Refraining from seeking dental care among the Sámi in Sweden: a cross-sectional study.

IF 4.5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH International Journal for Equity in Health Pub Date : 2024-10-26 DOI:10.1186/s12939-024-02305-1

Negin Yekkalam, Christina Storm Mienna, Jon Petter Anders Stoor, Miguel San Sebastian

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Abstract

Background: While equity in health care is the core of the Swedish health system, social inequalities in accessing health care, particularly regarding dental care, exist. There is however no information on how the Sámi population is affected. This study aimed to assess the prevalence and risk factors for refraining from seeking dental care among the Sámi in Sweden.

Methods: A Sámi sample was constructed from three pre-existing registers. Among the 9,249 invitations for individuals aged 18-84 years old, 3,779 answered the survey during February-May 2021. We first calculated frequencies and proportions of the independent variables in terms of socio-economic, socio-demographic, and cultural-related factors as well as the outcome, refraining from dental care. Then, we summarized the magnitude of the association between the independent variables and self-reported refrain from dental care with the prevalence difference (PD) using the 95% confidence interval (95% CI) for inferential purposes.

Results: Overall, 17.5% of the participants refrained from seeking dental care despite self-reported need in the last three months, with almost the same proportion between men and women. Among the socio-demographic factors, being in the 30-44 years group (PD = 8.0; 95% CI: 3.59, 12.48), in the 45-64 group (PD = 7.3; 95% CI: 2.96, 11.61) and in the 65-84 group (PD = 5.4; 95% CI: 0.92, 9.78) as well as being divorced/widow-er (PD = 6.7; 95% CI: 2.73, 10.70) and unmarried (PD = 3.1; 95% CI: 0.23, 6.04) were statistically significantly associated with refraining from seeking dental care. Among the socio-economic variables, those in the middle-income quintile (PD = 5.3; 95% CI: 1.28, 9.35), in the poor (PD = 8.1; 95% CI: 3.64, 12.51) and poorest (PD = 8.0 95% CI: 3.48, 12.50) quintiles, and especially those experiencing economic stress once (PD = 9.2; 95% CI: 2.93, 15.48) and several times (PD = 26.5; 95% CI: 19.50, 33.43), were strongly associated with refraining.

Conclusions: Approximately one in six of the Sámi participating in this study refrained from seeking dental care despite self-reported need in the last three months. Those who experienced economic difficulties were the most affected group. To achieve equity in dental health care in Sweden, policies removing economic barriers to access dental health care should be implemented.

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瑞典萨米人拒绝看牙医：一项横断面研究。

背景：虽然医疗保健的公平性是瑞典医疗保健系统的核心，但在获得医疗保健，尤其是牙科保健方面，仍存在社会不平等现象。然而，目前还没有关于萨米人如何受到影响的信息。本研究旨在评估瑞典萨米人不寻求牙科治疗的普遍程度和风险因素：方法：从三份已有的登记册中抽取萨米人样本。2021 年 2 月至 5 月期间，在 9,249 份针对 18-84 岁个人的邀请函中，有 3,779 人回答了调查。我们首先计算了社会经济、社会人口和文化相关因素以及结果（拒绝牙科保健）等自变量的频率和比例。然后，我们总结了自变量与自我报告的不看牙医之间的关联程度，并使用 95% 置信区间 (95% CI) 计算了患病率差异 (PD)，以达到推论目的：总体而言，17.5%的受试者尽管自称在过去三个月中有牙科保健需求，但却没有去看牙医，男性和女性的比例几乎相同。在社会人口因素中，30-44 岁组（PD = 8.0; 95% CI: 3.59, 12.48）、45-64 岁组（PD = 7.3; 95% CI: 2.96, 11.61）和 65-84 岁组（PD = 5.4; 95% CI: 0.92，9.78）以及离婚/丧偶（PD = 6.7；95% CI：2.73，10.70）和未婚（PD = 3.1；95% CI：0.23，6.04）与不寻求牙科保健在统计学上有显著关联。在社会经济变量中，中等收入五分位数（PD = 5.3；95% CI：1.28，9.35）、贫困五分位数（PD = 8.1；95% CI：3.64，12.51）和最贫困五分位数（PD = 8.0 95%CI：3.48，12.50）五分位数，尤其是经历过一次（PD = 9.2；95% CI：2.93，15.48）和多次（PD = 26.5；95% CI：19.50，33.43）经济压力的人，与不吸烟密切相关：参与这项研究的萨米人中，约有六分之一的人尽管自称在过去三个月中有牙科保健需求，但仍拒绝就医。经济困难的萨米人是受影响最大的群体。为了在瑞典实现牙科保健的公平性，应实施消除获得牙科保健的经济障碍的政策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal for Equity in Health Medicine-Health Policy

CiteScore

7.80

自引率

4.20%

发文量

162

审稿时长

28 weeks

期刊介绍： International Journal for Equity in Health is an Open Access, peer-reviewed, online journal presenting evidence relevant to the search for, and attainment of, equity in health across and within countries. International Journal for Equity in Health aims to improve the understanding of issues that influence the health of populations. This includes the discussion of political, policy-related, economic, social and health services-related influences, particularly with regard to systematic differences in distributions of one or more aspects of health in population groups defined demographically, geographically, or socially.