Addressing social determinants of oral health, structural racism and discrimination and intersectionality among immigrant and non-English speaking Hispanics in the United States

Abstract

Background: The Hispanic population is the largest (18.5%) and fastest growing non-majority ethnic group in the United States (US), about half of whom are non-US born, and bears one of the highest oral disease burdens. Most current knowledge around oral health disparities in Hispanic populations examine the individual factors of culture, acculturation, and socioeconomic status. However, the root causes of this inequity; oral health literacy (OHL), social determinants of health (SDOH), structural racism and discrimination (SRD) and the intersectionality among the three, have not been well-studied. Addressing this critical gap will be central to advancing health equity and reducing oral health-related disparities in the Hispanic population, especially among immigrant and non-English speaking Hispanics.

Results: Recommendations for future OHL/SDOH/SRD-related research in oral health targeting Hispanic populations should include: (1) examining the direct and indirect effects of OHL/SDOH/SRD-related factors and intersectionality, (2) assessing the impact of SRD on oral health using zip-code level measures, (3) examining the role of OHL and SDOH as potential effect modifiers on the relationship between SRD and oral health outcomes, (4) conducting secondary data analysis to identify demographic, social and structural-level variables and correlations between and among variables to predict oral health outcomes, and (5) obtaining a deeper understanding of how OHL/SDOH and SRD factors are experienced among Hispanic immigrant and migrant populations.

Conclusion: It is hoped these recommendations will lead to a better understanding of the mechanisms through which OHL, SDOH and SRD impact oral health outcomes among the largest minority population in the US so they can be addressed.

Keywords: Hispanic immigrants; intersectionality; non-English speaking Hispanics; oral health; oral health literacy; social determinants of health; structural racism and discrimination.