Economic Stressors and Opportunities as Influences of Emerging Adult Oral Health

PROJECT SUMMARY/ABSTRACT Oral diseases are among the most common chronic conditions of humankind; their origins can often be traced to socioeconomic and behavioral circumstances much earlier in life. Frequently overlooked are key life transitions when behaviors and circumstances are especially fluid and potentially malleable with appropriately

tailored interventions. Emerging adulthood (the transitional period from adolescence to adulthood) is one such life stage that has garnered limited attention in oral health research. Emerging adulthood is a particularly sensitive period marked by changes in socioeconomic stressors, health risk factors, and potential protective

opportunities as young people enter new social circumstances. This proposed project combines detailed measures of economic, social, and behavioral factors with quality assessments of oral and systemic health in a diverse, prospective emerging adult cohort. We will examine potential interactions by race/ethnicity and gender

identities and the specific behavioral pathways connecting socioeconomic factors to disease risk, potentially revealing health promotion opportunities during this formative developmental period. Indeed, such insight informs a long-term objective to test how acquired access to socioeconomic opportunity afforded by higher

education impacts the trajectory of oral diseases, especially among those from minoritized and/or disadvantaged backgrounds. This time-sensitive proposal leverages the now-launching NHLBI-supported Economic and Educational Contributions to Emerging Adults' Cardiometabolic Health (“3E”) cohort study of 4,000 diverse first-year college

students from two public Hispanic-Serving Institutions of higher education (>50% first-generation college students, >40% Pell Grant recipients). This proposal augments rich prospective economic and behavioral data with oral health-specific risk factors and self-reported and objective measures oral health. Specifically, this

project will: Aim 1. Examine the influences of early adulthood socioeconomic stressors on oral health over time, including as potentially modified by race/ethnicity and gender. Aim 2. Examine the contributions of education-related opportunities (e.g., academic engagement programming, basic needs supports, social

capital) as protective factors against adverse oral health outcomes (e.g., service non-utilization, gingival inflammation). Aim 3. Assess the mechanistic role of health-related behaviors in linking socioeconomic stressors and education-related opportunities to oral health outcomes. Emerging adulthood, a transition period in health behaviors and socioeconomic opportunity, is a potential pivot

point in the development of chronic diseases and health inequality. Understanding influences of oral diseases near their emergence will inform more effective oral disease prevention efforts.