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美国华盛顿特区少数族裔社区的口腔卫生服务可及性:一项地理空间分析。

Oral Health Service Access in Racial/Ethnic Minority Neighborhoods: A Geospatial Analysis in Washington, DC, USA.

机构信息

School of Social Work, Howard University, Washington, DC 20059, USA.

School of Social Work, Carleton University, Ottawa, ON K1S 5B6, Canada.

出版信息

Int J Environ Res Public Health. 2022 Apr 20;19(9):4988. doi: 10.3390/ijerph19094988.

Abstract

Previous studies on individual-level variables have improved our knowledge base of oral health service use. However, environmental or contextual variables are also important in understanding oral health disparities in racial and ethnic neighborhoods. Based on Bronfenbrenner’s ecological framework, this study examines the geographic availability of oral health providers in Washing-ton DC, U.S.A. Census tract-level data were drawn from the American Community Survey, joined with tract-level shapefiles, and overlaid with the geographic location of dental services throughout the city. Visual maps, descriptive statistics, and spatial lag regression models showed that census tracts with higher concentrations of African Americans were significantly farther from their nearest oral health providers (r = 0.19, p < 0.001), after controlling for neighborhood poverty rate, median age, and gender. Such findings confirm that in urban areas with highly di-verse populations such as Washington DC, racial disparities in oral health care access are signifi-cant. The study highlights that identifying neighborhoods with limited oral health care providers should be a priority in diminishing racial disparities in oral health service access. Improving access to racial/ethnic minority communities, especially African American neighborhoods, will require changes in health policies and programs, workforce development, resource allocation, community outreach, and educational programs.

摘要

先前对个体层面变量的研究增进了我们对口腔卫生服务利用的知识基础。然而,在理解种族和民族社区中的口腔卫生差异时,环境或背景变量也很重要。本研究基于布伦芬布伦纳的生态框架,考察了美国华盛顿特区口腔卫生提供者的地理可得性。从美国社区调查中提取了普查区层面的数据,将其与普查区层面的形状文件合并,并将全市的牙科服务地理位置叠加在上面。可视化地图、描述性统计和空间滞后回归模型表明,在控制了邻里贫困率、中位年龄和性别后,非裔美国人浓度较高的普查区与最近的口腔卫生提供者之间的距离明显更远(r = 0.19,p < 0.001)。这些发现证实,在像华盛顿特区这样人口高度多样化的城市地区,口腔卫生保健获取方面的种族差异显著。该研究强调,确定口腔卫生服务提供者有限的社区应成为减少口腔卫生服务获取方面种族差异的优先事项。改善对少数族裔社区,特别是非裔美国社区的获取途径,需要改变卫生政策和计划、劳动力发展、资源分配、社区外联和教育计划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80ba/9105494/7a91057c7955/ijerph-19-04988-g001.jpg

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