Title : Examining social determinants of oral health for immigrant communities
Abstract:
Backgroud: Oral health disparities are particularly pronounced among immigrant populations and low-income families, highlighting the need for a comprehensive understanding of the social determinants of oral health. Despite changes over time, the issue remains severe. This study is grounded in intersectionality theory and the capability approach, emphasizing the need to address systemic barriers that hinder equitable access to care.
Methods: Using the capability approach, the study aimed to identify strategies to enhance the agency of ethnic communities in Pittsburgh. Semi-structured interviews were conducted with 20 participants, including 14 immigrants (IMs), 5 dentists (DTs), and 6 caseworkers (CWs) from a refugee resettlement center. Thematic analysis performed on the transcripts, focusing on 1) Social Determinants of Oral Health(SDOH) 2) the meaning of oral health 3) essential services for maintaining a good oral health.
Results: Accessibility challenges, such as limited interpretation services and transportation, were common among IMs, while CWs emphasized the need for greater cultural competency in healthcare delivery. CWs also noted that beyond individual or societal factors, there is a gap in how immigrant clients perceive oral health as a critical component of overall health. This gap complicated efforts to encourage preventive dental care, even after cases are closed. DTs, on the other hand, highlighted systemic issues, such as long waitlists and low reimbursement rates. They also pointed to the high cost of dental education, which has created a disconnect between their public health training and the financial pressures caused by student loans. Regarding the second and third research questions, DTs and CWs shared a similar understanding of the significance of oral health and the services required, linking oral health to overall systemic health. In contrast, most of IMs responded that oral health was not an essential part of health and oral health was limited to the mouth and gums.
Conclusion: The study underscores the urgent need for targeted interventions that address social determinants of oral health, such as fostering culturally friendly clinic environments. It also highlights the role of social workers in empowering immigrants to understand and prioritize oral health. By promoting collaboration between healthcare providers and community organizations, we can develop strategies that enhance cultural competency and improve access to dental services for immigrant and low-income populations. Ultimately, this research contributes to the broader discussion on health equity, emphasizing the importance of addressing social determinants in shaping oral health outcomes and advocating for comprehensive, culturally
