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美国黑人女性感知到的种族主义与自评口腔健康状况下降有关。

Perceived racism associated with declines in self-rated oral health among U.S. Black women.

机构信息

Slone Epidemiology Center at Boston University, Boston, MA; Department of Epidemiology, Boston University School of Public Health, Boston, MA.

Department of Epidemiology, Boston University School of Public Health, Boston, MA; Department of Health Policy and Health Services Research, Boston University Goldman School of Dental Medicine, Boston, MA.

出版信息

Ann Epidemiol. 2023 Aug;84:54-59. doi: 10.1016/j.annepidem.2023.05.012. Epub 2023 May 25.

Abstract

PURPOSE

Racial disparities in oral health are well-documented. Stress has been associated with both perceived racism and oral health, yet little research has directly investigated the association between perceived racism and oral health.

METHODS

We used data from the Black Women's Health Study, a longitudinal cohort study that includes a geographically diverse sample of Black women across the United States. Perceived exposure to racism was assessed via two scales, one assessing lifetime exposure and one everyday exposure. Self-rated oral health was subsequently assessed over multiple time points. We used Cox proportional hazard models to calculate adjusted incidence rate ratios estimating the association between higher levels of perceived racism and incident "fair" or "poor" oral health, and explored potential effect measure modification using stratified models.

RESULTS

The adjusted incidence rate ratios (n = 27,008) relating perceived racism to incident fair or poor oral health were 1.50 (95% confidence interval 1.35, 1.66) comparing the highest quartile of everyday racism to the lowest and 1.45 (95% confidence interval 1.31, 1.61) for the highest score of lifetime racism compared to the lowest. We did not see evidence of effect modification.

CONCLUSIONS

Higher levels of perceived racism documented in 2009 were associated with declines in self-rated oral health from 2011 to 2019.

摘要

目的

种族间的口腔健康差异有充分的记录。压力与感知到的种族主义和口腔健康都有关联,但很少有研究直接调查感知到的种族主义与口腔健康之间的关系。

方法

我们使用了来自黑人女性健康研究(Black Women's Health Study)的数据,这是一项纵向队列研究,包括来自美国各地的具有地理多样性的黑人女性样本。通过两个量表评估感知到的种族主义暴露程度,一个评估终身暴露程度,另一个评估日常暴露程度。随后,通过多个时间点评估自我报告的口腔健康状况。我们使用 Cox 比例风险模型计算调整后的发病率比值,以估计较高水平的感知种族主义与“一般”或“较差”口腔健康的发生率之间的关联,并通过分层模型探索潜在的效应修正。

结果

与感知到的种族主义相关的“一般”或“较差”口腔健康发生率的调整后发病率比值(n=27,008)为 1.50(95%置信区间 1.35, 1.66),将日常种族主义的最高四分位数与最低四分位数进行比较,以及将终生种族主义的最高得分与最低得分进行比较,得到的调整后发病率比值为 1.45(95%置信区间 1.31, 1.61)。我们没有发现效应修正的证据。

结论

2009 年记录的较高水平的感知种族主义与 2011 年至 2019 年自我报告的口腔健康状况下降有关。

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