Acculturation and Oral Health-related Quality of Life: HCHS/SOL Cohort

Objectives: To examine the association between acculturation and oral health-related quality of life (OHRQOL) in a diverse Hispanic/Latino population. Hispanics/Latinos experience worse OHRQOL compared with non-Hispanic Whites, yet few studies have examined this association.
Methods: We conducted cross-sectional analyses of baseline data (2008-2011) from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a prospective study of 15,357 Hispanic/Latino adults in the United States. Information was collected on markers of acculturation (language preference for baseline examination, birthplace, generation, and length of U.S. residence) and OHRQOL indicators (restriction in the amount/kind of food, oro-facial pain, difficulty chewing, tasting, or swallowing, and difficulty doing usual jobs or attending school). Multivariable logistic regression analyses were conducted to examine the odds of each OHRQOL indicator according to acculturation markers.
Results: Participants were predominantly born outside of the U.S. (74.1%), preferred Spanish (72.1%), and were first generation (72.5%). One-fifth of the participants experienced food restriction (21.4%) and difficulty chewing, tasting, or swallowing (21.4%), while almost half (45.6%) reported pain and 1.9% experienced difficulty doing usual jobs or attending school. In age and gender-adjusted analyses, higher acculturation was associated with greater food restriction (OR=1.20; 95% CI: 1.02-1.40 for 2^nd vs. 1^st generation, OR=1.22; 95% CI: 1.05-1.43 for U.S. vs. non-U.S. birthplace, and OR=1.35; 95% CI: 1.18-1.54 for ≥10 vs. <10 years of U.S. residence) and difficulty doing usual jobs or attending school (OR=1.50; 95% CI: 1.03-2.19 for 2^nd vs. 1^st generation and OR=1.65; 95% CI: 1.05-2.60 for ≥10 vs. <10 years of U.S. residence), but not associated with pain or difficulty chewing, tasting, or swallowing. Language preference was not significantly associated with OHRQOL indicators.
Conclusions: Preliminary findings suggest that higher acculturation was associated with worse OHRQOL among Hispanic/Latino adults. Our study will help inform health initiatives and policy decisions targeted towards improving oral health-related quality of life in this diverse population.