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预测纽约市出租车/网约车司机获得牙科保健服务受限的因素。

Predictors of Limited Access to Dental Health Care Among NYC Taxi/FHV Drivers.

机构信息

Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Science, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, Second Floor, 10017, New York, NY, USA.

Department of Medicine, Department of Public Health, Weill Cornell Medical College, New York, NY, USA.

出版信息

J Community Health. 2021 Oct;46(5):869-875. doi: 10.1007/s10900-020-00955-0. Epub 2021 Feb 1.

Abstract

Taxi and for-hire vehicle (FHV) drivers are a largely immigrant, low-income occupational group at increased cardiovascular disease (CVD) risk. Poor dental health is a CVD risk factor, and dental care access is an unexamined taxi/FHV driver CVD risk factor. A cross-sectional survey was administered to 422 taxi/FHV drivers (2016-2017) to identify predictors of access to dental health care among drivers. One-third (n = 128, 30.3%) reported needing dental care/tests/treatment within the past six months, and nearly one-half (n = 61, 48%) were delayed/unable to obtain care. Only 57.6% (n = 241) had past-year dental cleanings. Not having enough money to cover household expenses was a significant predictor of being delayed/unable to obtain needed dental care/tests/treatment in the prior six months (0.5 OR; 95% CI, 0.28-0.89; p < .05). Lack of dental insurance coverage (2.72 OR; 95% CI, 1.60-4.63; p < .001) or lack of primary care provider (2.72 OR; 95% CI, 1.60-4.63; p < .001) were associated with lack of past-year dental cleaning. Seventeen percent of drivers with Medicaid were unaware of their dental coverage, which was associated with both inability to access needed dental care/tests/treatment in the past 6 months (p = .026) and no past-year dental cleaning (p < .001). Limited understanding of dental coverage was associated with both an inability to access needed dental care/tests/treatment in the past 6 months (p = .028) and lack of past-year dental cleaning (p = .014). Our findings can inform targeted intervention development to increase taxi/FHV driver dental care access/uptake, potentially improving their CVD risk.

摘要

出租车和网约车司机是一个以移民和低收入者为主的职业群体,他们患心血管疾病(CVD)的风险较高。口腔健康状况不佳是 CVD 的一个风险因素,而获得口腔护理服务则是一个未经检验的出租车/网约车司机 CVD 风险因素。本研究对 422 名出租车/网约车司机(2016-2017 年)进行了横断面调查,以确定影响司机获得口腔保健服务的因素。三分之一(n=128,30.3%)报告在过去六个月内需要进行口腔护理/检查/治疗,近一半(n=61,48%)司机延迟/无法获得护理。仅有 57.6%(n=241)的司机在过去一年中进行过口腔清洁。报告称无法支付家庭开支的司机在过去六个月内延迟/无法获得所需的口腔护理/检查/治疗的可能性显著更高(OR=0.5;95%CI,0.28-0.89;p<.05)。缺乏牙科保险(OR=2.72;95%CI,1.60-4.63;p<.001)或缺乏初级保健提供者(OR=2.72;95%CI,1.60-4.63;p<.001)与缺乏过去一年的口腔清洁有关。17%的有医疗补助的司机不知道自己的牙科保险覆盖范围,这与过去 6 个月内无法获得所需的口腔护理/检查/治疗(p=.026)和过去一年没有口腔清洁(p<.001)有关。对牙科保险的了解有限与过去 6 个月内无法获得所需的口腔护理/检查/治疗(p=.028)和缺乏过去一年的口腔清洁(p=.014)有关。本研究结果可为针对性干预措施的制定提供信息,以增加出租车/网约车司机的口腔护理服务可及性/利用率,从而可能降低他们的 CVD 风险。

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本文引用的文献

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Disparities in oral health by immigration status in the United States.美国移民身份导致的口腔健康差异。
J Am Dent Assoc. 2018 Jun;149(6):414-421.e3. doi: 10.1016/j.adaj.2018.01.024. Epub 2018 Apr 1.

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