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Oral health status and possible explanatory factors of an inner-city low-income community.

ABSTRACT: Background/purpose:Individuals with low income bear a number of health challenges to healthcare services. Vancouver's Downtown Eastside (DTES) is known to be a low-income community in a metropolitan city. Because it is difficult to reach, the oral health (OH) status of these residents is unknown. The objectives of this study are (1) to design a tool and strategy to collect OH information in a low-income community, (2) to characterize the OH status and related factors among low-income adults, and (3) to identify the explanatory factors for their OH status. Materials and methods:Mobile screening clinics were established in the gathering centers of the DTES, and those of 19 years of age or older were recruited. Data were collected through survey interviews and clinical examinations. Potential explanatory factors were investigated by regression analysis. Results:The 356 screened participants were mostly males, middle-aged, less educated, and living with low income (?CAD$20,000/y). About 80% had dental coverage, mostly from public programs (94%). Many (86%) perceived a dental need. Among dentate participants (n = 306), on average, 3.8 decayed, 8.6 missing, 4.9 filled teeth, and a care index of 41.5% were observed. Social factors (barriers to care and length of DTES residence), dental hygiene (brushing/flossing), and personal (hepatitis C virus infection/methadone usage) factors contributed to their care index level. Conclusion:This is the first time that comprehensive information regarding OH status has been collected from a low-income, inner-city community in Canada. Further investigations in the challenges and needs in accessing dental care may develop solutions for better OH in similar communities.

SUBMITTER: Hau KP

PROVIDER: S-EPMC6395230 | biostudies-literature | 2017 Mar

REPOSITORIES: biostudies-literature

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Oral health status and possible explanatory factors of an inner-city low-income community.

Hau Keith Pak-Hei KP Currie Brenda Lee BL Ng Samson Pak-Yan SP Le Nhu N Poh Catherine Fang-Yeu CF

Journal of dental sciences 20161111 1

<h4>Background/purpose</h4>Individuals with low income bear a number of health challenges to healthcare services. Vancouver's Downtown Eastside (DTES) is known to be a low-income community in a metropolitan city. Because it is difficult to reach, the oral health (OH) status of these residents is unknown. The objectives of this study are (1) to design a tool and strategy to collect OH information in a low-income community, (2) to characterize the OH status and related factors among low-income adu ...[more]

PMID: 30895023

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Project description:Many people residing in low-income and middle-income countries (LMICs) are regularly exposed to catastrophic healthcare expenditure. It is therefore pertinent that LMICs should finance their health systems in ways that ensure that their citizens can use needed healthcare services and are protected from potential impoverishment arising from having to pay for services. Ways of financing health systems include government funding, health insurance schemes and out-of-pocket payment. A health insurance scheme refers to pooling of prepaid funds in a way that allows for risks to be shared. The health insurance scheme particularly suitable for the rural poor and the informal sector in LMICs is community-based health insurance (CBHI), that is, insurance schemes operated by organisations other than governments or private for-profit companies. We plan to search for and summarise currently available evidence on factors associated with the uptake of CBHI, as we are not aware of previous systematic reviews that have looked at this important topic.This is a protocol for a systematic review of the literature. We will include both quantitative and qualitative studies in this review. Eligible quantitative studies include intervention and observational studies. Qualitative studies to be included are focus group discussions, direct observations, interviews, case studies and ethnography. We will search EMBASE, PubMed, Scopus, ERIC, PsycInfo, Africa-Wide Information, Academic Search Premier, Business Source Premier, WHOLIS, CINAHL and the Cochrane Library for eligible studies available by 31 October 2013, regardless of publication status or language of publication. We will also check reference lists of included studies and proceedings of relevant conferences and contact researchers for eligible studies. Two authors will independently screen the search output, select studies and extract data, resolving discrepancies by consensus and discussion. Qualitative data will be extracted using standardised data extraction tools adapted from the Critical Appraisal Skills Program (CASP) qualitative appraisal checklist and put together in a thematic analysis where applicable. We will statistically pool data from quantitative studies in a meta-analysis; but if included quantitative studies differ significantly in study settings, design and/or outcome measures, we will present the findings in a narrative synthesis. This protocol has been registered with PROSPERO (ID=CRD42013006364).Recommendations will be made to health policy makers, managers and researchers in LMICs to help inform them on ways to strengthen and increase the uptake of CBHI.

Project description:BackgroundPreventable oral diseases such as dental caries remain common in the United Kingdom. Clustering of poor health is observed within deprived communities, such as inner-city areas, where elevated levels of dental need are associated with lower uptake of dental care. Successful oral health promotion (OHP) initiatives are contingent upon effective community engagement. The aim of this pilot study was to engage with families with young children to explore community views on oral health and dental care and thus tailor OHP initiatives more effectively to their needs.MethodsQualitative research, involving individual interviews and triad focus groups with parents/caregivers, was conducted in a south London inner-city community as part of a 'Well London' programme initiative.ResultsSeventeen parents/caregivers participated in this pilot study. Parents/caregivers described a spectrum of oral health behaviours based on their social history, past dental experiences and cultural influences. All parents described a clear desire to create healthy lives for their children; however, two broad groups were apparent, termed 'Oral Health Prioritisers' and 'Oral Health Non-prioritisers'. The former reported regularly accessing dental care for their children, believing that oral health contributes to systemic health. Non-prioritisers, however, preferentially used key services considered most beneficial to their child's wellbeing. Dental services were considered a low priority for this group, where oral health was synonymous with absence of pain. Participants in both groups favoured OHP initiatives involving a range of health and social care services, with schools at the epicentre of programmes. First-time parents were proposed as an important group requiring support in future OHP initiatives with evidence suggesting that first-born children may have delayed presentation to a dentist.ConclusionsThe findings suggest that this inner-city community may contain sub-groups with contrasting perspectives on oral health and oral health behaviours; nevertheless, there was support for a systems approach to oral health promotion initiatives involving a range of health and social care services, including a critcal role for schools, and actively connecting with first-time parents. The findings provide the basis for further research.

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Oral health status and possible explanatory factors of an inner-city low-income community.

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Oral health status and possible explanatory factors of an inner-city low-income community.

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