Oral Health Inequalities between Rural and Urban Populations of the African and Middle East Region

Abstract

Although there have been major improvements in oral health, with remarkable advances in the prevention and management of oral diseases, globally, inequalities persist between urban and rural communities. These inequalities exist in the distribution of oral health services, accessibility, utilization, treatment outcomes, oral health knowledge and practices, health insurance coverage, oral health-related quality of life, and prevalence of oral diseases, among others. People living in rural areas are likely to be poorer, be less health literate, have more caries, have fewer teeth, have no health insurance coverage, and have less money to spend on dental care than persons living in urban areas. Rural areas are often associated with lower education levels, which in turn have been found to be related to lower levels of health literacy and poor use of health care services. These factors have an impact on oral health care, service delivery, and research. Hence, unmet dental care remains one of the most urgent health care needs in these communities. We highlight some of the conceptual issues relating to urban-rural inequalities in oral health, especially in the African and Middle East Region (AMER). Actions to reduce oral health inequalities and ameliorate rural-urban disparity are necessary both within the health sector and the wider policy environment. Recommended actions include population-specific oral health promotion programs, measures aimed at increasing access to oral health services in rural areas, integration of oral health into existing primary health care services, and support for research aimed at informing policy on the social determinants of health. Concerted efforts must be made by all stakeholders (governments, health care workforce, organizations, and communities) to reduce disparities and improve oral health outcomes in underserved populations.

Rural‐urban disparity in oral health‐related quality of life

“…Utilization of healthcare services is an important determinant of oral health but is far from equal, geographically. This disparity can be explained mainly by unequal distribution of health professionals, as well as inequitable and inadequate access to oral healthcare services in rural and remote zones . In 2009‐2010, about 90.3% of the dental workforce in the province of Quebec were located in urban areas, and only 0.3% of the total dental workforce maintained their practice in remote rural zones .…”

Addressing Oral Health Inequalities in the Africa and Middle East Region

“…Oral diseases, like most diseases, are unequally distributed, with the greatest burden falling on disadvantaged and poor populations (Ogunbodede et al 2015). Thus, lower socioeconomic status (SES) populations have higher rates of caries and periodontal disease than their higher SES counterparts (Sgan-Cohen et al 2013).…”

Phytochemistry and antibacterial activity of extracts from medicinal plant Olea africana

“…Oral diseases, like most diseases, are unevenly distributed, with the greatest burden falling on needy and poor populations (Ogunbodede et al, 2015). Thus, lower socioeconomic status populations have higher rates of caries and periodontal diseases than their higher SES counterparts (Chidzonga et al, 2015).…”

“…Thus, lower socioeconomic status populations have higher rates of caries and periodontal diseases than their higher SES counterparts (Chidzonga et al, 2015). Elsewhere, there are also disparities in oral health between those from rural and urban areas of Africa (Ogunbodede et al, 2015). According to World Health Organization (2008), *Corresponding author.…”