Dental Service Utilization for Foreign and Native-born Children in America

项目摘要 来自移民家庭的儿童构成了最大和增长最快的种族和少数民族人口之一 在美国的团体。然而，移民儿童的口腔健康状况，牙科需求和牙科服务利用率 研究不足，理解不深。很少有关于移民成人和儿童口腔健康的研究是基于 便利性和小样本量或来自单个州的医疗补助数据，都提供了混合的结果。具体 外国出生人口的特征可以解释牙科服务利用的任何差异， 地址不一致是有限的。此外，关于口腔健康差异的现有文献集中在社会经济方面， 这些因素并不包括口腔健康的社会和文化决定因素，如移民身份。中的这一空白 知识特别阻碍制定和实施适当的政策和计划， 为移民儿童带来积极的口腔健康成果。移民口腔健康受个体影响， 移民前后的社区和医疗保健系统因素，但目前还不清楚这些因素是如何影响的 整体口腔健康差异。移民儿童的口腔健康是一个日益增长的牙科公共卫生问题， 如果不治疗，常见口腔疾病的严重后果。本项目的总体目标是解决以下方面的差距： 移民儿童口腔健康相关知识，探讨移民儿童口腔健康特征 造成口腔健康差异。此外，本研究将确定具体特征和保健水平 采取适当干预措施以减少这些差异所需的因素。本研究的具体目的是：（1） 从以下方面确定外国出生儿童使用牙科服务的模式和时间趋势，以及未得到满足的牙科需要： 2002年至2014年;（2）研究移民身份因素，如逗留时间，语言， 家庭和其他个人层面的人口统计学因素解释了牙科访问，利用和未满足的牙科需求的变化， 2002年至2014年，外国出生的儿童与本地出生的儿童相比。该项目将由一个团队进行， 多学科研究人员使用两个具有全国代表性的数据库：2001-2013年国家健康访谈 调查（NHIS）和2002-2014年医疗支出小组调查（MEPS）。将进行描述性统计， 提供牙科服务使用率和未满足牙科需求的估计数。Logistic回归模型 然后将拟合以确定与其他协变量相关的结果变量。结构方程模型（SEM） 用于描述由多个相关变量捕获的潜在现象之间的关系，例如 文化适应该项目的调查结果将用于为制定优先事项和政策提供信息， 移民儿童的口腔健康状况和口腔健康差异。

Project Summary Children from immigrant families constitute one of the largest and fastest growing racial and ethnic minority population groups in the United States. Yet, immigrant children's oral health status, dental needs and dental service utilization are understudied and poorly understood. Few published studies on oral health of immigrant adults and children are based on convenience and small sample sizes or Medicaid data from a single state and all have provided mixed results. The specific characteristics within the foreign-born population that could explain any differential uptake in dental service utilization to address disparity is limited. In addition, existing literature on oral health disparities have focused on socioeconomic factors and do not include social and cultural determinants of oral health such as immigration status. This gap in knowledge specifically hampers the development and implementation of appropriate policies and programs that could achieve positive oral health outcomes for immigrant children. Immigrant oral health is influenced by individual, community and healthcare system factors both before and after immigration, yet it is unclear how these factors contribute to overall oral health disparities. Immigrant children's oral health is a growing dental public health concern due to the significant consequences of common oral diseases if left untreated. The overall goal of this project is to address the gap in knowledge related to immigrant children's oral health and to explore how immigrant children's oral health characteristics contribute to oral health disparities. In addition, this study will identify specific characteristics and health care level factors required for appropriate intervention to reduce these disparities. The specific aims of this study are: (1) to determine the patterns and time trend of dental services utilization and unmet dental needs of foreign-born children from 2002 to 2014; and (2) to examine the extent to which immigrant status factors such as length of stay, language spoken at home and other person-level demographic factors explain variations in dental access, utilization and unmet dental needs of foreign-born children compared to native-born children from 2002 to 2014. This project will be conducted by a team of multidisciplinary researchers using two nationally representative databases: the 2001-2013 National Health Interview Survey (NHIS) and the 2002-2014 Medical Expenditure Panel Survey (MEPS). Descriptive statistics will be conducted to provide estimates of counts and rates of dental services utilization and unmet dental needs. Logistic regression models will then be fit to determine outcome variables associated with other covariates. Structural equation modeling (SEM) will be used to describe the relationship between latent phenomena captured by multiple related variables, such as acculturation. Findings from this project will be used to inform the development of priorities and policies directed at immigrant children's oral health and oral health disparities.