Racism in oral healthcare settings: Implications for dental care-related fear/anxiety and utilization among Black/African American women in Appalachia

IF 1.8 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry Pub Date : 2022-06-21 DOI:10.1111/jphd.12523

Kalo C. Sokoto MA, Lisa F. Platt PhD, Linda A. Alexander MEd, EdD, Betsy Foxman PhD, John R. Shaffer PhD, Mary L. Marazita PhD, Daniel W. McNeil PhD

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引用次数: 3

Abstract

Objective

To explore the association of racism in oral healthcare settings and dental care-related fear/anxiety with dental utilization among Black/African American women in Appalachia.

Methods

We analyzed self-report measures of racism in oral healthcare settings, dental care-related anxiety and fear, recency of a dental visit, and demographic information from 268 pregnant women participating in the Center for Oral Health Research in Appalachia (COHRA) SMILE cohort. All participants self-identified as African American or Black and resided in Appalachia (i.e., either West Virginia or Pittsburgh, PA).

Results

Over one-third of the participants reported at least one instance of racism in oral healthcare settings, with “not being listened to” due to their race or color as the most frequent issue (24.4%). Clinically significant levels of dental care-related anxiety and fear were reported by 14.3% of the sample. A mediational model demonstrated that the experience of racism in oral healthcare settings was a significant predictor of dental fear/anxiety, and that dental fear/anxiety was a significant predictor of dental utilization. There was a significant relationship between racism in oral healthcare settings and dental utilization only when mediated by the presence of dental care-related fear and anxiety.

Conclusions

Together, experiences of racism in oral healthcare settings and dental care-related fear/anxiety are predictive of decreased dental utilization for Black/African American women living in Appalachia. This study provides insight into racism in oral healthcare settings as a social determinant of dental anxiety/fear and inequities in dental utilization.

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口腔医疗机构中的种族主义:对阿巴拉契亚地区黑人/非裔美国妇女牙科护理相关恐惧/焦虑和利用的影响

目的探讨阿巴拉契亚地区黑人/非裔美国妇女口腔保健机构的种族主义和牙科保健相关恐惧/焦虑与牙科利用的关系。方法我们分析了268名参加阿巴拉契亚口腔健康研究中心(COHRA) SMILE队列的孕妇在口腔保健机构的种族主义自我报告测量、牙科护理相关的焦虑和恐惧、最近的牙科就诊和人口统计信息。所有参与者自我认定为非裔美国人或黑人，居住在阿巴拉契亚(即西弗吉尼亚州或宾夕法尼亚州匹兹堡)。结果超过三分之一的参与者报告说，在口腔保健机构中至少有一次种族歧视，其中最常见的问题是由于他们的种族或肤色而“不被倾听”(24.4%)。14.3%的样本报告了与牙科护理相关的临床显著水平的焦虑和恐惧。一个中介模型表明，在口腔保健机构种族主义的经验是牙科恐惧/焦虑的显著预测因子，牙科恐惧/焦虑是牙科利用的显著预测因子。只有当存在与牙科护理相关的恐惧和焦虑时，口腔保健环境中的种族主义与牙科利用之间才存在显著的关系。综上所述，阿巴拉契亚地区黑人/非裔美国妇女口腔保健机构的种族主义经历和与牙科保健相关的恐惧/焦虑可预测牙科使用率下降。本研究提供了洞察种族主义在口腔保健设置作为牙科焦虑/恐惧和牙科利用不公平的社会决定因素。

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来源期刊

Journal of public health dentistry 医学-公共卫生、环境卫生与职业卫生

CiteScore

3.80

自引率

4.30%

发文量

审稿时长

6-12 weeks

期刊介绍： The Journal of Public Health Dentistry is devoted to the advancement of public health dentistry through the exploration of related research, practice, and policy developments. Three main types of articles are published: original research articles that provide a significant contribution to knowledge in the breadth of dental public health, including oral epidemiology, dental health services, the behavioral sciences, and the public health practice areas of assessment, policy development, and assurance; methods articles that report the development and testing of new approaches to research design, data collection and analysis, or the delivery of public health services; and review articles that synthesize previous research in the discipline and provide guidance to others conducting research as well as to policy makers, managers, and other dental public health practitioners.

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