Racial/Ethnic Disparities in Dental Service Utilization for Foreign-Born and U.S.-Born Middle-Aged and Older Adults

Zhang, Wei; Wu, Yan Yan; Wu, Bei

doi:10.1177/0164027519860268

Cited by 14 publications

(23 citation statements)

References 39 publications

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“…These findings are consistent with previous studies that have shown the positive influence of social network support on oral health, as well as effect modification by nativity status. 14,[36][37][38][39] In particular, previous studies of immigrant populations have demonstrated that caries experience, as well as oral health-related quality of life, is mediated by age at arrival and length of residence in the new country. 15,37,40,41 That the effect of social support on DMFS is greater for recent immigrants (<10 years in the US) is perhaps attributable to retention of culture and specifically the importance of 'familismo' in the Hispanic/Latino family.…”

Section: Discussionmentioning

confidence: 99%

Social support and dental caries experience: Findings from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study

Laniado

Sanders

Fazzari

et al. 2021

Comm Dent Oral Epid

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Objective To examine the association of social support with dental caries experience in Hispanics/Latinos living in the United States (US) and to assess whether the relationship is modified by nativity status. Methods This cross‐sectional study analysed data for 4459 dentate men and women aged 18‐74 years in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sociocultural Ancillary Study. At baseline (2008‐2011), dentists quantified dental caries experience as the number of decayed, missing, and filled permanent tooth surfaces (DMFS) for all teeth excluding third molars. Social support was assessed according to measures of structural support (Social Network Index) and functional support (Interpersonal Support Evaluation List). Covariate‐adjusted multiple linear regression estimated the relationship between social support and dental caries experience and tested whether the association was modified by nativity status (born within the 50 US states, foreign‐born <10 years in the United States, foreign‐born >10 years or more in the United States). Results In covariate‐adjusted models, each additional role in the social network was associated with 1.39 fewer DMF tooth surfaces (95% CI: −2.21, −0.58) among foreign‐born Hispanics/Latinos with fewer than 10 years lived in the US. For foreign‐born Hispanics/Latinos with 10 years or more in the United States, each additional social network role was associated with 0.57 fewer DMF tooth surfaces (95% CI: −1.19, 0.04). No association was observed between functional social support and dental caries experience regardless of nativity status. Conclusions Our findings suggest that structural social support is protective against dental caries experience among recent immigrants of Hispanic/Latino background. This association may reflect the importance of social support to integration into the medical and dental infrastructure and thus receipt of dental care. Future research that examines the behavioural and cultural factors that moderate the relationship between social support and dental caries experience will inform development of culturally sensitive dental caries prevention programs for Hispanics/Latinos in the United States.

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Section: Discussionmentioning

confidence: 99%

Social support and dental caries experience: Findings from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study

Laniado

Sanders

Fazzari

et al. 2021

Comm Dent Oral Epid

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“…5 Those who bear the greatest burden of disease are vulnerable populations (ie, low-income individuals, ethnic minorities, immigrants, and individuals with disabilities) who may have low oral health literacy and limited access to care. 6,7 There is a robust and growing body of evidence that oral health is a critical component of overall health and that poor oral health may lead to negative health outcomes including the exacerbation of chronic inflammatory diseases and conditions such as diabetes, cardiovascular disease, and pulmonary disease. [8][9][10][11][12] The US Surgeon General's landmark report, Oral Health in America, reminded educators and practitioners of the fundamental fact that oral diseases and disorders present a systemic burden and that health-care providers should be "ready, willing, and able to work in collaboration to provide optimal health care for their patients."…”

Section: Introductionmentioning

confidence: 99%

Interprofessional Oral Health Collaboration: A Survey of Knowledge and Practice Behaviors of Hospital-Based Primary Care Medical Providers in New York City

Laniado

Cloidt

Altonen

et al. 2021

AMEP

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Background:The siloed delivery of oral and medical health care in the United States has contributed to a lack of awareness of the consequences of poor oral health and has hampered effective interprofessional education and collaboration. The aim of this study was to assess the knowledge and practice behaviors of primary care medical providers in an urban safety-net hospital regarding collaboration with dentists and integration of oral health into overall health-care delivery. Methods: A 36-item survey was designed in a web-based platform (Survey Monkey ® ) and electronically distributed in September 2020 to 181 primary care medical providers (physicians, nurses, physician assistants) within a municipal hospital in the Bronx, New York. The questionnaire included sections on demographics, current practices, oral health knowledge, and opinions regarding interprofessional collaboration. Descriptive statistics and bivariate analyses using the chi-square and Fisher's exact test were performed with a significance level of 0.05. Results: The response rate was 66% (119 respondents). The vast majority (80%) reported little or no training in oral health and 85% reported no team experience with oral health professionals. Medical providers' confidence in examining the oral cavity was positively associated with previous additional training (p = 0.001) and with team experience (p = 0.005). The two most commonly reported barriers to willingness to collaborate were lack of formal relationships with dental providers (74%) and competing priorities (69%). Conclusion: Overall, there is very limited awareness and integration of oral health into the clinical practice of medical providers at this safety-net hospital. However, those providers with previous training and team experience had greater oral health confidence. Given the critical importance of oral health to overall health, increased efforts should be directed to further educate and train medical providers and address barriers to interprofessional care.

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“…After excluding 149 participants with missing values and 16 participants without any teeth (edentulism), the final analytical sample consisted of 4835 individuals. We did not include individuals with complete tooth loss because the dental care utilization pattern is very different between those with and without natural teeth [ 41 ].…”

Section: Methodsmentioning

confidence: 99%

Disparities in Dental Service Utilization among Adults in Chinese Megacities: Do Health Insurance and City of Residence Matter?

2020

IJERPH

Self Cite

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The aims of the study were to present the prevalence of dental service utilization among adults (age between 18 and 65) in Chinese megacities and to examine the associations of health insurance and city of residence with dental visits. This study was a cross-sectional analysis of the 2019 New Era and Living Conditions in Megacities Survey data with a sample of 4835 participants aged 18–65 from 10 different megacities in China. The data including gross domestic product (GDP) per capita of each megacity obtained from the National Bureau of Statistics of China as a city-level characteristic. After adjusting sampling weights, approximately 24.28% of the participants had at least one dental visit per year. Findings from multilevel mixed-effects linear models showed that participants residing in megacities with higher GDP per capita (β = 0.07, p < 0.001) who had Urban Employee Basic Medical Insurance (β = 0.25, p < 0.001) or Urban Resident Basic Medical Insurance (β = 0.19, p < 0.01) had more frequent dental visits after adjusting demographic characteristics, socioeconomic status, health status, health behavior and attitude, and oral health indicators. Margins post-estimation model results demonstrated disparities in the predicted probability of having never visited a dentist by types of health insurance and city of residence. In conclusion, the prevalence of dental visits in China was found to be low. This study highlights socioeconomic inequalities in dental service utilization. There is a great need to develop more dental care programs and services and expand health insurance to cover dental care in China.

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Racial/Ethnic Disparities in Dental Service Utilization for Foreign-Born and U.S.-Born Middle-Aged and Older Adults

Cited by 14 publications

References 39 publications

Social support and dental caries experience: Findings from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study

Social support and dental caries experience: Findings from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study

Interprofessional Oral Health Collaboration: A Survey of Knowledge and Practice Behaviors of Hospital-Based Primary Care Medical Providers in New York City

Disparities in Dental Service Utilization among Adults in Chinese Megacities: Do Health Insurance and City of Residence Matter?

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