Publication Date
2024
Document Type
Dissertation/Thesis
First Advisor
Patel, Kunal N.
Degree Name
Ph.D. (Doctor of Philosophy)
Legacy Department
School of Health Studies
Abstract
Oral health disparities remain a persistent and pressing public health issue in the United States, with access to dental care and outcomes disproportionately affected by socio-economic status, race, ethnicity, and insurance coverage. This three paper format dissertation highlights various aspects of disparities that do exist in oral health cancer incidence across the United States. The first paper utilizes data from the Surveillance, Epidemiology, and End Results (SEER) program to analyze 19,378 invasive Oral cavity and pharyngeal cancers (OCPC) cases diagnosed between 2018 and 2021, categorized by HPV status. Findings highlight that HPV-positive OCPCs are more prevalent among males, individuals aged 30–79, and those living in lower socioeconomic areas, with the base of the tongue and tonsils as the most affected sites between 2018 and 2021. Despite progress, significant disparities persist. American Indian/Alaska Native and Asian or Pacific Islander populations, as well as non-Spanish-Hispanic-Latino individuals, exhibit lower odds of HPV positivity. Marital status plays a role, with married individuals more likely to be diagnosed with HPV-positive cancers. The study underscores the need for targeted public health strategies, including HPV testing at non-oropharyngeal sites and enhanced screening efforts for high-risk populations. The second study, which was a literature review of early interventions from 2007 to 2024 reveals that while screenings improve early detection, disparities in access to services remain, particularly for low-income and minority populations. The Affordable Care Act (ACA) has increased screening rates, but barriers such as fear of diagnosis, limited provider availability, and financial costs persist. Technological innovations like fluorescence imaging offer promise, but their adoption is limited. Additionally, HPV vaccination remains underutilized, especially among men, underscoring the need for better advocacy. The third paper analyzes dental care disparities using data from the 2022 National Health Interview Survey. Results show that individuals without insurance are 2.35 times more likely to delay dental care. Employment, education, income, and marital status significantly influence dental care utilization, with young adults and minority groups experiencing the greatest barriers. Ultimately, this dissertation calls for collaborative public health efforts, including expanding insurance coverage, improving provider training, and promoting preventive care through community outreach. Addressing these disparities through multi-faceted interventions is essential to reducing the burden of OCPC and ensuring equitable access to care in the U.S.
Recommended Citation
Nii-Aponsah, Harold, "Oral Cancer Inequalities: Unmasking Health Disparities of Vulnerable Populations in the U.S." (2024). Graduate Research Theses & Dissertations. 8026.
https://huskiecommons.lib.niu.edu/allgraduate-thesesdissertations/8026
Extent
87 pages
Language
en
Publisher
Northern Illinois University
Rights Statement
In Copyright
Rights Statement 2
NIU theses are protected by copyright. They may be viewed from Huskie Commons for any purpose, but reproduction or distribution in any format is prohibited without the written permission of the authors.
Media Type
Text
