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.

中文翻译：

---

模拟社会关系和交通选择对老年人获得口腔保健的影响

当前美国人口向老年人口转移，以及在情况变得严重之前进行干预的重要性，需要共同努力减轻老年人获得医疗保健的负担。在口腔保健方面，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。使用基于代理的模拟模型，本文研究了社会关系和交通方式选择对老年人参与基于社区的预防性筛查活动和获得所需口腔保健的机会的影响。这种方法解释了在社会因素（包括社会经济手段和社会支持）方面表现出多样性的人群所产生的行为异质性。在生活在城市环境中的老年人的背景下，应考虑不同运输方式的可用性。为了探索曼哈顿北部老年中心提供的预防性筛查活动可及性的替代方案，基于代理的模型 (ABM) 与地理信息系统 (GIS) 一起创建，以模拟社会关系和交通选择对老年人的影响寻求预防性筛查服务和口腔保健。模拟实验的结果表明，对公共交通的偏好和可达性方面的不公平现象可以通过社会支持来缓解。该模拟模型提供了一种探索社会支持的方法，将社会支持作为选择交通方式的重要因素，从而调节口腔医疗保健的可及性，从而影响老年人的口腔健康结果。