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
Source: American Community Survey collected Jan 2006-Dec 2008 from United States
Life Tables by Hispanic Origin
Socioeconomic Status Indicators
Source: “United States Life Tables by Hispanic Origin” from the CDC
Socioeconomic Status Indicators
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 Indicators
Children Ages 2-11
19.5
27.6
33.1
61.4
56.6
44.6
Source: “Trends in Oral Health Status: United States, 1988-1994 and 1999-2004” by
Dye BA, et al.
Oral Health Indicators
Children Ages 12-19
16.2
25.7
28.6
41.9
45.6
35.5
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
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!