Social Disadvantage and Multimorbidity Including Oral Conditions in the United States

Area of Science:

• Public Health
• Epidemiology
• Oral Health Research

Background:

• Multimorbidity studies often exclude prevalent oral diseases, creating a gap in understanding disease burden.
• Chronic oral conditions affect over half the global population, yet their contribution to multimorbidity is underrepresented.

Purpose of the Study:

• To examine the relationship between social disadvantage and multimorbidity, comparing estimates with and without the inclusion of oral health conditions.
• To assess how social gradients in multimorbidity differ when oral health is considered.

Main Methods:

• Cross-sectional analysis of US adults aged 30+ from the National Health and Nutrition Survey (2013-2014).
• Multimorbidity defined as ≥2 chronic conditions, including 5 medical and 4 oral health conditions.
• Inverse probability treatment weighting (IPTW) used to analyze social gradients (education, income) with and without oral conditions.

Main Results:

• Inclusion of oral conditions increased multimorbidity prevalence from 20.8% to 53.4%.
• Clear social gradients were observed for multimorbidity, becoming more pronounced with oral conditions included.
• Low education and low income were significantly associated with higher multimorbidity prevalence, especially when oral health was considered.

Conclusions:

• Chronic oral conditions substantially impact multimorbidity prevalence estimates.
• Oral health is a critical component for accurate assessment of multimorbidity and understanding health disparities.
• Public health strategies addressing multimorbidity should integrate oral health considerations.