Perceived Racial Discrimination, Resilience, and Oral Health Behaviours of Adolescents with Immigrant Backgrounds
Creators: Saluja, Priyanka
Publisher: name: University of Alberta Library
Year: 2024

<p>Background- Canada boasts one of the world&#39;s highest annual immigration rates, with around 500,000 newcomers each year, amounting to nearly 8.3 million immigrants constituting about 23% of the population by 2021. Among these newcomers, adolescents form a considerable part, facing the intricate challenges of adapting to new cultures, social structures, and peer dynamics. Studies on the oral health of immigrant-background adolescents reveal their unmet dental care needs, but there remains a gap in understanding the determinants of their oral health behaviours. To address oral health concerns in this vulnerable group, it is essential to study the risk factors influencing their oral health behaviours and identify the factors aiding immigrants in navigating post-immigration challenges. Thus, this study aimed to explore the interplay between perceived racial discrimination and oral health behaviours in immigrant-background adolescents, while also investigating whether resilience moderates this association. <br>
Methods- The ethics approval for this study was obtained from the University of Alberta Research Ethics Board (Ethics approval # Pro00119608). First, we conducted a systematic review to explore the existing body of literature about the correlation between perceived racial discrimination and oral health. Further to study the association between perceived racial discrimination and oral health behaviours among adolescents with immigrant backgrounds we designed a cross-sectional study. The participants were 12 to 18-year-old immigrant adolescents recruited through nine community organizations working with immigrant populations. After obtaining active parental consent and adolescent assent, participants completed a questionnaire. The questionnaire gathered data on demographic characteristics, six oral health behaviours as dependent variables, and the independent variables (Perceived racial discrimination and resilience) using validated scales. Descriptive statistics were used to summarize the categorical and continuous variables. Univariate and multivariate logistic regression analyses were used to examine the association between the dependent and independent variables, controlling for confounding factors. Additionally, the potential moderating role of resilience was explored by examining the interaction of resilience and the independent variables in the regression analysis. <br>
Results- The systematic review included 21 studies. These Studies were mainly based in the United States (38 %), Australia (28%), and other countries including Canada (14%), Brazil (14%), and Korea (4%). Perceived racial discrimination was assessed by using validated scales in 11 studies, the others assessed discrimination by including one or two items in the questionnaire. The outcomes assessed in these studies were oral health problems, oral health-related quality of life, dental care utilization, oral health behaviors, and self-rated oral health. Overall, a negative association was found between perceived racial discrimination and oral health outcomes.<br><br>
The cross-sectional study included 316 participants with an average age of 15.3 (±1.9) and a median age of 15 years (IQR-12-18). Among the participants, 56% were female, 45% were born in Canada, 62.9% had dental insurance, and 76% reported experiences of discrimination. The statistical analysis showed that, after adjusting for confounding factors, an increase of one unit in the total discrimination distress score was associated with 51% less likelihood of categorizing self-rated oral health as good (OR=0.49, 95% CI: 0.29-0.81). The odds of brushing teeth more than twice a day, as opposed to once a day, decreased by 58% with a one-unit increase in the total discrimination distress score (OR=0.42, 95% CI: 0.25-0.71). The odds of visiting the dentist for an urgent procedure instead of a regular check-up were 2.3 times higher with a one-unit increase in the total discrimination distress score (OR=2.3: 95% CI:1.3-4.0) Resilience did not moderate the association between perceived racial discrimination and oral health behaviours.<br>
Conclusion- This study contributes to the growing literature on the link between perceived racial discrimination and oral health outcomes. The findings reveal a negative association between perceived racial discrimination and oral health behaviours. However, the study did not find supportive evidence for the moderating effect of resilience in this context.</p>