{"title":"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","authors":"Astha Singhal BDS, MPH, PhD, John W. Jackson ScD","doi":"10.1111/jphd.12515","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objectives</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>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.</p>\n </section>\n </div>","PeriodicalId":16913,"journal":{"name":"Journal of public health dentistry","volume":"82 S1","pages":"63-72"},"PeriodicalIF":1.8000,"publicationDate":"2022-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9233570/pdf/","citationCount":"8","resultStr":"{\"title\":\"Perceived racial discrimination partially mediates racial-ethnic disparities in dental utilization and oral health\",\"authors\":\"Astha Singhal BDS, MPH, PhD, John W. Jackson ScD\",\"doi\":\"10.1111/jphd.12515\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objectives</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>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.</p>\\n </section>\\n </div>\",\"PeriodicalId\":16913,\"journal\":{\"name\":\"Journal of public health dentistry\",\"volume\":\"82 S1\",\"pages\":\"63-72\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2022-06-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9233570/pdf/\",\"citationCount\":\"8\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of public health dentistry\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/jphd.12515\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"DENTISTRY, ORAL SURGERY & MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of public health dentistry","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jphd.12515","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
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.
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.