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拉丁裔口腔健康悖论?运用民族志方法明确流行病学模型背后的生物文化因素。

A LATINO ORAL HEALTH PARADOX? USING ETHNOGRAPHY TO SPECIFY THE BIO-CULTURAL FACTORS BEHIND EPIDEMIOLOGICAL MODELS.

作者信息

Horton Sarah B, Barker Judith C

机构信息

Department of Anthropology, University of Colorado, Denver.

出版信息

NAPA Bull. 2010 Nov 24;34(1):68-83. doi: 10.1111/j.1556-4797.2010.01052.x.

Abstract

This article presents evidence of a "Latino oral health paradox," in which Mexican immigrant parents in California's Central Valley report having had better oral health status as children in Mexico than their U.S.-born children. Yet little research has explored the specific environmental, social, and cultural factors that mediate the much-discussed "Latino health paradox," in which foreign-born Latinos paradoxically enjoy better health status than their children, U.S.-born Latinos, and whites. Through ethnography, we explore the dietary and environmental factors that ameliorated immigrant parents' oral health status in rural Mexico, while ill-preparing them for the more cariogenic diets and environments their children face in the U.S. We argue that studies on the "Latino health paradox" neglect a binational analysis, ignoring the different health status of Latino populations in their sending countries. We use the issue of immigrant children's high incidence of oral disease to initiate a fuller dialogue between U.S.-based studies of the "health paradox" and non-U.S. based studies of the "epidemiological transition." We show that both models rely upon a static opposition between "traditional" and "modern" health practices, and argue that a binational analysis of the processes that affect immigrant children's health can help redress the shortcomings of epidemiological generalizations.

摘要

本文提供了“拉丁裔口腔健康悖论”的证据,即加利福尼亚州中央山谷的墨西哥移民父母报告称,他们在墨西哥儿时的口腔健康状况比在美国出生的孩子更好。然而,很少有研究探讨那些介导了备受讨论的“拉丁裔健康悖论”的具体环境、社会和文化因素,在这一悖论中,出生在国外的拉丁裔享有比他们在美国出生的孩子以及白人更好的健康状况。通过人种志研究,我们探究了改善墨西哥农村移民父母口腔健康状况的饮食和环境因素,同时也发现这些因素使他们难以应对孩子在美国所面临的更易致龋的饮食和环境。我们认为,关于“拉丁裔健康悖论”的研究忽视了跨国分析,忽略了拉丁裔人群在其原籍国的不同健康状况。我们利用移民儿童口腔疾病高发这一问题,在美国对“健康悖论”的研究与非美国对“流行病学转变”的研究之间展开更全面的对话。我们表明,这两种模式都依赖于“传统”与“现代”健康实践之间的静态对立,并认为对影响移民儿童健康的过程进行跨国分析有助于弥补流行病学概括的不足。

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