Department of Anthropology, Middlebury College, Middlebury, Vermont, USA.
Community Dent Oral Epidemiol. 2024 Feb;52(1):59-67. doi: 10.1111/cdoe.12901. Epub 2023 Jul 28.
Primary dental healthcare services are not accessible for a majority of Latino/a/e migrant farmworkers in the United States. Unmet dental health needs are well documented in larger states like California, Florida and New York, but the dental healthcare picture in smaller states is not well understood. The goal of this qualitative ethnographic study was to understand the delivery model of a free dentistry network serving Latine farmworkers in rural Vermont and specific barriers experienced at the network during the COVID-19 pandemic.
Semi-structured ethnographic interviews were carried out with clinicians and transcripts were analysed using the constant comparison method to identify salient concerns and recommendations about barriers and delivery of care.
Clinicians highlighted structural issues including farmworkers' lack of time off work and absence of transportation to attend appointments, concerns about COVID-19 safety, concerns about immigration surveillance and language barriers. Providers outlined steps for improved service delivery including mobile care at local farms, enhanced intercultural training for providers, recognizing dentistry as essential healthcare at the state level and the leverage of existing appointments for preventive health. Drawing on anthropological frameworks of place-based care and deservingness of healthcare, our ethnographic findings emphasize the role of community dentistry in bridging gaps in migrant healthcare during and beyond the COVID-19 pandemic.
在美国，大多数拉丁裔/西班牙裔移民农场工人无法获得初级牙科保健服务。在加利福尼亚、佛罗里达和纽约等较大的州，未满足的牙科健康需求有详细记录，但较小州的牙科保健情况尚不清楚。这项定性民族志研究的目的是了解在佛蒙特州农村为拉丁裔农场工人提供免费牙科服务的网络的交付模式，以及在 COVID-19 大流行期间网络所经历的具体障碍。
对临床医生进行半结构化民族志访谈，并使用恒定性比较方法分析转录本，以确定有关障碍和护理提供的突出问题和建议。
临床医生强调了一些结构性问题，包括农场工人没有时间休假以及没有交通工具来预约，对 COVID-19 安全的担忧，对移民监督和语言障碍的担忧。提供者概述了改进服务提供的步骤，包括在当地农场提供移动护理，加强提供者的跨文化培训，在州一级承认牙科是基本医疗保健，并利用现有的预约进行预防性保健。借鉴基于场所的护理和医疗保健应得性的人类学框架，我们的民族志研究结果强调了社区牙科在弥合 COVID-19 大流行期间和之后移民医疗保健差距方面的作用。
