The Causal Structure of the Role of Physicians and Dentists in the Healthy Longevity of Elderly Dwellers Residents

Abstract

Background: The significance of living a healthy and long life in an aging society is increasing. The causal structure of the role of physicians and dentists in healthy longevity is not clear. Objective: The purpose of this research was to clarify the socioeconomic factors underlying three health factors and the relationship among these three health factors. In addition, a main purpose of this research is to clarify the causal structure between subjective health after 3 years and healthy longevity, which is a dependent variable that is defined as the survival days for the next 3 years, as an observation variable, based on the presence of a physician and/or dentist by gender. Method: For the survey method, a self-administered questionnaire was mailed to 16,462 suburban elderly residents in Tama City, Tokyo, in September 2001. Responses were obtained from 13,066 residents (response rate of 79.4%). A similar survey was conducted in 2004. We analyzed a total of 7,905 subjects, including 3,754 males and 4,151 females aged 65 to 84, for whom we were able to clearly determine the need for long-term care after 3 years and their survival days for the next 3 years. Following these subjects for three years from 2004 to 2007, we confirmed the death dates of 278 men and 160 women. Results: According to this study, elderly people with desirable socioeconomic factors tended to have a family dentist. A causal structure was shown, indicating that three health factors are advisable based on socioeconomic status, and as a result, healthy longevity, including both a high level of subjective health and a reduced bedridden status, was maintained. This related structure could explain 64% of healthy longevity. In addition, a similar tendency was shown by gender. Future research will require the use of oral care and health indicators such as blood pressure and blood glucose levels. It is also expected that the external validity would be enhanced by analyzing the causal structure through intervention studies including a randomized control group.