Abstract:
This study contributes to the ongoing debate on social determinants of oral
health of older persons. Specifically, it examines the direct and indirect eects
of health literacy and access to healthcare on oral health status of older
persons. The study also investigates whether general health status and health
behavior (routine medical check-ups) explain the association of health literacy
and healthcare access with oral health status. The gender dimensions of
these relationships are also explored. Data were derived from 522 participants
aged 50 years and older located in five regions in Ghana. Path analyses in
structural equation modeling (SEM) were used to analyse the data. General
health status (b = −0.049, p < 0.005), medical check-up (b = 0.124, p <
0.01), and health literacy (b = 0.133, p < 0.01) were positively associated with
oral health status. General health status mediated the positive relationship
between health literacy and oral health status (b = 0.048, p < 0.01). General
health status (b = 0.016, p < 0.05) and medical check-ups (b = 0.025, p < 0.05)
mediated the association between access to healthcare and oral health
status. The mediational role of routine medical check-up in the association
between access to healthcare and oral health status was significantly stronger
(B = 0.063, p < 0.01) among men (b = 0.051, p < 0.01) than women
(b = 0.003, p > 0.05). Analyses of oral health issues among older persons in
Ghana and settings alike must recognize the complex interplay among critical
social determinants to initiate pragmatic health and social policy interventions.