Racial Discrimination and Uptake of Dental Services among American Adults

Sabbah, Wael; Gireesh, Aswathikutty; Chari, Malini; Delgado‐Angulo, Elsa K.; Bernabé, Eduardo

doi:10.3390/ijerph16091558

Cited by 34 publications

(55 citation statements)

References 33 publications

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“…Although our estimate is limited to adults only, the percentage is very close to the Healthy People 2020 target (61.2%) for all diabetic individuals aged 2 years or older [ 13 ]. However, our figure is lower than that previously reported for the adult US population in 2011–2014 (66%) and 2014 (68%) [ 22 , 23 ]. This finding is not unexpected, as prior studies have also reported lower compliance among diabetic individuals compared to the general population [ 24 ].…”

Section: Discussioncontrasting

confidence: 97%

“…However, income was not linked to compliance in rural populations after adjusting for other factors. Having lower education or no health insurance coverage were associated with lower odds of dental compliance, as expected based on prior studies of both the diabetic and the general population [18,23]. Notably, the links between dental visits compliance and education or health insurance were more pronounced among rural diabetic residents.…”

Section: Plos Onesupporting

confidence: 79%

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US adults with diabetes mellitus: Variability in oral healthcare utilization

et al. 2021

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Background Diabetic patients are advised to have at least one dental examination per year. It is unclear to what extent different subgroups of US diabetic adults closely follow this recommendation. Thus, we assessed dental care utilization and related factors in a representative sample of US diabetic adults from rural and urban counties. Methods Cross-sectional data were from the 2018 Behavioral Risk Factor Surveillance System (BRFSS). Survey logistic regression was used to account for the complex sampling design. Results Among 40,585 eligible participants, 24,887 (60% of the population) had at least one dental visit for any reason within the past year. The lowest compliance was observed among edentulous participants (27%, adjusted OR = 0.26, 95% CI = 0.22–0.31 vs. fully dentate). Dental compliance was also negatively associated with having a lower income or education, ever being a smoker, or having barriers to access to care. Rural residents had lower dental compliance compared to urban residents, particularly those without healthcare coverage. Conclusions Dental compliance among US adult diabetic individuals was low, particularly among rural residents, and as compared to other recommended diabetic care practices. Future public health interventions may target rural individuals without healthcare coverage, smokers and edentulous individuals. There is a need to integrate dental and medical care to facilitate cross-talks among different health professionals, so that educational preventive messages are reinforced at every healthcare visit.

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Section: Discussioncontrasting

confidence: 97%

Section: Plos Onesupporting

confidence: 79%

US adults with diabetes mellitus: Variability in oral healthcare utilization

et al. 2021

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“…In so doing, they ignore gender and miss the opportunity to understand how inequalities are experienced by different intersections (eg being a male, White, newly arrived immigrant in the UK subjected to discrimination). Finally, Sabbah et al 42 analysed data from the 2014 U.S. Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System (BRFSS) to test associations between racial discrimination and use of dental services. This study used hierarchical logistic models to disentangle and exclude what were theorized as “confounders”: gender, race and ethnicity.…”

Section: What Do We Know About the Application Of Intersectionality Imentioning

confidence: 99%

What is intersectionality and why is it important in oral health research?

Muirhead

Milner

Freeman

et al. 2020

Comm Dent Oral Epid

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This paper is the second of two reviews that seek to stimulate debate on new and neglected avenues in oral health research. The first commissioned narrative review, “Inclusion oral health: Advancing a theoretical framework for policy, research and practice”, published in February 2020, explored social exclusion, othering and intersectionality. In it, we argued that people who experience social exclusion face a “triple threat”: they are separated from mainstream society, stigmatized by the dental profession, and severed from wider health and social care systems because of the disconnection between oral health and general health. We proposed a definition of inclusion oral health and a theoretical framework to advance the policy, research and practice agenda. This second review delves further into the concept of intersectionality, arguing that individuals who are socially excluded experience multiple forms of discrimination, stigma and disadvantage that reflect intersecting social identities. We first provide a theoretical and historical overview of intersectionality, rooted in Black feminist ideologies in the United States. Our working definition of intersectionality, requiring the simultaneous appreciation of multiple social identities, an examination of power and inequality, and a recognition of changing social contexts, then sets the scene for examining existing applications of intersectionality in oral health research. A critique of the sparse application of intersectionality in oral health research highlights missed opportunities and shortcomings related to paradigmatic and epistemological differences, a lack of robust theoretically engaged quantitative and mixed methods research, and a failure to sufficiently consider power from an intersectionality perspective. The final section proposes a framework to guide future oral health research that embraces an intersectionality agenda consisting of descriptive research to deepen our understanding of intersectionality, and transformative research to tackle social injustice and inequities through participatory research and co‐production.

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“…According to the results, favoritism is another dimension of discrimination in health care and a barrier to justice in providing medical services. In many countries, according to the patient rights charter, patients have the right to receive full medical services irrespective of ethnicity, culture, language, type of disease, and gender (46) while the present study participants had experienced ethnicity as one of the dimensions of discrimination in health care. Discrimination based on ethnicity and the individual's origin is one of the most common forms of discrimination in health care and has been addressed in numerous studies (47)(48)(49).…”

Section: Discussionmentioning

confidence: 94%

Discrimination in Healthcare, Experiences of Nurses, Physicians and Patients: A Qualitative Content Analysis

Hosseinabadi-Farahani¹,

Fallahi-Khoshknab²,

Arsalani³

et al. 2021

Preprint

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Background: Justice in health is one of the main concerns of health organizations, and discrimination in health care is one of the negative outcomes to achieving this goal. Hence, a full understanding of the phenomenon of discrimination in health care and adopting strategies to eliminate it is necessary. The present study was conducted to determine the experiences of nurses, physicians, and patients of discrimination in health care. Methods: The present qualitative content analysis study was conducted between 2019 and 2020. Data were collected through semi-structured interviews with 18 participants (2 physicians, 3 nursing supervisors, 2 head nurses, 4 clinical nurses, 2 nursing assistants, and 3 hospitalized patients) in one public and one private hospital in the city of Tehran. The participants were selected by purposive sampling, which continued until saturation of data. Data obtained were analyzed using Graneheim and Lundman method.Results: Four main categories and 14 subcategories were extracted from data analysis: 1) Habitual discrimination (everyday discrimination in health centers, ignoring patient rights, low levels of trust in medical staff); 2) interpersonal relationships (expectations of associates, respect for colleagues and friends, the possibility of the occurrence of similar situations, reciprocating people’s favors); 3) shortage of health care resources (shortage of medical equipment, heavy workload, infrastructures of medical centers, lack of access to physicians); and 4) Favoritism (ethnicity, favoritism as a common method, and as the ultimate solution to problems).Conclusion: The present study revealed certain dimensions of discrimination in health care that remain hidden in many quantitative studies. Thus, it appears that health system managers will be able to move towards eliminating discrimination in health care and providing ethical care by considering these issues and adopting appropriate strategies.

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Racial Discrimination and Uptake of Dental Services among American Adults

Cited by 34 publications

References 33 publications

US adults with diabetes mellitus: Variability in oral healthcare utilization

US adults with diabetes mellitus: Variability in oral healthcare utilization

What is intersectionality and why is it important in oral health research?

Discrimination in Healthcare, Experiences of Nurses, Physicians and Patients: A Qualitative Content Analysis

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