SOCIAL DETERMINANTS OF HEALTH
Overview
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Social gradients exist in oral health, which simply means that oral diseases are directly associated with socioeconomic status. Underserved, low-income, disadvantaged, medically compromised and marginalized segments of society are disproportionately affected by oral disease. (1) The influencing and causal factors in oral disease are themselves distributed unequally, thus contributing to oral (and general) health inequalities. As dental care providers, we are educated and trained to treat oral disease at the tooth and person level. We provide preventive services and encourage behavior change to promote good oral health. But broader social issues impact the occurrence of dental disease and the continuing disparities in oral and general health among different groups of people. Increased attention to these issues, through policy, advocacy, and health system change can have a measurable impact on addressing these social determinants and decreasing health disparities.
This section includes selected topics related to social determinants. The Fisher-Owens model is a contemporary, visual organization of the ‘spheres’ of influence on oral health, particularly for pediatric oral disease. But the components that comprise this model are applicable to any dental issue. Models such as this one serve as an organizing framework; researchers build a model, incorporate relevant theory and then test the model through a series of experiments and /or analyses of data measuring some (rarely all) of the model elements. |
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To date, results from Fisher-Owens and other independent researchers have tested and validated certain components of this model, most notably that higher level spheres (family, community) have direct and independent influences on the oral health of children, beyond personal characteristics and behaviors. Awareness of the model components and the supporting scientific evidence helps dental providers care for patients in their social context, mindful of how social circumstances enable or challenge personal behaviors and dental protocol adherence.
Have you ever had a time when you did not know how to best serve a patient from a different background than your own? As the U.S. population becomes more and more diverse, did you know that racial and ethnic minorities are more likely to have worse oral health outcomes? The Office of Minority Health has just released an e-Learning program on cultural competency for oral health professionals available at https://oralhealth.thinkculturalhealth.hhs.gov/. It is well worth your time to take this program. In addition, the resources include the National CLAS (Culturally and Linguistically Appropriate Services) standards which are applicable to all Health Center patient care.
Health literacy has been described as the 6th vital sign. Research indicates that today's health information is presented in ways that are not usable by most adults. "Limited health literacy" occurs when people can't find and use the health information and services they need. Health literacy, including oral health literacy, can be influence the care-seeking and self-management behavior of your dental patients. Both written and spoken health information must be understandable in order for a patient to act upon it. This module presents basic facts about health literacy plus suggestions on how to measure literacy levels in your patient population and help ensure the use of the appropriate materials for your patients. Health literacy is a great topic to consider for inter-professional projects, since it is likely to affect many of the Health Center’s patients, across a variety of health topics.
(1) Watt RG. Social determinants of oral health inequalities: implications for action. Community Dent Oral Epidemiol 2012; 40 (Suppl. 2): 44–48.
Have you ever had a time when you did not know how to best serve a patient from a different background than your own? As the U.S. population becomes more and more diverse, did you know that racial and ethnic minorities are more likely to have worse oral health outcomes? The Office of Minority Health has just released an e-Learning program on cultural competency for oral health professionals available at https://oralhealth.thinkculturalhealth.hhs.gov/. It is well worth your time to take this program. In addition, the resources include the National CLAS (Culturally and Linguistically Appropriate Services) standards which are applicable to all Health Center patient care.
Health literacy has been described as the 6th vital sign. Research indicates that today's health information is presented in ways that are not usable by most adults. "Limited health literacy" occurs when people can't find and use the health information and services they need. Health literacy, including oral health literacy, can be influence the care-seeking and self-management behavior of your dental patients. Both written and spoken health information must be understandable in order for a patient to act upon it. This module presents basic facts about health literacy plus suggestions on how to measure literacy levels in your patient population and help ensure the use of the appropriate materials for your patients. Health literacy is a great topic to consider for inter-professional projects, since it is likely to affect many of the Health Center’s patients, across a variety of health topics.
(1) Watt RG. Social determinants of oral health inequalities: implications for action. Community Dent Oral Epidemiol 2012; 40 (Suppl. 2): 44–48.