Eight Ways to Mitigate US Rural Health Inequity

Henderson-Frost, Jo; Deutchman, Mark

doi:10.1001/amajethics.2022.73

Cited by 2 publications

(4 citation statements)

References 13 publications

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“…However, disparities in access to oral health care exist, particularly for low-income and uninsured individuals (Northridge et al, 2020). Social and cultural determinants also play a significant role in reducing oral health disparities (Frost & Deutchman, 2022). Rural communities face several barriers to accessing dental care, including geographic isolation, lack of transportation, and poverty.…”

Section: B Bridging the Gap: Challenges And Gaps In Dental Health Ser...mentioning

confidence: 99%

“…Rural communities face several barriers to accessing dental care, including geographic isolation, lack of transportation, and poverty. Inadequate exposure to fluoride, availability and affordability of food with high sugar content, and poor access to oral health care services are some of the factors contributing to the increase in oral diseases globally (Frost & Deutchman, 2022).…”

Section: B Bridging the Gap: Challenges And Gaps In Dental Health Ser...mentioning

confidence: 99%

“…Strengthening the dental workforce through training and collaboration between governments, non-governmental organizations, and the private sector can also help to address the dental care gap. Policies that promote oral health and improve access to dental health services are also needed (Frost & Deutchman, 2022).…”

Section: B Bridging the Gap: Challenges And Gaps In Dental Health Ser...mentioning

confidence: 99%

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Implementation of Management Strategy in the Development of Dental Health Services for the Indonesian Maritime Community

Lelyana

2023

IJMRA

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Aim: This qualitative research aims to explore the key geographical and demographic characteristics of the Indonesian maritime community and their impact on dental health services. Research Method: This research will utilize secondary data sources such as existing studies, reports, and statistical data to analyze the geographical and demographic characteristics of the Indonesian maritime community. Research Findings: The Indonesian maritime community faces complex challenges in dental health services, influenced by factors like access, social and cultural determinants, rural health, and oral health policies. Addressing these challenges requires expanding access, strengthening the dental workforce, and implementing policies that promote oral health. Socioeconomic factors, cultural beliefs, and geographic location significantly influence dental health within the Indonesian maritime community, emphasizing the need for targeted interventions. Evaluating the effectiveness of policies and initiatives related to dental health services is important in reducing disparities and identifying areas for improvement. To implement effective management strategies for dental health services, healthcare management theories, social determinants of health, and collaboration and partnerships are necessary to address the unique challenges in this community. Conclusion: Implementing a management strategy that addresses the challenges in dental health services within the Indonesian maritime community is essential for improving oral health outcomes. Collaboration and partnerships, along with targeted interventions based on socioeconomic and cultural factors, are key to achieving this goal.

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Section: B Bridging the Gap: Challenges And Gaps In Dental Health Ser...mentioning

confidence: 99%

Section: B Bridging the Gap: Challenges And Gaps In Dental Health Ser...mentioning

confidence: 99%

Section: B Bridging the Gap: Challenges And Gaps In Dental Health Ser...mentioning

confidence: 99%

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Implementation of Management Strategy in the Development of Dental Health Services for the Indonesian Maritime Community

Lelyana

2023

IJMRA

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“…Over fifty years ago, the “inverse care law” demonstrated that as the need for healthcare increases in a population, access decreases 5 . This inequity largely persists today, with those living in rural areas facing lower access to dental care 6 and being less likely to have dental insurance 7 , 8 . As a result, these populations are disproportionately affected by caries and other oral diseases 9 , 10 .…”

Section: Introductionmentioning

confidence: 99%

School-based caries prevention using silver diamine fluoride: A pragmatic randomized trial in low-income rural children

Ruff,

Niederman

2024

Preprint

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BackgroundDental caries is the world’s most prevalent noncommunicable disease, disproportionately affecting children from low-income families and rural geographic areas.MethodsThe CariedAway 3.0 study was a cluster-randomized pragmatic non-inferiority trial comparing silver diamine fluoride (SDF) to sealants and atraumatic restorations (ART) for the prevention and control of dental caries. All participants also received fluoride varnish. Analysis consisted of mixed-effects logistic regression for caries prevalence and weighted least squares and mixed-effects negative binomial regression for caries incidence. A non-inferiority margin of 10% for the difference between groups was used. Dental caries was defined as an ICDAS score of four or greater.ResultsA total of 3345 children were enrolled across 35 schools; however there was a large proportion of children who were noncompliant and received external dental care over the course of the trial. In adjusted analyses of compliant participants (n=1083; 543 in the SDF group and 540 in the sealant and ART group), there was no difference in the weighted risk difference between treatment groups (B=0.003, 95% CI = -0.0001, 0.0008). The odds of caries prevalence was elevated in the SDF group in longitudinal analyses (OR = 1.35, 95% CI = 0.86, 2.11) but was not significant and was below the non-inferiority margin. There were no significant differences between groups for caries incidence in adjusted models (IRR = 1.19, 95% CI = 0.81, 1.74). Results for intent to treat analyses were similar to that of per-protocol.DiscussionIn this school-based clinical trial, the prevalence of dental caries in children treated with SDF and fluoride varnish was non-inferior compared to those treated with sealants, ART, and fluoride varnish, although the overall risk was slightly higher. Unfortunately, a high rate of dropout and participant noncompliance was observed, likely due to the impacts of COVID-19 on study procedures. As a result, observed effects may be unreliable beyond the short-term.Trial Registration:NCT03448107

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Eight Ways to Mitigate US Rural Health Inequity

Cited by 2 publications

References 13 publications

Implementation of Management Strategy in the Development of Dental Health Services for the Indonesian Maritime Community

Implementation of Management Strategy in the Development of Dental Health Services for the Indonesian Maritime Community

School-based caries prevention using silver diamine fluoride: A pragmatic randomized trial in low-income rural children

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