Department of Dental Public Health and Policy, School of Dentistry, and Division of Epidemiology, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA.
Institute for Inclusion, Inquiry and Innovation, Virginia Commonwealth University, Richmond, VA, USA.
JDR Clin Trans Res. 2021 Apr;6(2):222-233. doi: 10.1177/2380084420923338. Epub 2020 May 21.
Access to routine dental services is important to maintaining good oral health. The aims of this study were to describe the dental care utilization patterns of a diverse group of Hispanic/Latino men and women and assess differences in dental care utilization by perceived need for dental care and proxy measures of acculturation.
Data from 13,792 participants of the Hispanic Community Health Study were analyzed with SAS 9.4. Time since last dental visit was dichotomized into <1 and ≥1 y. Acculturation measures included the language and social subscales of the Short Acculturation Scale for Hispanics, the Multiethnic Study of Atherosclerosis nativity subscore, and immigrant generation. Survey logistic regression adjusted for demographic (age and sex) and health-related variables, estimated associations among perceived need for dental care, acculturation measures, and dental care utilization.
About a quarter (23%) of the participants were born in the 50 US states, excluding territories, while 77% were non-US born. Overall, 74% perceived a need for dental care. Upon covariate adjustment, perceiving a need for dental care was associated with reduced odds of reporting a past-year dental visit (odds ratio, 0.32; 95% CI, 0.28 to 0.37), while there appeared to be no meaningful association between proxy measures of acculturation and past-year dental visit. Having health insurance was significantly associated with a past-year dental visit (odds ratio, 2.23; 95% CI, 1.99 to 2.49) for all groups combined and among the different Hispanic/Latino background groups.
Acculturation affects general health and contributes to general health disparities; however, its role in dental care utilization remains questionable. Given that acculturation is a process that occurs over several years, longitudinal studies that evaluate oral health trajectories along the acculturation continuum are needed.
The results of this study are valuable for dental public health program planning and implementation for minority groups, as it describes the varying patterns of dental care utilization among US-born and non-US born Hispanics/Latinos and identifies factors that may partly explain dental care utilization patterns, such as acculturation.
获得常规牙科服务对维持良好的口腔健康很重要。本研究的目的是描述一组不同的西班牙裔/拉丁裔男女的牙科护理利用模式，并评估牙科护理利用与感知牙科护理需求和文化适应度替代指标之间的差异。
使用 SAS 9.4 分析了 13792 名西班牙裔社区健康研究参与者的数据。上次看牙医的时间分为<1 年和≥1 年。文化适应度测量包括西班牙语和社会短量表、多民族动脉粥样硬化研究原籍国亚分数和移民代际。调查逻辑回归调整了人口统计学（年龄和性别）和健康相关变量，估计了感知牙科护理需求、文化适应度测量和牙科护理利用之间的关联。
约四分之一（23%）的参与者出生于美国 50 个州（不包括领土），而 77%的参与者出生于美国以外。总体而言，74%的人认为需要看牙。在调整了协变量后，感知到需要看牙与报告过去一年看牙的几率降低有关（比值比，0.32；95%置信区间，0.28 至 0.37），而文化适应度的替代指标与过去一年看牙之间似乎没有明显的关联。拥有健康保险与所有组别的过去一年看牙（比值比，2.23；95%置信区间，1.99 至 2.49）以及不同西班牙裔/拉丁裔背景组之间都有显著关联。
文化适应度会影响整体健康并导致整体健康差异；然而，其在牙科护理利用中的作用仍存在疑问。鉴于文化适应度是一个需要多年时间的过程，需要进行纵向研究，评估沿着文化适应度连续体的口腔健康轨迹。
本研究的结果对于少数民族的牙科公共卫生计划规划和实施具有重要价值，因为它描述了美国出生和非美国出生的西班牙裔/拉丁裔之间不同的牙科护理利用模式，并确定了可能部分解释牙科护理利用模式的因素，如文化适应度。
