Schluter Philip J, Kanagaratnam Sathananthan, Taylor Steve, Tautolo El-Shadan
School of Health Sciences, University of Canterbury - Te Whare Wānanga o Waitaha, Christchurch, New Zealand.
School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Australia.
J Public Health Dent. 2017 Jun;77(3):225-233. doi: 10.1111/jphd.12202. Epub 2017 Feb 7.
Immigration and acculturation are increasingly recognized as important explanatory factors for health disparities, although their impact on oral health is less well understood. This study investigates the relationship between Pacific children's cultural orientation and oral health, after adjusting for potentially moderating and confounding variables.
The Pacific Islands Families (PIF) study follows a cohort of Pacific infants born in 2000. PIF study participants' data from their last dental examination were extracted from service records, and matched to the cohort. A bi-directional acculturation classification, derived from maternal reports, was related to children's oral health indices in crude and adjusted analyses.
1,376 children were eligible, of whom 922 (67.0 percent) had mothers born outside New Zealand. Matching was successful for 970 (70.5 percent) children, with mean age 12.2 years (range: 6.8, 15.4 years). Significant differences were found between acculturation groups for children's tooth brushing frequency and school dental service enrollments but these differences did not moderate relationships between acculturation and oral health status. Unmet treatment need was significantly different between acculturation groups, with children of mothers having higher Pacific orientation having worse unmet needs than those with lower Pacific orientation. No other significant differences were noted.
Pacific children carry a disproportionate oral health burden, particularly amongst those with mothers more aligned to their Pacific culture. Strategies which enable Pacific people to re-shape their oral health understanding, together with reducing barriers to accessing dental health care, are needed to prevent a legacy of poor oral health in Pacific people within New Zealand.
移民和文化适应日益被视为健康差异的重要解释因素,尽管它们对口腔健康的影响尚鲜为人知。本研究在对潜在的调节变量和混杂变量进行校正后,调查太平洋儿童的文化取向与口腔健康之间的关系。
太平洋岛屿家庭(PIF)研究追踪了一组2000年出生的太平洋婴儿。PIF研究参与者上次牙科检查的数据从服务记录中提取,并与该队列进行匹配。从母亲报告中得出的双向文化适应分类,在粗分析和校正分析中与儿童的口腔健康指数相关。
1376名儿童符合条件,其中922名(67.0%)儿童的母亲出生在新西兰以外。970名(70.5%)儿童匹配成功,平均年龄12.2岁(范围:6.8至15.4岁)。不同文化适应组儿童的刷牙频率和学校牙科服务注册情况存在显著差异,但这些差异并未调节文化适应与口腔健康状况之间的关系。不同文化适应组之间未满足的治疗需求存在显著差异,母亲具有较高太平洋文化取向的儿童,其未满足的需求比母亲具有较低太平洋文化取向的儿童更差。未发现其他显著差异。
太平洋儿童承担着不成比例的口腔健康负担,尤其是在那些母亲更认同其太平洋文化的儿童中。需要采取策略,使太平洋人群能够重塑他们对口腔健康的认识,并减少获得牙科保健的障碍,以防止新西兰太平洋人群遗留不良口腔健康问题。