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种族健康不平等。

Racial Inequalities in Oral Health.

机构信息

1 Department of Public Health, Federal University of Santa Catarina, Brazil.

2 Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Brazil.

出版信息

J Dent Res. 2018 Jul;97(8):878-886. doi: 10.1177/0022034518768536. Epub 2018 Apr 10.

Abstract

Together with other social categories, race has been at the core of much scholarly work in the area of humanities and social sciences, as well as a host of applied disciplines. In dentistry, debates have ranged from the use of race as a criterion for the recommendation of specific dental procedures to a means of assessing inequalities in a variety of outcomes. What is missing in these previous discussions, though, is a broader understanding of race that transcends relations with genetic makeup and other individual-level characteristics. In this review, we provide readers with a critique of the existing knowledge on race and oral health by answering the following 3 guiding questions: (1) What concepts and ideas are connected with race in the field of dentistry? (2) What can be learned and what is absent from the existing literature on the topic? (3) How can we enhance research and policy on racial inequalities in oral health? Taken together, the reviewed studies rely either on biological distinctions between racial categories or on other individual characteristics that may underlie racial disparities in oral health. Amidst a range of individual-level factors, racial inequalities have often been attributed to lower socioeconomic status and "health-damaging" cultural traits, for instance, patterns of and reasons for dental visits, dietary habits, and oral hygiene behaviors. While this literature has been useful in documenting large and persistent racial gaps in oral health, wider sociohistorical processes, such as systemic racism, as well as their relationships with economic exploitation, social stigmatization, and political marginalization, have yet to be operationalized among studies on the topic. A nascent body of research has recently begun to address some of these factors, but limited attention to structural theories of racism means that many more studies are needed to effectively mitigate racial health differentials.

摘要

与其他社会类别一样,种族一直是人文社会科学领域以及许多应用学科的大量学术工作的核心。在牙科领域,争论的范围从将种族用作推荐特定牙科程序的标准到评估各种结果中的不平等的手段。然而,在这些先前的讨论中,缺少的是对超越与遗传构成和其他个体层面特征的关系的更广泛的种族理解。在这篇综述中,我们通过回答以下 3 个指导问题,为读者提供了对种族与口腔健康相关现有知识的批判:(1)在牙科领域,哪些概念和思想与种族有关?(2)可以从关于该主题的现有文献中学到什么,又遗漏了什么?(3)如何加强口腔健康中种族不平等的研究和政策?总的来说,所审查的研究要么依赖于种族类别之间的生物学差异,要么依赖于可能导致口腔健康方面种族差异的其他个体特征。在一系列个体层面的因素中,种族不平等通常归因于较低的社会经济地位和“损害健康”的文化特征,例如,看牙的模式和原因、饮食习惯和口腔卫生行为。虽然该文献在记录口腔健康方面存在较大且持续的种族差距方面非常有用,但更广泛的社会历史进程,例如系统性种族主义,以及它们与经济剥削、社会污名化和政治边缘化的关系,尚未在该主题的研究中得到体现。最近,一个新的研究领域已经开始解决其中的一些因素,但对种族主义结构理论的关注有限意味着,需要进行更多的研究才能有效减轻种族健康差异。

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