https://www.dental.theclinics.com/article/S0011-8532(13)00012-8/pdf

Sex/Gender Differences in Tooth Loss and Edentulism: Historical Perspectives, Biological Factors, and Sociologic Reasons

Introduction People from vulnerable groups have higher levels of untreated dental disease compared to the general population, yet often experience barriers to accessing care. Difficulties accessing oral healthcare services have been suggested as one of the pathways that contribute to oral health inequalities.Aim To conduct a rapid review of current literature related to barriers to oral healthcare for people from vulnerable groups.Methods Electronic searching u sing MEDLINE via Ovid, covering articles from 2007 to 2017, and limited to the English language. Publication types included primary and secondary evidence from peer-reviewed journals and reports.Results From a total of 536 records, 308 full-text articles were included in the final review. Barriers were summarised at the individual, organisational and policy levels. Common barriers across all vulnerable groups included lack of affordability, difficulties accessing care, lack of availability of appropriate care, and lack of public funding for specialised services. In addition, specific barriers were identified for certain groups. Potential solutions included the provision of training and information to patients and carers about oral health and accessing dental services, training dental professionals in caring for vulnerable groups, and better use of skill mix and guidance to ensure publicly-funded dental services are commissioned to meet the needs of vulnerable groups.Conclusion This rapid review identified barriers to dental care for vulnerable groups at individual, organisational and policy levels to inform policymakers and commissioners.

A rapid review of barriers to oral healthcare for vulnerable people.

Dental insurance and income are positively associated with regular dental visiting. Higher income earners face fewer financial barriers to dental care, while dental insurance provides partial reimbursement. The aim was to explore whether household income has an effect on the relationship between insurance and visiting. A random sample of adults aged 30–61 years living in Australia was drawn from the Electoral Roll. Data were collected by mailed survey in 2009–10, including age, sex, dental insurance status and household income. Responses were collected from n = 1,096 persons (response rate = 39.1%). Dental insurance was positively associated with regular visiting (adjusted prevalence ratio (PR) = 1.18; 95% CI: 1.01-1.36). Individuals in the lowest income tertile had a lower prevalence of regular visiting than those in the highest income group (PR = 0.78; 95% CI: 0.65-0.93). Visiting for a check-up was less prevalent among lower income earners (PR = 0.65; 95% CI: 0.50-0.83). Significant interaction terms indicated that the associations between insurance and visiting varied across income tertiles showing that income modified the effect. Household income modified the relationships between insurance and regular visiting and visiting for a check-up, with dental insurance having a greater impact on visiting among lower income groups.

/pdf/household-income-modifies-the-association-of-insurance-and-5cbenqzw1i.pdf

Household income modifies the association of insurance and dental visiting.

Background: Environmental health (EH) professionals, one of the largest segments of the public health workforce, are responsible for delivery of essential environmental public health services. The ...

Environmental Health Practice Challenges and Research Needs for U.S. Health Departments

Background

The aim of this study was to explore whether oral health has an influence on the association between dental insurance and dental visiting.



Methods

A random sample of adults aged 30–61 years living in Australia was drawn from the Australian Electoral Roll. Data were collected by mailed survey in 2009–2010, including age, gender, household income, dental insurance status, dental visiting and oral health impact.



Results

Responses were collected from n = 1096 persons (response rate = 39.1%). Dental insurance was positively associated with visiting a dentist in the last 12 months (prevalence ratio (PR) = 1.48; 95% CI: 1.31–1.67), while oral health impact was not associated with recent visiting PR = 1.01; 95% CI: 0.89–1.14). Visiting for the purpose of pain relief was less prevalent among insured participants (PR = 0.60; 95% CI: 0.44–0.81), but more prevalent among those with poor oral health (PR = 2.85; 95% CI: 2.15–3.76). It was found that oral health impact did not alter the relationship between dental insurance and visiting.



Conclusions

Oral health impacts were not associated with recent dental visits, but were associated with visits for pain relief. Dental insurance was associated with a greater likelihood of recent visits and lower levels of relief of pain visits.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/adj.12082

Dental visiting by insurance and oral health impact.

Recent research suggests that the resurgence of bed bugs in the U.S. has occurred at an alarming rate. Assumptions have been made that socioeconomic status is not associated with the prevalence of bed bug infestations. Little information is available at the local level, however, about the prevalence of bed bugs in private homes. The authors' pilot study aimed to identify prevalence, knowledge, and concern about bed bugs in one higher income village in Ohio utilizing survey methodology. Responses from 96 individuals who completed the Prevalence, Knowledge, and Concern About Bed Bugs survey were utilized for analysis. The majority of the sample respondents were white and 95% reported that they owned their residence. Only 6% knew someone with bed bugs. Additionally, 52% reported they were somewhat concerned about bed bugs. About 46% reported that they had changed their behavior. For a higher income area, the prevalence was dissimilar to the rate reported in the general public (about 20%). This suggests that bed bugs may be an environmental issue effecting low-income populations disproportionately. Further research is needed in areas of differing socioeconomic levels.

/pdf/prevalence-knowledge-and-concern-about-bed-bugs-37cklgb8x6.pdf

Prevalence, Knowledge, and Concern About Bed Bugs.

For women of childbearing age, oral health not only affects their physical and psychological well-being but also that of their children. This study used the 2003-2004 Ohio Family Health Survey (N = 9,819) to examine dental need and utilization by women in Ohio. Predisposing, enabling, and need variables were examined as they effect dental health service utilization by women of childbearing age at different socioeconomic status (SES) levels. The proportion of women in the low SES group self reporting a dental need (18%) was 3 times that of the proportion of women in the higher SES group with a self reported need (6%). Results of bivariate analysis showed that having a dental visit in the past year varied significantly by SES, race, insurance status, provider density, and need. A racial disparity in dental service utilization was noted in the bivariate analysis of the middle SES group. While dental need and type of dental coverage varied by SES, both were significantly associated with utilization of dental services within all 3 SES categories in the logistic regressions. These results suggest that measures need to be implemented to meet the goal of increasing access and utilization of dental health services by low-income populations.

Dental services utilization by women of childbearing age by socioeconomic status

Objectives: Oral health has a significant effect on health, and for women, poor oral health can lead to poor birth outcomes and can affect their child's health. Nursing interventions to improve the oral health of at-risk women have the potential to increase maternal and child systemic and oral health. The identification of women at a high risk for poor oral health is a necessary to develop and evaluate these interventions.



Design and Sample: This study examined the factors related to dental insurance and dental service use for women of childbearing age in the United States. A secondary analysis of the 2003–2004 National Health and Nutrition Examination Survey was completed to examine the predisposing, enabling, and need variables associated with dental insurance status and dental service use in a representative random sample of 1,071 women.



Results: The results showed that over 40% of women had no dental insurance. Women with less education, lower income, and dental need were significantly less likely to have dental insurance. Dental utilization by the uninsured was low and a racial/ethnic disparity was noted.



Conclusion: A lack of dental insurance and dental service utilization is a significant concern. Nurses working with low-income women should educate the population about oral health and advocate for policies to increase dental insurance coverage.

Dental insurance and dental service use by U.S. women of childbearing age

The purpose of this study was to replicate and expand on Persky, Nelson, Watson, and Bent (2008) study of characteristics related to nurses who were effective in Watson's Caritas framework. Previous research suggests that poorer work environments are associated with higher levels of caring. This surprising finding warrants further investigation. Registered nurses were recruited from a mid-sized community-based hospital in the Midwest portion of the United States of America (N = 20). Each completed the health environment survey (HES). Ten patients that had received primary care from the nurse completed the caring factors survey (CFS). Two hundred nurse/patient dyads were used to determine the relationship between the CFS and HES. Six of the 13 HES scales were positively associated with CFS scores. As nurses' positive perceptions of the work environment increased, patients' perceptions of caring increased. Our findings contrast Persky et al.'s. Further research is needed examining factors influencing the relationship between job environment and patient perceptions of caring.

Caritas and job environment: a replication of Persky et al.

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Prevalence, Knowledge, and Concern About Bed Bugs.

Dental services utilization by women of childbearing age by socioeconomic status

Dental insurance and dental service use by U.S. women of childbearing age

Caritas and job environment: a replication of Persky et al.