LAUSR

OBJECTIVES To determine the extent to which living conditions and individual behaviors influence the association between oral health status and systemic disease outcomes in Ontario, Canada's most populated province. METHODS A secondary data analysis of Ontario data from the Canadian Community. Health Survey 2013/14 was undertaken. Separate analyses were conducted for participants aged 35-59 years (n = 11,858) and 60+ years (n = 11,273). A series of regression models were constructed to examine the association between self-reported oral health status and systemic disease outcomes (arthritis, diabetes, hypertension, heart disease, chronic obstructive pulmonary disease, and stroke). Models were adjusted by proxies of living conditions (income, education, ethnicity, country of birth, employment, and food security) and individual behaviors (smoking status, alcohol use, tooth brushing, life stress, physical activity, sense of belonging). Percent attenuation between models was calculated to determine the extent of the living condition-behavior impact. RESULTS In both age groups, the prevalence of arthritis and high blood pressure was the highest, followed by heart disease. There was variation in percent attenuation by age group and outcome. Among participants aged 35-59 years, living conditions had a greater impact on the oral-systemic relationship, while individual behaviors played a greater role in this association among adults aged 60+ years. CONCLUSION There is an association between oral and systemic diseases; however, after accounting for living conditions and individual behaviors, this relationship was attenuated. This highlights the need to address upstream and midstream factors that are common to oral and systemic conditions.