Senior citizens living in rural areas have poorer health outcomes compared to their urban and suburban peers, according to the United Health Foundation’s America’s Health Rankings Senior Report. Using 34 measures of senior health, including oral health, the report highlights the successes and challenges the 65+ population faces on a national and state-by-state basis.
“It is our goal with this report to help seniors, family caregivers, and advocates better understand the specific health concerns in their own communities so we can all work together to address them,” said Rhonda Randall, DO, senior advisor to the United Health Foundation and chief medical officer and executive vice president of UnitedHealthcare Retiree Solutions.
For example, 19.9% or rural seniors have had all their teeth extracted, compared to 13.7% of suburban seniors, 13.6% of urban seniors, and 14.5% of seniors overall. Also, only 60.6% of rural seniors have visited a dentist in the past year, compared to 69.5% of suburban seniors, 69.3% of urban seniors, and 66.9% of seniors overall.
“By examining the differences in health between seniors living in rural areas and those living in urban and suburban areas, for example, we believe we can empower communities to help seniors access the resources and services they need to live happier, healthier lives,” Randall said.
The report notes that edentulism can have a profound effect on older health, presenting greater risks of heart disease and stroke. Also, people who lack teeth or who use dentures may gravitate toward soft foods and avoid fruits and vegetables, impacting their nutrition. Untreated caries and periodontal disease are the most common reasons for extractions.
Hawaii seniors had the fewest full-mouth extractions at 5.6%, followed by California (9.4%), Connecticut (9.6%), Colorado (9.8%) and Utah (9.9%). West Virginia had the most seniors without any natural teeth at 30.4%, preceded by Mississippi (26.1%), Arkansas (22.9%), Kentucky (22.0%), and Tennessee (21.6%).
Extractions decreased with education. Those who didn’t graduate high school saw a 31.4% rate, with graduates rated at 18.3%, those with some college at 11.1%, and college grads at 3.7%. Income plays a role too, with those making less than $25,000 seeing a 25.2% rate, $25,000 to $49,999 at 13.9%, $50,000 to $74,999 at 7.4%, and more than $75,000 at 3.8%.
Dental visits are essential to maintaining oral health and, therefore, quality of life by preserving the ability to chew, speak, and interact socially, while also decreasing the risks of diseases such as diabetes and cancer. Yet retirees often lose dental insurance coverage, and Medicare doesn’t cover dental care either, leaving them to pay for dental work out of pocket.
Hawaii similarly saw the most seniors visit the dentist in the past year at 77.9%, followed by Minnesota (76.1%), Wisconsin (75.1%), Connecticut (75.5%), and Rhode Island (74.6%). West Virginia was last in this category as well with 52.5% visiting their dentist, preceded by Mississippi (53.0%), Louisiana (55.3%), Arkansas (56.0%), and Tennessee (56.8%).
Visits increased with education. Those who didn’t graduate high school saw a 41.5% rate, with graduates rated at 61.1%, those with some college at 70.6%, and college grads at 84.8%. Income also matters, with those making less than $25,000 visiting at a 47.0% rate, $25,000 to $49,999 at 65.0%, $50,000 to $74,999 at 79.3%, and more than $75,000 at 87.4%.
Women have more full-mouth extractions than men, 14.8% compared to 14.1%. But they visited the dentist more often, at 67.7% versus 65.8%. Also, the report notes that all of the factors it measured have improved since the 2016 study likely due to improved access to oral healthcare, public water fluoridation programs, and reduced smoking rates.