感知到的种族歧视在一定程度上介导了牙科利用和口腔健康的种族-民族差异

IF 1.8 4区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE
Astha Singhal BDS, MPH, PhD, John W. Jackson ScD
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引用次数: 8

摘要

人们认为种族歧视与健康状况不佳有关,但其对口腔健康差异的影响尚不清楚。我们研究了在解释牙科就诊和牙齿脱落的种族-民族差异的医疗保健设置中感知到的种族歧视的作用。方法采用行为风险因素监测系统(BRFSS) 2014年4个不同州(AZ、MN、MS和NM)的数据,其中包含“种族反应”模块。使用泊松回归估计风险比,在平衡其他混杂因素和风险因素后,我们采用逆优势比(IOR)加权估计进行中介分析,以估计感知歧视的作用。结果我们发现,在风险因素相似的人群中,经历过种族歧视的人去看牙医的可能性比其他种族的人低15%,牙齿脱落的可能性比其他种族的人高12%。西班牙裔和非西班牙裔黑人去看牙医的可能性都要低26%(西班牙裔,RR = 0.74, 95%CI: 0.69-0.78;非西班牙裔黑人,RR = 0.74, 95%CI: 0.70-0.79),非西班牙裔黑人牙齿脱落的可能性比具有相似危险因素的非西班牙裔白人高36% (RR = 1.36, 95%CI: 1.28-1.45)。感知到的歧视似乎导致了西班牙裔人在牙科使用方面的种族差异,以及非西班牙裔黑人相对于非西班牙裔白人在牙齿脱落方面的差异。结论种族歧视在一定程度上解释了具有相同危险因素的人群在牙齿利用和牙齿脱落方面的种族差异。解决歧视和系统性种族主义问题可以减少口腔健康方面的种族差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Perceived racial discrimination partially mediates racial-ethnic disparities in dental utilization and oral health

Perceived racial discrimination partially mediates racial-ethnic disparities in dental utilization and oral health

Objectives

Perceived racial discrimination has been associated with poor health outcomes, yet its impact on oral health disparities is not understood. We examine the role of perceived racial discrimination in healthcare settings in explaining racial-ethnic disparities in dental visits and tooth loss.

Methods

We used behavioral risk factor surveillance system (BRFSS) data for 2014 from four diverse states (AZ, MN, MS and NM) that included “reactions to race” module. Using Poisson regression to estimate risk ratios, we employed inverse odds ratio(IOR)-weighted estimation for mediation analyses to estimate the role of perceived discrimination, after equalizing other confounders and risk factors.

Results

We found that among those with similar risk factors, those who experienced racial discrimination were 15% less likely to visit a dentist, and 12% more likely to have tooth loss than those who were treated same as other races. Both Hispanics and non-Hispanic Blacks were 26% less likely to visit a dentist (for Hispanics, RR = 0.74, 95%CI: 0.69–0.78; for non-Hispanic Blacks, RR = 0.74, 95%CI: 0.70–0.79), and non-Hispanic Blacks were 36% more likely to have tooth loss relative to non-Hispanic Whites with similar risk factors (RR = 1.36, 95%CI: 1.28–1.45). Perceived discrimination appears to contribute to racial-ethnic disparities in dental utilization among Hispanics, and disparities in tooth loss among non-Hispanic Blacks, relative to non-Hispanic Whites.

Conclusions

Perceived racial discrimination partially explains the racial-ethnic disparities in dental utilization and tooth loss among those who otherwise share the same risk factors for these outcomes. Addressing discrimination and systemic racism can reduce the racial-ethnic disparities in oral health.

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来源期刊
Journal of public health dentistry
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
69
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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