Centre for Dental Public Health and Primary Care, Institute of Dentistry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK.
Community Dent Oral Epidemiol. 2020 Dec;48(6):464-470. doi: 10.1111/cdoe.12573. Epub 2020 Aug 25.
This paper is the second of two reviews that seek to stimulate debate on new and neglected avenues in oral health research. The first commissioned narrative review, "Inclusion oral health: Advancing a theoretical framework for policy, research and practice", published in February 2020, explored social exclusion, othering and intersectionality. In it, we argued that people who experience social exclusion face a "triple threat": they are separated from mainstream society, stigmatized by the dental profession, and severed from wider health and social care systems because of the disconnection between oral health and general health. We proposed a definition of inclusion oral health and a theoretical framework to advance the policy, research and practice agenda. This second review delves further into the concept of intersectionality, arguing that individuals who are socially excluded experience multiple forms of discrimination, stigma and disadvantage that reflect intersecting social identities. We first provide a theoretical and historical overview of intersectionality, rooted in Black feminist ideologies in the United States. Our working definition of intersectionality, requiring the simultaneous appreciation of multiple social identities, an examination of power and inequality, and a recognition of changing social contexts, then sets the scene for examining existing applications of intersectionality in oral health research. A critique of the sparse application of intersectionality in oral health research highlights missed opportunities and shortcomings related to paradigmatic and epistemological differences, a lack of robust theoretically engaged quantitative and mixed methods research, and a failure to sufficiently consider power from an intersectionality perspective. The final section proposes a framework to guide future oral health research that embraces an intersectionality agenda consisting of descriptive research to deepen our understanding of intersectionality, and transformative research to tackle social injustice and inequities through participatory research and co-production.
本文是两篇综述中的第二篇，旨在激发人们对口腔健康研究中新的和被忽视的领域的讨论。第一篇委托撰写的叙述性综述“包容性口腔健康：为政策、研究和实践推进理论框架”于 2020 年 2 月发表，探讨了社会排斥、他者化和交叉性。在这篇综述中，我们认为经历社会排斥的人面临着“三重威胁”：他们与主流社会隔绝，被口腔专业人员污名化，并且由于口腔健康与整体健康之间的脱节，与更广泛的健康和社会保健系统隔绝。我们提出了包容性口腔健康的定义和理论框架，以推进政策、研究和实践议程。这第二篇综述更深入地探讨了交叉性的概念，认为社会排斥的个体经历着多种形式的歧视、污名和劣势，反映了交叉的社会身份。我们首先提供了交叉性的理论和历史概述，其根源在于美国的黑人女权主义思想。我们对交叉性的工作定义要求同时理解多种社会身份、审视权力和不平等、并认识到不断变化的社会背景，然后为检查交叉性在口腔健康研究中的现有应用奠定了基础。对口腔健康研究中交叉性应用稀疏的批判强调了与范式和认识论差异、缺乏强有力的理论上有针对性的定量和混合方法研究以及未能从交叉性角度充分考虑权力相关的错失机会和缺点。最后一节提出了一个框架，以指导未来的口腔健康研究，该框架包含一个交叉性议程，包括描述性研究以加深我们对交叉性的理解，以及通过参与式研究和共同制定来解决社会不公正和不平等的变革性研究。
