Advancing racial equity in oral health (research): more of the same is not enough

Abstract

By critically appraising the literature on the oral health effects of race-based oppression, this focus article makes four recommendations that may both facilitate more nuanced research on the topic and mitigate racial/ethnic inequities in (oral) health. The first is recognizing that science itself may perpetuate racial/ethnic injustice, such that adopting a 'neutral' position must be replaced with actively fostering anti-racist narratives. The second is to not imply that racial oppression is bad because it harms oral health. Rather, studies should help build a fairer world, wherein oral health inequities would not abound. The third recommendation is encouraging initiatives that understand systems of oppression as conjointly operating to shape oral health. The fourth and final recommendation is taking race-based oppression as a multilevel system that operates on three interrelated conceptual levelsintra-personal, inter-personal, and structural. The extent to which scholars, practitioners, and policymakers are willing to follow these recommendations may determine how successful attempts to eradicate (oral) health inequities might be. Learning from, and avoiding mistakes made in, previous publications is one ethical pathway towards this end.

Where are race-based oral health inequities bound? Protocol for a systematic review on interventions to tackle racial injustice in dental outcomes

“…Our focus is population groups oppressed along ancestral and/or cultural lines, most notably those that have been defined on the basis of race, ethnicity, indigeneity, caste, religion, tribe, origin, nationality, immigration status, and/or language in the field of dentistry [ 1 , 2 , 7 ].…”

“…Research on racial oral health inequities has moved apace in the past few decades. Since the 1990s, tallies of articles on race and poor oral health have increased exponentially, outnumbering studies focused on, for instance, class-based oral health inequities [ 1 ]. This quantitative growth has not been followed by the construction of a compelling anti-racist narrative, however [ 2 ].…”

“…Amid technical developments in measuring racial [ 3 , 4 ] and socioeconomic [ 5 , 6 ] gaps in dental outcomes, oral health scholars have mostly relied on biological conceptions of race, which often ignore the major root cause of race-based oral health inequities, i.e., racism [ 2 ]. Indeed, as a macro-level system that differentially allocates power and social resources along racial lines, racism is almost entirely absent from the oral health literature [ 1 , 2 , 7 ]. Unsurprisingly, this general trend echoes the main debates taking place in scholarly medical journals, which draw heavily from race as a context-free, fixed, individual-level characteristic [ 8 – 10 ].…”

Oral Health Equity Must Address Oppression: On the BSSOH Consensus Statement

“…We implore our fellow social and behavioral scientists, dental researchers, clinicians, educators, and policy makers to turn the mirror on ourselves. We must consider how we Approaches rooted in cultural humility and structural competency hold promise in training current and future researchers, clinicians, and other stakeholders (Kelly et al 2021; see also Bastos et al 2020;Muirhead et al 2020). Oral health scholars must also adopt antiracist publishing standards in journals and expand funding opportunities to support these efforts.…”

“…Emerging work in oral health research holds promise to advance equity and address racism—its forms, measurement, and effects in population health, workforce development, and scientific inquiry. Scientific fields, including our own ( Bastos et al 2020 ; Ioannidou and Feine 2020 ; Evans and Smith 2021 ; Jamieson 2021 ; Fleming, Bastos, et al unpublished ), are interrogating their legacies of racism and oppression. The omission from the Consensus Statement 1 simultaneously reflects the dominant intellectual history of the field, at least in the United States, 2 and left us wondering: where is our accounting for racial justice epistemologically and ethically?…”