Luo Huabin, Wu Bei, Wu Yanyan, Moss Mark E
Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, North Carolina.
Rory Meyers College of Nursing, New York University, New York, New York.
AJPM Focus. 2024 Apr 19;3(4):100230. doi: 10.1016/j.focus.2024.100230. eCollection 2024 Aug.
National data on dental caries and dental service use among immigrant children in U.S. are limited. It is not known whether race/ethnicity would interact with immigration status to increase these disparities. Using a nationally representative sample, this study assessed the interaction effects of immigrant generation status and race/ethnicity on dental caries and dental visits among children in the U.S.
Data were from the 2020 and 2021 National Survey of Children's Health. All data were self-reported by parents/guardians. The 2 outcomes were (1) dental caries (yes/no) in the past 12 months and (2) preventive dental visits (yes/no) in the past 12 months. Racial/ethnic groups included non-Hispanic White, Black, Hispanics, and Asian Americans. The analytical sample included 66,167 children aged 2-17 years, including 1,243 first-generation immigrant children; 11,017 second-generation immigrant children; and 53,907 nonimmigrant children. Study authors ran separate multiple logistic regression models for the 2 outcome variables. All analyses accounted for the survey design of National Survey of Children's Health.
First-generation immigrant children were more likely to have dental caries than nonimmigrant children (AOR=1.44). The interaction of race/ethnicity and immigrant generation status was significant (=0.04) in the preventive dental visits model, indicating increased challenges in getting dental visits among minority immigrant children in comparison with that among non-Hispanic White immigrant children, especially among first-generation immigrant children of Asian Americans (AOR=0.41) and non-Hispanic Black immigrant children (AOR=0.37).
First-generation immigrant children were less likely to see a dentist and more likely to have dental caries than nonimmigrants. Moreover, first-generation immigrant children from minority racial/ethnic groups were the least likely to seek dental services. To further reduce disparities in oral health and dental use among children in the U.S., culturally sensitive health promotion is warranted to improve oral health literacy and reduce barriers to dental care for immigrants, especially immigrant children of the minority groups.
关于美国移民儿童龋齿和牙科服务使用情况的全国性数据有限。尚不清楚种族/族裔是否会与移民身份相互作用，加剧这些差异。本研究使用具有全国代表性的样本，评估了移民代际身份和种族/族裔对美国儿童龋齿和看牙次数的交互作用。
数据来自2020年和2021年全国儿童健康调查。所有数据均由父母/监护人自行报告。两个结果分别为：（1）过去12个月内是否患龋齿；（2）过去12个月内是否进行预防性看牙。种族/族裔群体包括非西班牙裔白人、黑人、西班牙裔和亚裔美国人。分析样本包括66167名2至17岁的儿童，其中有1243名第一代移民儿童；11017名第二代移民儿童；以及53907名非移民儿童。研究作者针对这两个结果变量分别进行了多元逻辑回归模型分析。所有分析均考虑了全国儿童健康调查的调查设计。
第一代移民儿童比非移民儿童患龋齿的可能性更高（比值比=1.44）。在预防性看牙模型中，种族/族裔与移民代际身份的交互作用显著（P=0.04），这表明与非西班牙裔白人移民儿童相比，少数族裔移民儿童在看牙方面面临更大挑战，尤其是亚裔美国人的第一代移民儿童（比值比=0.41）和非西班牙裔黑人移民儿童（比值比=0.37）。
与非移民相比，第一代移民儿童看牙医的可能性更小，患龋齿的可能性更大。此外，来自少数种族/族裔群体的第一代移民儿童寻求牙科服务的可能性最小。为了进一步减少美国儿童在口腔健康和牙科服务使用方面的差异，有必要开展具有文化敏感性的健康促进活动，以提高口腔健康素养，减少移民尤其是少数族裔移民儿童获得牙科护理的障碍。
