Inequity in oral health care for elderly canadians: part 1. Oral health status (original) (raw)
Related papers
Oral health care in Canada--a view from the trenches
Journal, 2006
PURPOSE Concern is increasing over the effect of lack of access to oral health care on the oral health, and hence general health, of disadvantaged groups. In preparation for a national symposium on this issue, key informants across Canada were canvassed for their perceptions of oral health services and their recommendations for improving oral health care delivery. This paper reports the results of that survey. METHOD A questionnaire was constructed to address problems facing agencies with responsibility for meeting the oral health care needs of people receiving government assistance, the underhoused and the working poor. The survey was sent to 200 agencies, government and professional organizations. Data from the returned questionnaires were entered into a Statistical Package for the Social Sciences database and analyzed. Responses from Ontario were compared with those from the rest of Canada, those from government organizations were compared with others and results were examined by...
2015
Objectives: The objectives of this study were to determine the rate of use of dental services by independently living older dentate and edentulous adults and the factors affecting utilization. Methods: Data were derived from the cross-sectional Manitoba Study of Health and Aging. A personal interview included over 240 questions addressing sociodemographics, well-being, oral and general health, and health service utilization. Results: The sample included 1,751 participants with a mean age of 76.2 years (standard deviation 7.1); 58.5 % were women and 72.7 % were edentulous. Only 383 participants (21.9%) reported having visited a dentist in the past 6 months. The visitation rate for dentate seniors was significantly higher than that for edentulous seniors (36.2 % vs. 13.5%, p < 0.001). Multiple logistic regression analysis revealed significant independent effects of 5 variables for each group. Predisposing factors predicting visitation for both groups were higher level of education ...
Dental service utilization by independently dwelling older adults in Manitoba, Canada
Journal (Canadian Dental Association), 2008
The objectives of this study were to determine the rate of use of dental services by independently living older dentate and edentulous adults and the factors affecting utilization. Data were derived from the cross-sectional Manitoba Study of Health and Aging. A personal interview included over 240 questions addressing sociodemographics, well-being, oral and general health, and health service utilization. Variables that were significantly associated with visitation on bivariate analysis were entered into separate logistic regressions for dentate and edentulous participants. The Anderson model of health service utilization was used to categorize variables with significant independent effects as predisposing, enabling and need factors. The 1,751 participants had a mean age of 76.2 years (standard deviation 7.1); 58.5% were women and 72.7% were edentulous. Only 383 participants (21.9%) reported having visited a dentist in the past 6 months. The visitation rate for dentate seniors (36.2%...
Canadian Opinions on Publicly Financed Dental Care
Canadian Journal of Public Health, 2007
Background: Inequalities in oral health and care are long recognized in Canada, with public health environments increasingly focusing on issues of equity and access to care. How does Canada publicly insure for diseases that are largely preventable, minimally experienced by the majority, but that still cause tremendous suffering among the socially marginalized? We consider this dynamic by asking Canadians their opinions on publicly financed dental care. Methods: Data were collected from 1,006 Canadian adults through a telephone interview survey using random digit dialling and computer-assisted telephone interview technology. Simple descriptive and bivariate analyses were undertaken to assess relationships among variables, with logistic regression odds ratios calculated for significant relations. Results: Canadians support the idea of universal coverage for dental care, also recognizing the need for care to specific groups. Generally preferring to access public care through the private sector, Canadians support the idea of opting out, and expect those who access such care to financially contribute at point of service. Conclusion: Support for publicly financed dental care is indicative of a general support for a basic right to health care. Within the limits of economy, the distribution of oral disease, and Canadian values on health, the challenge remains to define what we think is equitable within this sector of the health care system. This question is ultimately unanswerable through any survey or statistical means, and must, to become relevant, be openly promoted and debated in the social arena, engaging Canadians and their sense of individual and social responsibility. MeSH terms: Dental care delivery; public opinion; access to health care; policy La traduction du résumé se trouve à la fin de l'article.
Dental treatment needs in the Canadian population: analysis of a nationwide cross-sectional survey
BMC Oral Health, 2012
Background: Nationally representative clinical data on the oral health needs of Canadians has not been available since the 1970s. The purpose of this study was to determine the normative treatment needs of a nationally representative sample of Canadians and describe how these needs were distributed. Methods: A secondary analysis of data collected through the Canadian Health Measures Survey (CHMS) was undertaken. Sampling and bootstrap weights were applied to make the data nationally representative. Descriptive frequencies were used to examine the sample characteristics and to examine the treatment type(s) needed by the population. Bivariate logistic regressions were used to see if any characteristics were predictive of having an unmet dental treatment need, and of having specific treatment needs. Lastly, multivariate logistic regression was used to identify the strongest predictors of having an unmet dental treatment need. Results: Most of the population had no treatment needs and of the 34.2% who did, most needed restorative (20.4%) and preventive (13.7%) care. The strongest predictors of need were having poor oral health, reporting a self-perceived need for treatment and visiting the dentist infrequently. Conclusions: It is estimated that roughly 12 million Canadians have at least one unmet dental treatment need. Policymakers now have information by which to assess if programs match the dental treatment needs of Canadians and of particular subgroups experiencing excess risk.
Oral healthcare for older people: 'I can't afford not to go to the dentist, but can I afford it?
The New Zealand medical journal, 2008
The purpose of this study was to examine challenges older people encounter in maintaining satisfactory oral health status. This interpretive qualitative study involved 19 in-depth interviews with participants aged 65 to 87 years. Data were examined using a three-level analytic process. NVivo Qualitative Software assisted data management. Participants in this study didn't 'just go' to the dentist. Much effort went into solving the dilemmas and tensions of maintaining their oral health through a process of option balancing. Balancing personal and financial costs, they continually assessed their 'bottom line'. They negotiated issues of: dental cost versus service quality; basic treatment versus functionality and social appearance; future living costs versus current dental costs; and 'how long will it need to last' versus 'how long will I live'? Problems exist in the provision of affordable oral health care for the older population in Aotearoa New Zea...
Visits to physicians for oral health-related complaints in Ontario, Canada
Can J Public Health, 2015
OBJECTIVE: Canada's national system of health insurance facilitates equitable access to health care; however, since dental care is generally privately financed and delivered, access to oral health care remains uneven and inequitable. To avoid the upfront costs, many argue that socially marginalized groups should seek oral health care from medical providers. This study therefore explored the rates and numbers of visits to physicians for oral health-related diagnoses in Ontario, Canada's most populated province. METHODS: A retrospective secondary data analysis of health system utilization in Ontario was conducted for visits to physicians for oral health-related diagnoses. Data for all Ontario Health Insurance Plan (OHIP) approved billing claims were accessed over 11 fiscal years (2001-2011). Age-and sex-adjusted rates were calculated. RESULTS: Approximately 208,375 visits per year, with an average of 1,298/100,000 persons, were made to physicians for oral health-related diagnoses. Women, irrespective of the year, made more visits, and there was an increasing trend in visits made by elderly people. CONCLUSION: The number of people visiting physicians for oral health reasons is arguably high. The public health system is being billed for services for oral health issues that the provider is not appropriately trained to treat. Provision of timely and accessible oral health care for socially marginalized populations needs to be prioritized in health care policy.
Strengthening the approach to oral health policy and practice in Canada
Paediatrics & Child Health
Evidence suggests that Canadian children from marginalized populations experience higher rates of oral diseases than their more fortunate counterparts. Oral health care in Canada is a nearly exclusively privatized and siloed system. In order to close the gap in child oral health, a combination of cohesive strategies and accessible providers is essential. The Health Impact Pyramid is a paradigm to guide health policy and programming with ready application to oral health care in Canada for the delivery of evidence-based oral health interventions with high impact. A collaborative approach among primary care providers (oral health and nonoral health), educators and the public sector, and the utilization of oral health service providers to their full scope of practice is needed to access priority populations and to deliver the most impactful interventions. Strengthening the approach to oral health care in Canada is necessary to reduce the inequities in oral health and, in turn, overall c...