Symposium Explores How to Reduce Inequities in Oral Healthcare
Health practitioners, educators and leaders from across the country gathered at the University of the Pacific Arthur A. Dugoni School of Dentistry for the “Dentistry as Participant and Casualty of Racism and Bias in Medicine: Moving Toward Equity in Oral Health Care” symposium hosted by the Pacific Center for Equity in Oral Health Care. The gathering was among the first events of its kind in dental education to explore the structural disparities in oral healthcare through the intersection of racism, ageism, ableism, sexism/gender bias and other inequities.
“Our goal was to understand the history and consequences of systemic racism and bias in healthcare and engage participants in identifying strategies and steps that could be used in dental practice, research, education and healthcare policy to advance equity for all members of our communities,” notes symposium organizer Elisa M. Chávez, DDS, director of the Pacific Center for Equity in Oral Health Care.
“Unfortunately, many patients experience barriers to receiving medical or dental care based on their race, age, sex, gender, disabilities or socioeconomic status,” Chavez adds. “Poor oral health can also perpetuate bias and discrimination. The historical positioning of dentistry as an elective service made it OK for oral healthcare to be accessible only to those who could afford care. And at the same time, this rhetoric devalued the importance of oral health to overall health and well-being, further limiting resources and opportunities to make oral healthcare accessible to those most in need. Moreover, it stymied research and policy to support optimal oral health as integral to systemic health.”
Speakers highlighted some of the inequities experienced across health care that are ground in racism or bias.
- In a recent research survey of 714 practicing U.S. physicians nationwide, only 40.7% were very confident about their ability to provide the same quality of care to patients with disability; just 56.5% strongly agreed that they welcomed patients with disability into their practices; and 18.1% strongly agreed that the healthcare system often treats these patients unfairly.
- A recent systematic review found that ageism led to significantly worse health outcomes in 95.5% of the studies and 74.0% of the 1159 ageism-health associations examined. The analysis revealed the detrimental impact of ageism on older adults’ health has been occurring simultaneously at the structural and individual level across many continents.
- The racial mix of the dentist workforce does not reflect the U.S. population, with Black and Hispanic dentists significantly underrepresented in the profession, according to recent data from the American Dental Association’s Health Policy Institute (HPI). The HPI also reports that while racial disparities in cost barriers to dental care have narrowed slightly for children, they have widened for adults and seniors.
Following the morning presentations, attendees gathered for an afternoon of roundtable discussions and the formation of a reflection/action plan to close the gaps. Action items from the discussions will be compiled into a follow-up “call to action” report that will be posted on the Pacific Center’s website.