Social backgrounds, oral behaviors and dental service utilization among Thai older adults: data from the national oral health survey

Building a healthy migrant workforce in Singapore - A cross-sectional study to understand health-seeking behaviours of male migrant workers

Background

The healthcare policies for migrant workers in Singapore had a traditional focus on improving occupational health and preventing workplace injuries. The COVID-19 pandemic led to a rapid paradigm shift in the provision of healthcare for migrant workers, with an urgent focus on improving the accessibility and affordability of primary and preventive health services and strengthening public health surveillance. The purpose of this study is to identify areas for improvement, so that policy makers can improve the implementation effectiveness of healthcare policies for migrant workers. This is achieved by establishing a baseline understanding of (a) the health-seeking behaviours of migrant workers in Singapore, (b) how they consume primary and preventive health services, and (c) systemic gaps in the delivery of services.

Methods

A cross-sectional study was conducted at five migrant worker dormitories and two community spaces in Singapore, between August and November 2022. 1101 male migrant workers participated in a survey and 1089 valid responses were analysed. Multivariable logistic regression was used to identify sociodemographic factors associated with health service utilisation and awareness of the new healthcare financing plan introduced for migrant workers, called the Primary Care Plan (PCP).

Results

The mean age of participants was 34 years. Most of them were of Indian or Bangladeshi nationality. At least 82 % of participants reported that they could access varying health services in Singapore and 73 % were satisfied with the costs of healthcare. However, a lower percentage of the participants (54 %) had seen a doctor, mostly for respiratory, fever or musculoskeletal conditions, and only 7 % saw a dentist at least once in a year. This was attributable to their low perceived need to see a doctor (91 %) or dentist (71 %). While the prevalence of chronic diseases (4 %) was low among the participants, about one-third of participants smoked (26 %), consumed alcohol (32 %), or resorted to self-treatment or medication (39 %).

Conclusion

This study corroborated with previous observational studies where migrant workers in Singapore only sought care during an acute episode of illness. While participants perceived healthcare in Singapore to be accessible and affordable, there was limited evidence to suggest that preventive health care was prioritised. This indicates possible gaps in current outreach programmes and further development of new targeted programmes to increase the health literacy and awareness of primary and preventive health services among migrant workers in Singapore.

Factors affecting oral and dental services` utilization among Elderly: a scoping review

BACKGROUND

Regular use of oral and dental services by the elderly is one of the important factors in reducing oral and dental diseases. This study aimed to identify the factors affecting oral and dental services` utilization among elderly.

METHODS

The published articles on the factors affecting oral and dental services` utilization among elderly were found through a scoping search and using related keywords in PubMed, Scopus, Embase, and Web of Science databases within January 2000 - December 2022 according to the PRISMA guidelines. The data were analyzed using the thematic analysis method.

RESULTS

Among the 2381 articles retrieved from the databases, forty-two were extracted. The factors affecting oral and dental services` utilization among elderly were classified into five main components as follows: access, demographic factors, social factors, health level, and mental factors. The results showed that income, education level, living area, number of teeth, and importance of care were the most frequent in the main components of access, demographic factors, social factors, health level, and mental factors, respectively.

CONCLUSION

Equitable utilization of oral and dental services is the right of all members of the society, especially the elderly. Therefore, it is necessary to provide the elderly with suitable conditions to utilize such services, which are mostly luxury items. Furthermore, increasing the elderly's awareness and encouraging them to use oral and dental services regularly can help reduce the burden of oral and dental diseases.

Inequalities in Periodontal Disease According to Insurance Schemes in Thailand

Few studies have considered the effects of insurance on periodontal disease. We aimed to investigate the association between insurance schemes and periodontal disease among adults, using Thailand's National Oral Health Survey (2017) data. A modified Community Periodontal Index was used to measure periodontal disease. Insurance schemes were categorized into the Universal Coverage Scheme (UCS), Civil Servant Medical Benefit Scheme (CSMBS), Social Security Scheme (SSS), and "others". Poisson regression was applied to estimate the prevalence ratios (PRs) of insurance schemes for periodontal disease, with adjustment for age, gender, residential location, education attainment, and income. The data of 4534 participants (mean age, 39.6 ± 2.9 years; 2194 men, 2340 women) were analyzed. The proportions of participants with gingivitis or periodontitis were 87.6% and 25.9%, respectively. In covariate adjusted models, lowest education (PRs, 1.03; 95% CI, 1.01-1.06) and UCS (PRs, 1.05; 95% CI, 1.02-1.08) yielded significantly higher PRs for gingivitis, whereas lowest education (PRs, 1.20; 95% CI, 1.05-1.37) and UCS (PRs, 1.17; 95% CI, 1.02-1.34) yielded substantially higher PRs for periodontitis. Insurance schemes may be social predictors of periodontal disease. For better oral health, reduced insurance inequalities are required to increase access to regular dental visits and utilization in Thailand.