Oral Health Disparities Amongst Hispanics as

Compared to the General Population

Britiany Browning, Amy Merino, Obinna Ndugba, Donna Nguyen, Shaun Polissack

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What is a Health Disparity?Dis·par·i·ty/diˈsparitē/

A difference in health outcomes across various groups of the population, often linked to economic, social, or environmental disadvantages.

Health disparities negatively affect certain groups of the population who have experienced greater obstacles to health on the basis of their racial or ethnic group, religion, socioeconomic status, gender, age, mental health, cognitive, sensory, physical disability, sexual orientation or gender identity, geographic location, or other characteristics historically linked to discrimination or exclusion.

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Hispanic Culture A term created by the U.S. federal government in the early 1970s in an

attempt to provide a common denominator to a large, but diverse, population with connection to the Spanish language or culture from a Spanish-speaking country.

Hispanics usually give great importance to and place great value on looks and appearance as a sense of honor, dignity, and pride.

Being late is a socially acceptable behavior.

More than 90% of the Spanish-speaking world is Roman Catholic.

Mid-day and evening meals are important family or social events. .

Their cultures may vary considerably.

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Causes of Oral Health Diseases

Diets of Sugary snacks or beverages

Plaque AccumulationTartarSmoking or Chewing tobaccoIrregular visits to a dentist or

oral health professional

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Effects of Oral Health Diseases

CavitiesGingivitisPeriodontitis (Often

leading to tooth loss)Bad breath/ HalitosisAbscesses and pus build

upNon-Oral issues such as

Preterm Labor or Heart Disease

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Hispanic youths (ages 6-15) receive less dental sealants compared to the general population

Tooth decay is more prevalent amongst Hispanic youth than the general population

Hispanics have lower levels of tooth retention in adults

Disparities in Preventative Care

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Oral Health Disparity within the Hispanic Community

Dental caries is the most common childhood chronic disease. It is 5x more common than asthma.

Hispanics have a higher incidence of dental caries than non-Hispanics.

40.9% Hispanic kindergarten children have been affected by dental caries

49.2% of Hispanics adolescents have been affected by dental caries

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Oral Health Disparity Within the Hispanic Community

Limited access to healthcareLatinos are the highest proportion of uninsured

individuals

PovertyMassachusetts’ children who were poor and those with

MassHealth had poorer oral health.

Language Hispanics report more difficulty with communication

with their physicians than do non-Hispanic whites. 76% of Hispanics speak a language other than English

at home

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Healthcare Coverage & Access to Treatment

MassHealth adult dental benefits were reduced significantly for adults in July 2010. Benefits are limited to preventive and emergency services only.

MassHealth no longer pays for the following adult services:- Restorative- Endodontic- Periodontic- Crowns- Dentures- Surgical procedures related to full or partial dentures

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Falling Through the GapsRates of

Medically Uninsured Individuals by Ethno-Racial Group in 2008 in MA

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Ethnic Demographics by Area Code

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Access to Health ProfessionalsDensely

populated Hispanic communities in Massachusetts tend to have low numbers of practicing dentists.

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Healthcare Coverage & Access to Treatment

Family Health has an unduplicated count of 20782 patients seen last year (2012) with 8072 (39%) Hispanic. 

23% of the total patient population is uninsured.

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Economic Strategies: Water Fluoridation

Fluoridation is the most economic avenue to improve oral health to the general population.

Major populated areas have voted against water fluoridation multiple times

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“Read All About It” – Heated Issue, Not Black or

White“New studies show this to be false, however, and there

is mounting evidence of serious side effects of fluoride ingestion that can result in bone decay, infant mortality, and brain damage.” (Telegram & Gazette)

“The researchers concluded that English-speaking Hispanics were almost as likely to be insured as non-Hispanic whites, after adjusting the data for differences in factors such as age and income.” (Boston Globe)

“It’s really a neglected topic, given that such a large percentage of the national uninsured population is Hispanic, it should be a much higher priority.’’ (Boston Globe)

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Strategies for Federal Government

Support and expand cross-sector activities to enhance quality of life.

Identify and map high-need areas that experience health disparities.

Develop and evaluate community-based interventions.Support policies to reduce exposure to environmental

and occupational hazards.Support and expand training programs that bring new

and diverse workers into the health care.

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Options at Local LevelOptions for State, Tribal, Local, and Territorial Governments

Use data to identify populations at greatest risk and work with communities to implement policies and programs that address highest priority needs.

Improve coordination, collaboration, and opportunities for engaging community leaders and members in prevention.

Options for Health Care Systems, Insurers, and Clinicians

Increase the cultural and communication competence of health care providers.

Train and hire more qualified staff from underrepresented racial and ethnic minorities and people with disabilities.

Options that Individuals and Families can take Participate in community-led prevention efforts. Use community resources (e.g., libraries, literacy programs) to improve

their ability to read, understand, and use health information.

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The Whole PictureResponsibility to mitigate disparities is on a

global level World Health Organization MSF – Doctors Without Borders

Central & Local Government Foreign Policy Healthcare Legislature

Healthcare Providers & Individuals Cultural Education Workshops Communication

Images from Wikipedia

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References Clutter, Ann W., and Ruben D. Nieto. "Ohio State University Fact Sheet." Understanding the

Hispanic Culture, HYG-5237-00. Ohio State University, n.d. Web. 12 June 2013. Pew Hispanic Center. (2008). Demographic profile of Hispanics in Massachusetts, 2008.

http://pewhispanic.org/states/?stateid=MA. Accessed July 10, 2010.

White BA, Monopoli MP, Souza BS. Catalyst Institute The Oral Health of Massachusetts’ Children January, 2008

Telegram & Gazette Boston Globe Anthes, Frances. "Family Health Centers." Contemporary and Cultural Health Issues S.

University of Massachusetts Medical School, Worcester. 4 June 2013. Lecture. Flieger, Signe P., M. S. W, and Michael T. Doonan, Ph.D. Putting the Mouth Back in the Body:

Improving Oral Health Across the Commonwealth. Issue brief no. 36. Boston: Massachusetts Health Policy Forum, 2009. Print.

"National Prevention Strategy: Elimination of Health Disparities." Surgeongeneral.gov. National Prevention Council, 2010. Web. 13 June 2013. <http://www.surgeongeneral.gov/initiatives/prevention/strategy/health-disparities.pdf>.

Massachusetts Department of Public Health, Office of Oral Health. The Status of Oral Disease in Massachusetts: A Great Unmet Need 2009. Boston, Massachusetts Department of Public Health, 2009.

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