Journal of public health dentistry最新文献

The global history of racial discrimination and oppression influences the racial inequities that are evident today. The protests after the murder of George Floyd raised the public consciousness about systemic racism, which was further amplified by the evident inequities caused by the pandemic, and highlighted the intersection of poverty, social and racial injustices, and health.

Many cities, states, and organizations across the United States have declared that racism is a public health crisis. As dental public health professionals, we have seen decades of scientific evidence showing the degree and persistence of racial inequities in oral health access, outcomes, and workforce diversity. However, evidence in scientific research and public health practice that explores and/or addresses the root causes of these inequities – namely, racism – have been scarce. This special issue aims to elevate the voices of scholars, public health professionals, and organizations that have been doing the work of anti-racism in dental public health in order to inspire and highlight opportunities for further action within our field.

To be clear, the root causes of racial inequities are individual and systemic racism. And to make progress on reducing racial inequities, we as a dental public health community need to be actively engaged in anti-racism work. It is the hope of the authors and editors that after reading the special issue, readers will be inspired to reflect on their work with an eye toward opportunities for anti-racist action, and to gain a deeper commitment to equity. As practitioners and those committed to oral health, we must center anti-racism in our work – to deliver care, train students and residents, improve population-level health, conduct the best scientific research, and advocate and implement effective policies – if we are to live up to the ideals of equity and justice.

Following a call to action by AAPHD [2], this special issue advances  knowledge on anti-racism and oral health, and demonstrates numerous anti-racist approaches in the areas of scientific research, education, practice, and policy. Topics include new scholarship and guidance on anti-racist methodological approaches in research, perspectives and scholarship on anti-racism in dental public health education and workforce, and examples of anti-racist programs and advocacy activities. Many historically underrepresented racial and ethnic minority populations are represented in this special issue, not as populations of study but as scholars, advocates, authors, contributors, and reviewers.

With intention, the special issue was curated to explore, with as many diverse voices as possible and from a holistic perspective, how the discipline can be anti-racist not just in its words but in its works. This issue also highlights the activities of various organizations that are engaging in anti-racist practices, including the American Dental Education Associa

Background: The inequities caused by racism include negative impacts on health and quality of life. A key grant-making strategy of the CareQuest Institute for Oral Health has been the development of a network of stakeholders, the Oral Health Progress and Equity Network (OPEN), which engages and leverages community voices to address racism and the corresponding health inequities across the lifespan.

Methods: OPEN's nearly 3000 members undertake various approaches to acknowledge and address the negative impact of systemic racism on health. OPEN has developed structures and offerings that have advanced a unique culture of equity, which encourages authentic dialogue. OPEN created and facilitated cohorts within the network called Network Response Teams to elevate awareness and develop strategies to address health disparities advocating for specific populations, including LGBTQIA+, Native American, LatinX, People with Disabilities, and rural residents, Medicare, and Medicaid. Network members work toward an equitable oral health system by aligning common goals.

Results: The activities and products of these teams and OPEN developed trusted relationships to combat the impacts of racism and promoted equitable oral health locally and nationally.

Conclusion: Supporting network development is a highly effective tool to combat racism.

Racism is understudied in the oral health literature at the same time that race is overutilized as an explanatory factor in study design. Social and behavioral methodologies offer conceptual models that can be used to include racism in dental public health questions. In addition, interdisciplinary and mixed methods approaches allow for understanding racism as an underlying cause of social and health disparities and exploring solutions that address historical, institutional, social, political, and economic drivers of oral health inequity, while recognizing the limits of measuring racism quantitatively. In a collective acknowledgement of the limitations of conventional methods, there are new opportunities to explore how qualitative and mixed methods research can serve as drivers for both social justice and health equity, while building and sustaining a diverse research workforce that can better close these disparities and offer antiracist solutions to oral health inequities.

American Indian and Alaska Native (AI/AN) communities have experienced a history of systemic racism and still face significant oral health disparities. These disparities extend to the youngest community members in the form of early childhood caries (ECC). Although behavior and biology contribute to ECC, the conditions where people live, grow, and work, and the systems and political and economic forces that shape individual health outcomes, are thought to greatly impact ECC among AI/AN populations. To address ECC in AI/AN communities, we used a community based participatory approach that incorporated social determinants of health. We found that implementing culturally-tailored, culturally-centered, and AI/AN-created materials for ECC interventions is viewed favorably by community members and tribal leaders. Because of the complexity of ECC in AI/AN communities we adopted a bundled approach of best practices to reduce ECC including: (1) incorporating locally, contextually, and culturally relevant strategies to present recommended ECC prevention approaches; (2) employing AI/AN community members as educators; (3) utilizing motivational interviewing with expectant mothers; and (4) providing fluoride varnish. Our work underscores the importance of developing trusting partnerships with each other and with our communities, drawing upon the insights of community advisory board members, and eliciting formative assessment data from tribal members to gain a more holistic understanding of our participants' lived experience to design relevant intervention materials. Incorporating local knowledge and situating Western oral health prevention approaches within culturally aligned frameworks can enhance partnerships and create sustainable materials for community work.