AUTHOR=Chen Hsueh-Fen , Lin Yun-Ti , Lin Jia-Ying , Lee Huey-Er 

TITLE=Rural-urban disparities in Oral Health-related Quality of Life for middle-aged and older adults with diabetes in Taiwan

JOURNAL=Frontiers in Public Health

VOLUME=Volume 11 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1162201

DOI=10.3389/fpubh.2023.1162201

ISSN=2296-2565

ABSTRACT=Background
Public health faces a significant challenge in reducing rural-urban disparities in diabetes.. Since dietary control is part of the medical regimen for diabetes management, how diabetic patients perceive the impact of oral health on their quality of life is critical. The present study aims to compare Oral Health-related Quality of Life (OHRQoL) between rural and urban diabetic patients. 
Methods
The study design was cross-sectional. The study sample was 831 self-reported  diabetic patients, extracted from the first wave of the new-cohort Taiwan Longitudinal Study on Aging survey (NC_TLSA) that comprised a nationally representative sample of community-dwelling adults aged 50 and above in Taiwan. The composite score generated from the Oral Health Impact Profile-7 (OHIP-7), which has seven questions, was used to construct two OHRQoL measures,. the severity of perceived poor OHRQoL, and the prevalence of poor OHRQoL. These two OHRQoL measures were treated as dichotomous variables.. Multivariate logistic regression models were applied for analysis. 
Results
Rural diabetic patients had a higher likelihood of experiencing the severity of perceived poor OHRQoL than those in urban areas (OR=2.40, 95% CI: 1.30-4.40). Although rural diabetic patients also had a higher prevalence of poor OHRQoL than urban diabetic patients, the difference was not significant. (OR=1.47, 95% CI: 0.95-2.28-) Social determinants, such as education matter to both OHRQoL measures.
Conclusion
Overall, rural diabetes community-dwelling patients had a poorer OHRQoL than those in urban areas. Given a bi-directional relationship between oral health and diabetes, improving oral health in rural areas may be a critical avenue to improve the quality of diabetes care in rural areas.  

Keywords: Oral Health-Related Quality of Life, social determinants, diabetes, disparities, diabetes-related complications, oral health impact profile