Postgraduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.
Adelaide Dental School, Australian Research Centre for Population Oral Health (ARCPOH), University of Adelaide, Adelaide, Australia.
Community Dent Oral Epidemiol. 2021 Feb;49(1):87-94. doi: 10.1111/cdoe.12581. Epub 2020 Oct 6.
There is a dearth of studies on the extent to which perceived racial discrimination shapes oral health. Following an intersectional perspective, we estimated the prevalence of perceived racial discrimination in Australia, its association with oral health impairment, and examined whether this association was more severe among low socioeconomic status (SES) groups.
Data came from the 2013 National Dental Telephone Interview Survey (N = 2798), a population-based study of Australian adults. Multivariable Poisson regression models were estimated to test the relationship between perceived racial discrimination and self-reported oral health impairment, as well as to investigate whether the magnitude of this association was greater among low-SES respondents. Relative Excess Risks due to Interaction (RERI) were used to indicate the presence of potentially large discrimination effects within low-SES strata.
Racial discrimination in the past 12 months was reported by 11.5% of all participants. Australians reporting racial discrimination had 1.4 (95% CI 1.1, 1.7) times the prevalence of impaired oral health. The association between perceived racial discrimination and oral health impairment was stronger among low-SES groups. The RERI was 0.55, indicating a super-additive Effect Measure Modification (EMM) by income on the additive scale. Similar results were observed with the EMM analyses by educational attainment.
Our findings indicate that perceived racial discrimination, as a specific form of widespread inequality, is associated with higher frequencies of oral health impairment among Australian adults. We also suggest that socially marginalized groups bear a greater burden of the oral health effects of racial discrimination.
关于感知到的种族歧视在多大程度上影响口腔健康的研究甚少。本研究采用交叉视角，估计了澳大利亚感知到的种族歧视的普遍程度，及其与口腔健康受损的关联，并检验了这种关联在社会经济地位（SES）较低的群体中是否更为严重。
数据来自 2013 年全国牙科电话访谈调查（N=2798），这是一项对澳大利亚成年人的基于人群的研究。采用多变量泊松回归模型来检验感知到的种族歧视与自我报告的口腔健康受损之间的关系，并调查这种关联在 SES 较低的受访者中是否更为严重。相对超额风险比（RERI）用于表明 SES 较低的群体中存在潜在的较大歧视效应。
11.5%的参与者报告在过去 12 个月中经历过种族歧视。报告有过种族歧视的澳大利亚人，其口腔健康受损的流行率是没有经历过种族歧视的人的 1.4 倍（95%CI 1.1, 1.7）。感知到的种族歧视与口腔健康受损之间的关联在 SES 较低的群体中更强。RERI 为 0.55，表明收入对加性尺度的效应修饰物（EMM）具有超相加性。通过教育程度进行的 EMM 分析也得到了类似的结果。
我们的研究结果表明，感知到的种族歧视作为一种普遍不平等的特定形式，与澳大利亚成年人口腔健康受损的频率增加有关。我们还表明，社会边缘化群体承受着更多的种族歧视对口腔健康影响的负担。
