国家层面的结构性种族主义和儿童牙科护理和口腔健康的获取
A M Kranz1, L A Evans2, C Gadwah-Meaden3,4
1RAND Corporation, Arlington, VA, USA.
JDR clinical and translational research
|December 21, 2024
概括
国家层面的结构性种族主义并不能解释儿童去看牙医或口腔健康方面的种族差异. 需要进一步的研究来了解和解决这些黑人儿童持续存在的口腔健康差距.
科学领域:
- 公共卫生 公共卫生
- 健康差异 在健康上的差异
- 儿科口腔健康 儿科口腔健康
背景情况:
- 与美国白人儿童相比,黑人儿童的口腔健康状况较差,牙医的诊断次数也较少.
- 现有的研究还没有充分探讨结构性种族主义对儿童口腔健康中的这些种族差异的影响.
研究的目的:
- 评估国家层面的结构性种族主义与儿童口腔健康结果之间的联系.
- 检查结构性种族主义在儿童使用牙科护理和口腔健康状况的黑人和白人差异中的作用.
主要方法:
- 一项重复的横截面观察研究,使用来自2016-2021年国家儿童健康调查 (NSCH) 的数据.
- 检查的结果包括牙医访问的利用率,任何口腔健康问题,以及1-17岁儿童的整体口腔健康状况.
- 构建了州级结构性种族主义指数 (司法,教育,经济,政治,社区隔离),并将其与NSCH数据联系起来,采用调整为人口统计和社会经济地位的回归模型.
主要成果:
- 这项研究包括98,423名儿童 (11%是黑人,88%是白人).
- 黑人儿童的口腔健康状况比白人儿童更差,牙科访问率也更低.
- 国家层面的结构性种族主义与获得牙科护理,口腔健康问题或整体口腔健康状况没有显著的关联;在调整后,差异仍然存在.
结论:
- 在儿童口腔健康方面,黑人和白人之间仍然存在显著的差异,而国家层面的结构性种族主义似乎不是直接的解释因素.
- 进一步的研究应该调查其他地理层面,并完善结构性种族主义指数,包括医疗保健准入和儿童特定的制度因素.
- 政策干预应侧重于扩大护理服务,多样化提供者,增加牙医的医疗补助参与,以减少口腔健康差异.
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