New York University College of Dentistry, New York, NY, USA.
J Urban Health. 2011 Aug;88(4):651-62. doi: 10.1007/s11524-011-9555-8.
There is a growing burden of oral disease among older adults that is most significantly borne by minorities, the poor, and immigrants. Yet, national attention to oral heath disparities has focused almost exclusively on children, resulting in large gaps in our knowledge about the oral health risks of older adults and their access to care. The projected growth of the minority and immigrant elderly population as a proportion of older adults heightens the urgency of exploring and addressing factors associated with oral health-related disparities. In 2008, the New York City Health Indicators Project (HIP) conducted a survey of a representative sample of 1,870 adults over the age of 60 who attended a random selection of 56 senior centers in New York City. The survey included questions related to oral health status. This study used the HIP database to examine differences in self-reported dental status, dental care utilization, and dental insurance, by race/ethnicity, among community-dwelling older adults. Non-Hispanic White respondents reported better dental health, higher dental care utilization, and higher satisfaction with dental care compared to all other racial/ethnic groups. Among minority older adults, Chinese immigrants were more likely to report poor dental health, were less likely to report dental care utilization and dental insurance, and were less satisfied with their dental care compared to all other racial/ethnic groups. Language fluency was significantly related to access to dental care among Chinese immigrants. Among a diverse community-dwelling population of older adults in New York City, we found significant differences by race/ethnicity in factors related to oral health. Greater attention is needed in enhancing the cultural competency of providers, addressing gaps in oral health literacy, and reducing language barriers that impede access to care.
老年人的口腔疾病负担日益加重,其中受影响最大的是少数族裔、贫困人群和移民。然而,国家对口腔健康差异的关注几乎完全集中在儿童身上,导致我们对老年人的口腔健康风险及其获得护理的机会知之甚少。少数族裔和移民老年人口在老年人口中所占比例的预计增长,凸显了探索和解决与口腔健康相关差异相关因素的紧迫性。2008 年,纽约市健康指标项目(HIP)对 1870 名年龄在 60 岁以上的成年人进行了一项代表性调查,这些成年人参加了纽约市 56 个老年人中心的随机选择。该调查包括与口腔健康状况相关的问题。本研究使用 HIP 数据库,检查了不同种族/族裔的社区居住老年人中,自我报告的牙齿状况、牙科保健利用率和牙科保险差异。与其他所有种族/族裔群体相比,非西班牙裔白人受访者报告的牙齿健康状况更好、牙科保健利用率更高、对牙科保健的满意度更高。在少数族裔老年人中,与其他所有种族/族裔群体相比,中国移民更有可能报告牙齿健康状况不佳、更不可能报告牙科保健利用率和牙科保险,对牙科保健的满意度也较低。语言流利程度与中国移民获得牙科保健的机会显著相关。在纽约市多样化的社区居住的老年人中,我们发现种族/族裔之间在与口腔健康相关的因素方面存在显著差异。需要更加关注提高提供者的文化能力,解决口腔健康素养差距问题,并减少阻碍获得护理的语言障碍。