Abstract: Culture and Dental Care Service Use Among Karen Refugees from Burma (Society for Social Work and Research 26th Annual Conference - Social Work Science for Racial, Social, and Political Justice)

Schedule:

Friday, January 14, 2022

Independence BR C, ML 4 (Marriott Marquis Washington, DC)

* noted as presenting author

Wooksoo Kim, PhD, Associate Professor, University at Buffalo, State University of New York, Buffalo, NY

Isok Kim, PhD, Associate Professor, University at Buffalo, The State University of New York, Buffalo, NY

Jay Kim, Doctoral Student, University at Buffalo, The State University of New York, Buffalo, NY

Krisztina Baltimore, MSW, Doctoral Student, University at Buffalo, The State University of New York, NY

Li Lin, PhD, Professor, University at Buffalo, The State University of New York, Buffalo, NY

Background and Purpose: Oral health among refugee populations is a critical public health concern that has been under examined. Refugees are more likely to have dental problems and limited access to dental care than the general population (Keboa et al., 2016). Cultural beliefs and behaviors are important factors for oral health, along with insurance, income, and education. For example, among Somali refugees in the U.S., being acculturated was found to be a potential risk factor for oral health (Adams-Hunter, 2018). Using the Andersen-Newman health care service use model, this study aims to explore the correlates of dental care service use among Karen refugees living in Buffalo with a particular interest in culture.

Method: A convenience sample of 201 Karen refugees in Buffalo were recruited. The questionnaire was translated into the Karen language and bilingual (Karen/English) interviewers collected data through face-to-face interviews. The Andersen-Newman model was used to classify diverse variables into three categories: predisposing factors (gender, marital status, age), enabling factors (education, income, social support, years in the U.S., dental care knowledge), and need factors (visits to a primary care physician[PCP], smoking, chewing betel nuts). Logistic regression analysis was used to examine the association between these variables and dental care service use.

Results: The majority of sample were women (63.7%) as well as a higher percentage of married individuals (81.1%). The mean age was 40.6 years. On average, they had received 5 years of formal education and lived in the U.S. for 8.2 years. Twenty-three percent of the participants were smokers and 66.8 percent reporting chewing betel nuts.

Logistic regression analysis revealed that the awareness of the need for dental visit every 6 months (an enabling factor; OR=3.33, p<0.05), visits to a PCP (a need factor; OR=25.02, p< 0.01) were positively associated with dental visits, while chewing betel nuts (a need factor; OR=0.20, p< 0.01) significantly decreased the odds of using the dental care services. None of the predisposing variables were associated with dental visits in terms of statistical significance.

Conclusion and Implication: The results of this study suggested that knowledge of dental care service (i.e., knowing how often they need to visit the dentist) may facilitate the use of dental care service(s). Also, PCP visits appear to be a crucial factor in fostering dental care utilization. Thus, whenever feasible, PCP should mention the importance of dental care during patient visits. Finally, the negative association between betel nuts and dental visits could be interpreted as the need for more education about adverse consequences of betel nut chewing to both oral and overall physical health. Further exploratory studies with the Karen community would help to expand current study results, improve overall oral health, and to improve dental care service use in this community.