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Alzaghoul A, Rahimpoor-Marnani P, Yunis K, Alamgir A, Alghalyini B, Tamim H. Characteristics of Self-Rated Oral Health among Syrian Refugee Parents in Ontario. Int J Dent 2023; 2023:4136520. [PMID: 38047273 PMCID: PMC10691882 DOI: 10.1155/2023/4136520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/16/2023] [Accepted: 10/24/2023] [Indexed: 12/05/2023] Open
Abstract
Background Canada has been hosting Syrian refugees since early 2015. Almost half of the Syrian refugee population lives in Ontario, with dental health being at the top of the list of important immediate needs. The objective of the study was to evaluate self-rated oral health and its associated factors among Syrian refugee parents residing in Ontario. Methods This was a cross-sectional study where 540 Syrian refugee parents, residing in Ontario and with at least one child less than 18 years of age, were interviewed. Information about self-rated oral health was collected based on the question "In general, how would you rate the health of your teeth and mouth?" with answers ranging from 1 representing "excellent" and 5 representing "very poor." Multiple linear regression analysis was performed to assess the independent relationship between each of the sociodemographic-, migration-, health-, dental-related factors, and self-rated oral health. Results The overall prevalence of poor and very poor self-rated oral health was 43.5%. The results showed that the presence of dental health insurance, private sponsorship, improved physical and mental health, and regular visits to the dentist were factors related to improved oral health. Discussion. To achieve better oral health outcomes among refugee populations, including Syrian refugees, efforts should be focused on improving dental care and dental insurance for vulnerable populations.
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Affiliation(s)
- Aseel Alzaghoul
- Division of Social and Transcultural Psychiatry, McGill University, Montreal, PQ, Canada H3A 1A2
| | | | - Khalid Yunis
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
| | - Akm Alamgir
- Access Alliance Multicultural Health and Community Services, 340 College Street, Suite 500, Toronto, ON, Canada M5T 3A9
| | - Baraa Alghalyini
- Family Medicine, Alfaisal University, Riyadh 50927, Saudi Arabia
| | - Hala Tamim
- School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, ON, Canada M3J 1P3
- College of Medicine, Alfaisal University, Riyadh 50927, Saudi Arabia
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Nicolau B, Eslamiamirabadi N, Dudubo O, Hong QN, Bedos C, Macdonald ME. How to use mixed methods in oral health research. Community Dent Oral Epidemiol 2023; 51:71-74. [PMID: 36749665 DOI: 10.1111/cdoe.12801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 09/05/2022] [Accepted: 10/10/2022] [Indexed: 02/08/2023]
Abstract
Wicked problems exist in the realm of oral health research. Due to their inherent complexity, using qualitative or quantitative methods alone may not be adequate for resolving them. Mixed methods approaches combine qualitative and quantitative methods, and thus, can provide a powerful tool for understanding and solving complex problems in dental public health. However, using mixed methods does not come without its challenges. This commentary outlines four main tips for researchers to consider when applying mixed methods to their research projects.
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Affiliation(s)
- Belinda Nicolau
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - Negin Eslamiamirabadi
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - Olawale Dudubo
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - Quan Nha Hong
- Department of Family Medicine, Faculty of Medicine, McGill University, Montreal, Canada
| | - Christophe Bedos
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - Mary Ellen Macdonald
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
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Macdonald ME, Muirhead V, Doughty J, Freeman R. Critically engaging vulnerability: Rethinking oral health with vulnerabilized populations. Community Dent Oral Epidemiol 2022; 50:469-475. [PMID: 34751455 DOI: 10.1111/cdoe.12703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 07/08/2021] [Accepted: 10/08/2021] [Indexed: 01/27/2023]
Abstract
This paper is the third in a series of narrative reviews challenging core concepts in oral health research and practice. Our series started with a framework for Inclusion Oral Health. Our second review explored one component of this framework, looking at how intersectionality adds important complexity to oral public health. This current manuscript drills into a second component of Inclusion Oral Health, exploring how labels can lead to 'othering' thereby misrepresenting populations and (re)producing harms. Specifically, we address a common oral public health label: vulnerable populations. This term is commonly used descriptively: an adjective (vulnerable) is used to modify a noun (population). What this descriptor conceals is the 'how,' 'why,' and 'therefore' that leads to and from vulnerability: How and why is a population made vulnerable; to what are they vulnerable; what makes them 'at risk,' and to what are they 'at risk'? In concealing these questions, we argue our conventional approach unwittingly does harm. Vulnerability is a term that implies a population has inherent characteristics that make them vulnerable; further, it casts populations as discrete, homogenous entities, thereby misrepresenting the complexities that people live. In so doing, this label can eclipse the strengths, agency and power of individuals and populations to care for themselves and each other. Regarding oral public health, the convention of vulnerability averts our research gaze away from social processes that produce vulnerability to instead focus on the downstream product, the vulnerable population. This paper theorizes vulnerability for oral public health, critically engaging its production and reproduction. Drawing from critical public health literature and disability studies, we advance a critique of vulnerability to make explicit hidden assumptions and their harmful outcomes. We propose solutions for research and practice, including co-engagement and co-production with peoples who have been vulnerabilized. In so doing, this paper moves forward the potential for oral public health to advance research and practice that engages complexity in our work with vulnerabilized populations.
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Affiliation(s)
- Mary Ellen Macdonald
- Faculty of Dentistry, and Institute of Health Sciences Education, McGill University, Montreal, Quebec, Canada
| | - Vanessa Muirhead
- Centre for Dental Public Health and Primary Care, Institute of Dentistry, Barts and The London, School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Janine Doughty
- Pathway Homelessness and Inclusion Oral Health Fellow, University College London Hospitals NHS Foundation Trust, London, UK
| | - Ruth Freeman
- Dental Health Services Research Unit, School of Dentistry, University of Dundee, Dundee, UK
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Jozaghi E, Vandu, Maynard R, Khoshnoudian Y, Brondani MA. Access to oral care is a human rights issue: a community action report from the Downtown Eastside of Vancouver, Canada. Harm Reduct J 2022; 19:42. [PMID: 35501857 PMCID: PMC9059447 DOI: 10.1186/s12954-022-00626-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 04/20/2022] [Indexed: 12/03/2022] Open
Abstract
To offer a critical reflection on an impoverished neighborhood in Vancouver, Canada, and their access to oral health care. A review of how a lack of publicly funded oral health care affects the most vulnerable, uninsured, and underserved citizens is performed. Personal and professional accounts on how entrepreneurial innovations of not-for-profit organizations can help to close the gap in access to oral health care are offered using the Vancouver Area Network of drug users (VANDU) and the PHS Community Services Society as case studies in British Columbia. Despite the efforts put forward by not-for-profit organizations such as the VANDU and the PHS Community Services Society, a national oral health care plan is warranted though still not a political imperative. Underserved citizens have a right to oral health care that is compassionate, collaborative, accessible, and affordable.
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Affiliation(s)
- Ehsan Jozaghi
- Faculty of Dentistry, 116/2199 Wesbrook Mall, University of British Columbia, Vancouver, BC, V6T 1Z3, Canada.
| | - Vandu
- Vancouver Area Network of Drug Users (VANDU), 380 East Hastings St, Vancouver, BC, V6A 1P4, Canada
| | - Russ Maynard
- PHS Community Services Society, 9 E Hastings St, Vancouver, BC, V6A 1M9, Canada
| | - Yasaman Khoshnoudian
- Faculty of Dentistry, 116/2199 Wesbrook Mall, University of British Columbia, Vancouver, BC, V6T 1Z3, Canada
| | - Mario A Brondani
- Faculty of Dentistry, 116/2199 Wesbrook Mall, University of British Columbia, Vancouver, BC, V6T 1Z3, Canada
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Nurelhuda NM, Keboa MT, Lawrence HP, Nicolau B, Macdonald ME. Advancing Our Understanding of Dental Care Pathways of Refugees and Asylum Seekers in Canada: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168874. [PMID: 34444623 PMCID: PMC8395044 DOI: 10.3390/ijerph18168874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/13/2021] [Accepted: 08/19/2021] [Indexed: 12/02/2022]
Abstract
The burden of oral diseases and need for dental care are high among refugees and asylum seekers (humanitarian migrants). Canada’s Interim Federal Health Program (IFHP) provides humanitarian migrants with limited dental services; however, this program has seen several fluctuations over the past decade. An earlier study on the experiences of humanitarian migrants in Quebec, Canada, developed the dental care pathways of humanitarian migrants model, which describes the care-seeking processes that humanitarian migrants follow; further, this study documented shortfalls in IFHP coverage. The current qualitative study tests the pathway model in another Canadian province. We purposefully recruited 27 humanitarian migrants from 13 countries in four global regions, between April and December 2019, in two Ontario cities (Toronto and Ottawa). Four focus group discussions were facilitated in English, Arabic, Spanish, and Dari. Analysis revealed barriers to care similar to the Quebec study: Waiting time, financial, and language barriers. Further, participants were unsatisfied with the IFHP’s benefits package. Our data produced two new pathways for the model: transnational dental care and self-medication. In conclusion, the dental care needs of humanitarian migrants are not currently being met in Canada, forcing participants to resort to alternative pathways outside the conventional dental care system.
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Affiliation(s)
- Nazik M. Nurelhuda
- Faculty of Dentistry, University of Toronto, 124 Edward St, Toronto, ON M5G 1G6, Canada; (N.M.N.); (H.P.L.)
| | - Mark T. Keboa
- Faculty of Dentistry, 500-2001 McGill College, McGill University, Montréal, QC H3A 1G1, Canada; (M.T.K.); (B.N.)
| | - Herenia P. Lawrence
- Faculty of Dentistry, University of Toronto, 124 Edward St, Toronto, ON M5G 1G6, Canada; (N.M.N.); (H.P.L.)
| | - Belinda Nicolau
- Faculty of Dentistry, 500-2001 McGill College, McGill University, Montréal, QC H3A 1G1, Canada; (M.T.K.); (B.N.)
| | - Mary Ellen Macdonald
- Faculty of Dentistry, 500-2001 McGill College, McGill University, Montréal, QC H3A 1G1, Canada; (M.T.K.); (B.N.)
- Correspondence:
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Freiberg A, Wienke A, Bauer L, Niedermaier A, Führer A. Dental Care for Asylum-Seekers in Germany: A Retrospective Hospital-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082672. [PMID: 32295091 PMCID: PMC7215588 DOI: 10.3390/ijerph17082672] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 04/08/2020] [Accepted: 04/10/2020] [Indexed: 12/16/2022]
Abstract
Background: The growing immigration to Germany led to more patients whose medical needs are divergent from those of the domestic population. In the field of dental health care there is a debate about how well the German health system is able to meet the resulting challenges. Data on asylum-seekers' dental health is scarce. This work is intended to reduce this data gap. Methods: We conducted this retrospective observational study in Halle (Saale), Germany. We included all persons who were registered with the social welfare office (SWO) in 2015 and received dental treatments. From the medical records, we derived information such as complaints, diagnoses, and treatments. Results: Out of 4107 asylum-seekers, the SWO received a bill for 568 people. On average, there were 1.44 treatment cases (95%-CI: 1.34-1.55) and 2.53 contacts with the dentist per patient (95%-CI: 2.33-2.74). Among those, the majority went to the dentist because of localized (43.2%, 95%-CI: 38.7-47.7) and non-localized pain (32.0%, 95%-CI: 27.8-36.2). The most widespread diagnosis was caries (n = 469, 98.7%, 95%-CI: 97.7-99.7). Conclusion: The utilization of dental care is lower among asylum-seekers than among regularly insured patients. We assume that the low prevalence rates in our data indicate existing access barriers to the German health care system.
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