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权力、牙科和口腔健康不平等;引言。

Power, dentistry and oral health inequities; an introduction.

机构信息

Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide Dental School, South Australia 5005, Australia.

出版信息

Community Dent Health. 2022 May 27;39(2):129-130. doi: 10.1922/CDH_IADR22JamiesonIntro02.

Abstract

Oral health inequities at a global level persist. This is despite marked advancements in technology, service delivery, training, research and population-level initiatives such as water fluoridation. Although the social determinants of health are frequently cited in the framing, analysis and description of oral health inequities, the explicit role of power is usually omitted. Lukes described power as the capacity of actors to make change, as well as to receive and resist change. An analysis of power thus provides a better understanding of how diverse and conflicting interests of multiple actors can lead to differential oral health norms within communities. An analysis of power also demonstrates the intersectional forms of oral inequities experienced among the socially marginalised; it is not rooted in economic deprivation alone. The training and practice of dentistry itself creates intersectional forms of inequalities through race, gender and class. Dental academic spaces are overwhelmingly White, with the knowledge created thus embedded with Eurocentric values. This needs to be challenged. We aim, in this special issue, to provide an overview of the pluralist and diverse nature of contemporary global society, and to show how attempting to impose singular forms of behaviours, values and knowledge that suppress the cultures of socially marginalised communities enhances oral health inequities. Specifically, this special issue will: (1) present an overview of how power operates generally, using implicit bias examples, with a strong underpinning from the literature; (2) describe what this means for power in dentistry, drawing upon sociological literature with a specific lens on dental organisations; (3) expand understanding of post-colonial theory and how this reinforces power structures in dentistry that further enable the privileged and; (4) examine the power relationship between dentists and patients, using theoretical underpinnings and elaborating on different power paradigms in the Australian vs Asian/Korean context.

摘要

全球范围内的口腔健康不平等现象仍然存在。尽管在技术、服务提供、培训、研究和人群层面的举措(如饮水氟化)方面取得了显著进展,但情况依然如此。尽管健康的社会决定因素经常在口腔健康不平等现象的框架、分析和描述中被提及,但权力的明确作用通常被忽略。卢克认为,权力是指行为者进行变革的能力,以及接受和抵制变革的能力。因此,对权力的分析可以更好地理解多个行为者的不同和相互冲突的利益如何导致社区内不同的口腔健康规范。权力分析还表明,社会边缘化群体中存在交叉形式的口腔不平等现象;它不仅仅植根于经济贫困。牙科本身的培训和实践通过种族、性别和阶级造成了交叉形式的不平等。牙科学术领域绝大多数是白人,由此产生的知识也嵌入了欧洲中心主义的价值观。这需要受到挑战。我们的目标是在本期特刊中,概述当代全球社会的多元化和多样性,并展示试图强加单一形式的行为、价值观和知识,从而抑制社会边缘化社区的文化,如何加剧口腔健康不平等现象。具体来说,本期特刊将:(1) 介绍权力的一般运作方式,使用隐性偏见的例子,并从文献中得到强有力的支持;(2) 描述这对牙科领域的权力意味着什么,借鉴社会学文献,并特别关注牙科组织;(3) 扩展对后殖民理论的理解,以及这如何在牙科领域进一步强化权力结构,使特权阶层受益;(4) 考察牙医和患者之间的权力关系,使用理论基础,并详细阐述澳大利亚和亚洲/韩国背景下不同的权力模式。

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