Socioeconomic status, food security, and dental caries in US children: mediation analyses of data from the National Health and Nutrition Examination Survey, 2007-2008

Am J Public Health. 2014 May;104(5):860-4. doi: 10.2105/AJPH.2013.301699. Epub 2014 Mar 13.


Objectives: We examined associations of household socioeconomic status (SES) and food security with children's oral health outcomes.

Methods: We analyzed 2007 and 2008 US National Health and Nutrition Examination Survey data for children aged 5 to 17 years (n = 2206) to examine the relationship between food security and untreated dental caries and to assess whether food security mediates the SES-caries relationship.

Results: About 20.1% of children had untreated caries. Most households had full food security (62%); 13% had marginal, 17% had low, and 8% had very low food security. Higher SES was associated with significantly lower caries prevalence (prevalence ratio [PR] = 0.77; 95% confidence interval = 0.63, 0.94; P = .01). Children from households with low or very low food security had significantly higher caries prevalence (PR = 2.00 and PR = 1.70, respectively) than did children living in fully food-secure households. Caries prevalence did not differ among children from fully and marginally food-secure households (P = .17). Food insecurity did not appear to mediate the SES-caries relationship.

Conclusions: Interventions and policies to ensure food security may help address the US pediatric caries epidemic.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Cross-Sectional Studies
  • Dental Caries / epidemiology*
  • Diet / statistics & numerical data*
  • Female
  • Health Status
  • Humans
  • Male
  • Nutrition Surveys
  • Poverty / statistics & numerical data*
  • Socioeconomic Factors
  • United States / epidemiology