Aboriginal Health Worker perceptions of oral health: a qualitative study in Perth, Western Australia

International Journal for Equity in Health

Linda Slack-Smith²  Barry Gibson¹  Dan McAullay²  Angela Durey² 

[1] School of Clinical Dentistry, University of Sheffield, 31 Claremont Crescent,, Sheffield S10 2TA, UK;School of Dentistry, University of Western Australia, 35 Stirling Highway, Perth 6009, WA, Australia

关键词: Racism;    Inequity;    Oral health;    Aboriginal;    Australia;   

Others  :  1235416
DOI  :  10.1186/s12939-016-0299-7

 received in 2015-07-17, accepted in 2016-01-07,  发布年份 2016

【 摘 要 】

Background

Improving oral health for Aboriginal Australians has been slow. Despite dental disease being largely preventable, Aboriginal Australians have worse periodontal disease, more decayed teeth and untreated dental caries than other Australians. Reasons for this are complex and risk factors include broader social and historic determinants such as marginalisation and discrimination that impact on Aboriginal people making optimum choices about oral health. This paper presents findings from a qualitative study conducted in the Perth metropolitan area investigating Aboriginal Health Workers’ (AHWs) perceptions of barriers and enablers to oral health for Aboriginal people.

Methods

Following extensive consultation with Aboriginal stakeholders, researchers conducted semi-structured interviews and focus groups across 13 sites to investigate AHWs’ perceptions of barriers and enablers to oral health based on professional and personal experience. Responses from 35 AHWs were analysed independently by two researchers to identify themes that they compared, discussed, revised and organised under key themes. These were summarised and interrogated for similarities and differences with evidence in the literature.

Results

Key findings indicated that broader structural and social factors informed oral health choices. Perceptions of barriers included cost of services and healthy diets on limited budgets, attending services for pain not prevention, insufficient education about oral health and preventing disease, public dental services not meeting demand, and blame and discrimination from some health providers. Suggested improvements included oral health education, delivering flexible services respectful of Aboriginal people, oral health services for 0–4 year olds and role modelling of oral health across generations.

Conclusion

Reviewing current models of oral health education and service delivery is needed to reduce oral health disparities between Aboriginal and non-Aboriginal Australians. Shifting the discourse from blaming Aboriginal people for their poor oral health to addressing structural factors impacting on optimum oral health choices is important. This includes Aboriginal and non-Aboriginal stakeholders working together to develop and implement policies and practices that are respectful, well-resourced and improve oral health outcomes.

【 授权许可】

   
2016 Durey et al.

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