Racial and ethnic minorities often face difficulties in finding access to oral healthcare in the United States, compared to non-Hispanic whites. Yet of these different demographics, there is very little research on Asian immigrants and the various subgroups that fall into that category. And with the Asian population being the second-fastest growing group in the country, there is a call for more comprehensive research on what inhibits their dental care.
Using data from the National Health Interview Surveys, a pair of researchers—Bei Wu, PhD, of the New York University Rory Meyers College of Nursing and Huabin Luo, PhD, assistant professor of the Department of Public Health at East Carolina University—have assessed dental service utilization across different Asian immigrant groups and examined the relationship between acculturation and dental service utilization among them in the United States.
“Untreated oral health problems can cause pain, difficulty eating, and speech problems, affecting self-esteem and quality of life,” said Wu. “It is imperative to examine dental care use within Asian groups.”
The researchers studied both predisposing and enabling characteristics affecting dental service utilization such as age, sex, marital status, and education combined with family income and dental insurance coverage. Next, they used these characteristics and whether these adults had a dental visit in the previous 12 months as the basis for their data.
The first acculturation variable, the length of stay in the United States, had the strongest association with having a dental visit in the previous 12 months among Asian immigrants. This finding remained significant even after controlling for family income level and dental care insurance status, further suggesting its important impact.
“We hypothesize that this could be because longer stays in the United States allow for immigrants to gain improved familiarity with the healthcare system, increased health literacy, and social support networks,” said Luo.
The second acculturation variable, English language proficiency, also was significantly related to dental visits. However, it became insignificant after controlling for family income and dental insurance. While language barriers often are seen as one of the most important factors, the researchers said, this highlights the larger impact of length of stay over English language proficiency, with important implications.
Overall, the study found that Asian immigrants, with the exception of Filipinos, had significantly lower use of dental services. Despite cultural differences and different attitudes toward dental care within Asian subgroups, enabling factors like affordability, familiarity with the healthcare system, and oral health status had important effects on dental services utilization. The most prominent factor affecting utilization proved to be dental insurance coverage.
Healthcare professionals need to pay more attention to providing oral health education among newer immigrants, the researchers said, and translation services may be necessary. There also is an apparent need for more dental care promotion among these groups, especially in the beginning stages of their arrival.
“Length of stay in the United States is a significant factor affecting dental service utilization among Asian immigrants. Variation in dental service utilization exists across adult Asian immigrant groups,” said Wu. “As Asian immigrant populations continue to grow in the United States, it is important to increase oral health awareness, promote dental care, and provide affordable dental coverage for them, especially new immigrants,” said Wu.
The study’s limitations include self-report bias; its examination of only Chinese, Filipino, and American Indian Asian groups; and a lack of distinction between reported dental visits for treatment of a problem versus preventive care, the researchers noted. They also cited the need for more research to gain a comprehensive understanding of these disparities and for further education among healthcare professionals on how best to combat the problem.
The study, “Acculturation and Dental Service Use Among Asian Immigrants in the U.S.,” was published by the American Journal of Preventive Medicine.
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