Effect of family income on the relationship between parental education and sealant prevalence, National Health and Nutrition Examination Survey, 2005-2010

Abstract

Introduction: We examined the association between sealant prevalence and parental education for different levels of family income, controlling for other covariates. Methods: We combined data from 2005-2006, 2007-2008, and 2009-2010 cycles of the National Health and Nutrition Examination Survey. The study sample was 7,090 participants aged 6 to 19 years. Explanatory variables, chosen on the basis of Andersen and Aday's framework of health care utilization, were predisposing variables - child's age, sex, race/ethnicity, and parental education (< high school diploma; high school diploma; > high school diploma); enabling variables - family income (< 100% of the federal poverty level [FPL]; 100%-200% of the FPL; and > 200% of the FPL), health insurance status, and regular source of medical care; and a need variable - future need for care (perceived child health status is excellent/very good, good, fair/poor). We conducted bivariate and multivariate analyses and included a term for interaction between education and income in the multivariate model. We report significant findings (P = .05). Results: Sealant prevalence was associated with all explanatory variables in bivariate and multivariate analyses. In bivariate analyses, higher parental education and family income were independently associated with higher sealant prevalence. In the multivariate analysis, higher parental education was associated with sealant prevalence among higher income children, but not among low-income children (< 100% FPL). Sealant prevalence was higher among children with parental education greater than a high school diploma versus less than a high school diploma in families with income =100% FPL. Conclusion: Our findings suggest that income modifies the association of parental education on sealant prevalence. Recognition of this relationship may be important for health promotion efforts.