Oral Health Disparities: How do Latino Children Fare? Clemencia M. Vargas, DDS, PhD. University of...
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Transcript of Oral Health Disparities: How do Latino Children Fare? Clemencia M. Vargas, DDS, PhD. University of...
Oral Health Disparities:How do Latino Children Fare?
Clemencia M. Vargas, DDS, PhD.University of Maryland Dental School
March 19, 2011
Disparities
Definition:
“Health differences which are unnecessary and avoidable but, in addition, are also considered unfair and unjust”.
Disparities
Social determinants of health:
Social conditions people are born, live, and work
Individual choices are important, but are influenced by social conditions.
(David Satcher PHR 2010)
Disparities
Health disparities put socially disadvantaged groups at further disadvantage regarding their health
Latinos in the US
Hispanics in the US by origin
Population in millions
Percentage
Hispanic 45.4 100.0
Mexican 29.3 64.5
Central American 3.6 7.9
South American 2.5 5.6
Puerto Rican 4.1 9.1
Dominican 1.2 2.8
Cuban 1.6 3.5
Other Hispanic 2.6 6
Source: American Community Survey collected Jan 2006-Dec 2008 from United States Life Tables by Hispanic Origin
Socioeconomic Status Indicators
Hispanic Non-H White
Non-H Black
Bachelor's Degreeor more(%)
12.6 30.4 17.2
Poverty (%) 18.9 6.1 17.2
Family Income (in US dollars) $43,240 $70,399 $41,567
Infant Mortality Rate(per 1000)
5.4 5.6 13.4
Source: “United States Life Tables by Hispanic Origin” from the CDC
Socioeconomic Status Indicators
Mexican Puerto Rican Cuban Central
Am.South Am.
Own home
55.0 44.7 68.4 44.5 56.2
BachelorDegree +
9.1 15.5 28.1 11.7 31.9
Children in poverty
29.8 34.1 14.0 24.0 13.7
Unempl. 7.9 9.7 5.5 7.1 6.9
Source: “The Hispanic Population in the United States: 2008 Detailed Tables” from the U.S. Census Bureau
Oral health
Oral health:Sources of Disparities
Structural issue– Dental care “system”– Financing dental care– Inadequate federal and state programs– Limited dental public health infrastructure
Source: Vargas & Arevalo, Dental Clinics of North America 2009
Oral health:Sources of disparities
Workforce– Shortage (5,000 pediatric dentists v. 47,000 pediatricians)
– Maldistribution– Limited scope of practice – Racial/ethnic homogeneity– Training deficiencies
Source: Vargas & Arevalo, Dental Clinics of North America 2009
Oral health:Sources of disparities
Population issues – » dentists, patients and community
– Social determinants– Oral health literacy !!!!!– Plain literacy– Cultural competency– Behavioral
Source: Vargas & Arevalo, Dental Clinics of North America 2009
Oral health literacy is …
Degree of capacity to
obtain,
process, and
understand
basic health information
services needed
to make decisions
Source: Healthy People 2010
Oral health literacy is …
Affected by:– Low English Proficiency (LEP)– Low educational attainment– Literacy and numeracy skills– Context
Still a new field … very limited information about Latinos with LEP
Oral Health Disparities
Monitoring Disparities: Data!
As long as there are disparities, data are necessary to:
– Plan, develop, and monitor programs– Track differences over time
Also to identify new disparities
Oral Health IndicatorsChildren Ages 2-11
GroupIndicators
NH white%
NH black%
Mexican American
%
Untreated 19.5 27.6 33.1
Caries free 61.4 56.6 44.6
Sealants (8 yr old) 37.6 22.6 19.4
Source: “Trends in Oral Health Status: United States, 1988-1994 and 1999-2004” by Dye BA, et al.
Oral Health IndicatorsChildren Ages 12-19
GroupIndicators
NH white%
NH black%
Mexican American
%
Untreated 16.2 25.7 28.6
Caries free 41.9 45.6 35.5
Sealants 43.9 25.7 27.2
Source: “Trends in Oral Health Status: United States, 1988-1994 and 1999-2004” by Dye BA, et al.
Oral Health Care
GroupDental visits
NH white%
NH black%
Mexican American
%Ages 2-11 Never 1 yr or less
22.867.3
21.964.7
28.256.5
Ages 12-19 Never 1 yr or less
1.078.7
3.365.3
10.654.8
Source: “Trends in Oral Health Status: United States, 1988-1994 and 1999-2004” by Dye BA, et al.
Conclusions
Compared to other groups, Latino children have:– Lower SES– More oral health problems– Less oral health care
Thank you!