Modeling the Influence of Social Ties and Transportation Choice on Access to Oral Healthcare for Older Adults.

The current U.S. demographic shift toward an older population and the importance of intervening before conditions become severe warrant a concerted effort to ease the burden of access to healthcare for older adults. With regard to oral healthcare, more integrated services for older adults are needed to effectively serve their complex medical and dental needs. Using an agent-based simulation model, this paper examines the influence of social ties and transportation mode choices on opportunities for older adults to participate in community-based preventive screening events and access needed oral healthcare. This approach accounts for the heterogeneity of behavior that arises for a population exhibiting diversity in terms of social factors, including socioeconomic means and social support. In the context of older adults living in urban environments, the availability of different transportation modes ought to be taken into consideration. To explore alternative scenarios for the accessibility of preventive screening events offered at senior centers in northern Manhattan, an agent-based model (ABM) was created with a geographic information system (GIS) to simulate the influence of social ties and transportation choices on older adults seeking preventive screening services and oral healthcare. Results of simulation experiments indicate preferences for public transportation and inequities in accessibility that may be mitigated with social support. This simulation model offers a way to explore social support as an important factor in making transportation mode choices that mediate oral healthcare accessibility and thus oral health outcomes for older adults.

当前美国人口向老龄化转变，且在病情变得严重之前进行干预非常重要，这就需要共同努力来减轻老年人获取医疗保健的负担。在口腔医疗保健方面，需要为老年人提供更多综合服务，以有效满足他们复杂的医疗和牙科需求。本文利用基于主体的模拟模型，研究了社会关系和交通方式选择对老年人参加社区预防性筛查活动以及获取所需口腔医疗保健机会的影响。这种方法考虑到了在社会因素（包括社会经济手段和社会支持）方面存在差异的人群所产生的行为异质性。对于生活在城市环境中的老年人，应该考虑不同交通方式的可获取性。为了探索曼哈顿北部老年人活动中心提供的预防性筛查活动的可及性的替代方案，利用地理信息系统（GIS）创建了一个基于主体的模型（ABM），以模拟社会关系和交通选择对寻求预防性筛查服务和口腔医疗保健的老年人的影响。模拟实验结果表明了对公共交通的偏好以及可及性方面的不平等，而社会支持可能会缓解这种不平等。这个模拟模型提供了一种方法，将社会支持作为一个重要因素进行研究，该因素影响交通方式选择，进而影响老年人的口腔医疗保健可及性以及口腔健康结果。