived experiences. PSS is hypothesized to better capture social status compared to traditional measures of socioeconomic status (SES) (i.e., education, occupation, and income). Although recognized as a predictor of health-related morbidity and mortality, limited research has explored PSS and oral health. This study investigated PSS as a predictor of self-reported oral health among low-income adults. Methods: In spring 2018, a survey was administered to a random sample of low-income adults in the state of Iowa with public dental insurance (N = 18,000). Respondents were asked about PSS, oral health status, and demographics. Multivariable linear regression models examined PSS as a predictor of self-reported oral health and compared the predictive power of PSS and SES indicators. Results: The final adjusted sample size was 2,331. The mean PSS (range 1-10) was 5.3 (standard deviation 2.0). A significant positive association was noted between PSS (ß = 0.16, p < 0.0001) and self-reported oral health status when controlling for demographics. Furthermore, PSS accounted for an additional 3% of variance when controlling for demographic and SES indicators. Conclusions: PSS was associated with self-reported oral health status after adjusting for SES indicators, which reflects the importance of exploring the impact of individuals’ perceptions of their social status in addition to objective measures of SES. Results suggest the need for future dental research to explore cumulative effects of lived experiences on current oral health status.https://www.liebertpub.com/doi/10.1089/heq.2023.0227perceived social statusoral healthsocial classhealth inequalitieshealth statushealth surveys
spellingShingle Jennifer M.C. Sukalski
Natoshia M. Askelson
Julie C. Reynolds
Peter C. Damiano
Wei Shi
Xian Jin Xie
Susan C. McKernan
Perceived Social Status and Oral Health Among Medicaid Insured Adults in Iowa
Health Equity
perceived social status
oral health
social class
health inequalities
health status
health surveys
title Perceived Social Status and Oral Health Among Medicaid Insured Adults in Iowa
title_full Perceived Social Status and Oral Health Among Medicaid Insured Adults in Iowa
title_fullStr Perceived Social Status and Oral Health Among Medicaid Insured Adults in Iowa
title_full_unstemmed Perceived Social Status and Oral Health Among Medicaid Insured Adults in Iowa
title_short Perceived Social Status and Oral Health Among Medicaid Insured Adults in Iowa
title_sort perceived social status and oral health among medicaid insured adults in iowa
topic perceived social status
oral health
social class
health inequalities
health status
health surveys
url https://www.liebertpub.com/doi/10.1089/heq.2023.0227
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