Understanding and tackling oral health inequalities in vulnerable adult populations: from the margins to the mainstream

Watt, Richard G.; Venturelli, Renato; Daly, Blánaid

doi:10.1038/s41415-019-0472-7

Cited by 64 publications

(66 citation statements)

References 38 publications

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“…Similar to our ndings regarding socio-economic status, El-Yous et al (2019) described how "cultural differences in oral healthcare seeking behaviour" was one cultural barrier and the "limited ability to express need for dental treatment" as the main economic challenge [40]. Watt et al (2019) provided evidence that Indigenous populations at a global level are vulnerable adult population groups in utilizing oral health services. They described how a population`s social class, income, education, psychosocial factors and social relationships are considered as the intermediate determinants that affect the utilization of oral health services [43].…”

Section: Discussionsupporting

confidence: 80%

“…tour ndings identify public health challenges as one of the barriers to provision of oral health services among Indigenous Australians. This is supported by Levesque et al (2013) who emphasized that ability to perceive health care needs containing health beliefs, expectations and literacy can lead to access to health care services [47]. Similarly, Göstemeyer et al (2019) indicated that lack of oral health knowledge, beliefs and behaviors can act as barriers to access oral healthcare.…”

Section: Discussionmentioning

confidence: 98%

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Challenges in Oral Health Provision and Utilization in the Australian Indigenous Population: A Scoping Review

Bastani

Sarikhani

Ghanbarzadegan

et al. 2020

Preprint

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Background Oral health is a vital area of public health. Access to dental services are particularly important among Indigenous populations at a global level. This scoping review aimed to investigate challenges in the provision and utilization of oral health services among Indigenous Australians. The findings may be an important contribution to the literature and facilitate policymakers in reducing inequities in dental service access and utilisation among this vulnerable population. Methods This scoping review was conducted up to June 10, 2020. Five main databases were searched, including PUBMED, SCOPUS, ISI Web of Science, EMBASE and PROQUEST. The main key words were: oral health, dental health, utilization, provision, access, Indigenous, Native, Aboriginal and Torres Strait Islander. Arksey and O’Malley`s protocol was applied, which comprises 5 steps of: (1) identifying the research question; (2) identifying relevant studies; (3) study selection; (4) charting the data and collating and; (5) summarising and reporting results. Thematic analysis was used to summarize and analyse the data applying MAX QDA10 software for qualitative data analysis. For a better understanding of the themes and subthemes, a thematic network was presented. Results Results show that there are six main themes and fourteen sub-themes affecting Indigenous Australians` utilization and provision of oral health services. Personal characteristics, Socio-economic status and challenges regarding access were that the main factors influencing utilization of oral health services. The findings suggest that challenges relating to public health, policymaking and service provision can affect Indigenous Australians provision to oral health services. Conclusion Benefits in Indigenous Australian access and utilization of oral health services may improve if policy makers at both national and local levels increase resourcing in this important public health sector. A deeper understanding of the social and cultural nuances driving Indigenous Australians’ reluctance to attend for dental care is crucial.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 98%

Challenges in Oral Health Provision and Utilization in the Australian Indigenous Population: A Scoping Review

Bastani

Sarikhani

Ghanbarzadegan

et al. 2020

Preprint

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“…Access to dental care is affected by systems-level decisions in the provision of services and the degree of dental insurance coverage [6]. These factors can have far-reaching consequences on oral health outcomes and inequalities on a population level [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Providing dental insurance can positively impact oral health outcomes in Ontario

Zivkovic

Aldossri

Gomaa

et al. 2020

BMC Health Serv Res

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Background: Universal coverage for dental care is a topical policy debate across Canada, but the impact of dental insurance on improving oral health-related outcomes remains empirically unexplored in this population. Methods: We used data on individuals 12 years of age and older from the Canadian Community Health Survey 2013-2014 to estimate the marginal effects (ME) of having dental insurance in Ontario, Canada's most populated province (n = 42,553 representing 11,682,112 Ontarians). ME were derived from multi-variable logistic regression models for dental visiting behaviour and oral health status outcomes. We also investigated the ME of insurance across income, education and age subgroups. Results: Having dental insurance increased the proportion of participants who visited the dentist in the past year (56.6 to 79.4%, ME: 22.8, 95% confidence interval (CI): 20.9-24.7) and who reported very good or excellent oral health (48.3 to 57.9%, ME: 9.6, 95%CI: 7.6-11.5). Compared to the highest income group, having dental insurance had a greater ME for the lowest income groups for dental visiting behaviour: dental visit in the past 12 months (ME highest: 17.9; 95% CI: 15.9-19.8 vs. ME lowest: 27.2; 95% CI: 25.0-29.3) and visiting a dentist only for emergencies (ME highest: -11.5; 95% CI: − 13.2 to − 9.9 vs. ME lowest: -27.2; 95% CI: − 29.5 to − 24.8).Conclusions: Findings suggest that dental insurance is associated with improved dental visiting behaviours and oral health status outcomes. Policymakers could consider universal dental coverage as a means to support financially vulnerable populations and to reduce oral health disparities between the rich and the poor.

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“…Disproportionate differences in oral health between population groups are due to an interaction of a number of factors (eg socioeconomic and political environment), many beyond an individual’s control 11,12 . Dental service utilization contributes to oral health inequalities 13 .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a community dental clinic providing care to people experiencing homelessness: A mixed methods approach

Paisi

Baines

Worle

et al. 2020

Health Expectations

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Background People who experience homelessness have higher dental treatment needs compared to the general population. However, their utilization of dental services and levels of treatment completion are low. Peninsula Dental Social Enterprise, a not‐for‐profit organization in the United Kingdom, established a community dental clinic to improve access to dental care for this population. Objectives To evaluate the impact and acceptability of the community dental service for patients and examine the barriers and enablers to using and providing the service. Methods The evaluation included a retrospective assessment of anonymous patient data and thematic analysis of semi‐structured interviews with patients, support staff and service providers. The interviews were thematically analysed. A cost analysis of the dental service was also conducted. Results By 18 February 2020, 89 patients had attended the clinic. These included 62 males (70%) and 27 females (30%), aged 38.43 years on average (SD ± 11.07). Of these, 42 (47%) patients have completed their treatment, 23 (26%) are in active treatment and 24 (27%) left treatment. In total, 684 appointments (541.5 hours clinical time) were given. Of these, 82% (562) of appointments were attended (452.5 hours clinical time). The 22 interviews that were conducted identified flexibility, close collaboration with support services and health‐care team attitudes as key factors influencing service utilization and continuity of care. Conclusions This study provides details of a highly acceptable and accessible dental care model for people experiencing homelessness, with recommendations at research, practice and commissioning levels.

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Understanding and tackling oral health inequalities in vulnerable adult populations: from the margins to the mainstream

Cited by 64 publications

References 38 publications

Challenges in Oral Health Provision and Utilization in the Australian Indigenous Population: A Scoping Review

Challenges in Oral Health Provision and Utilization in the Australian Indigenous Population: A Scoping Review

Providing dental insurance can positively impact oral health outcomes in Ontario

Evaluation of a community dental clinic providing care to people experiencing homelessness: A mixed methods approach

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