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UBC Theses and Dissertations

Characterizing the oral health of low-income adults in Vancouver's Downtown Eastside Hau, Keith Pak-Hei


Low-income residents from the Vancouver’s Downtown Eastside (DTES) are known to be medically underserved, but little is known about their oral health (OH) status. The objectives of this study are to: 1) determine OH characteristics (clinical and subjective) of low-income adults in this community; 2) identify explanatory factors for their OH status. Material and Methods: Screening clinics were set up in the DTES. Eligibility criteria were adults 19 years of age or over and residence in the DTES for the preceding 3 months. Data were collected through questionnaires and clinical examinations. Results: Among the 356 screened participants, most were males, middle-aged, less educated, and living with low-income (≤$20,000/year). Alcohol and tobacco consumption was common. About 80% had dental coverage, mostly publicly funded benefits (94%). Fifty (14%) participants were edentulous. Dentate participants (n=306), on average, had 3.8 decayed (Dt), 8.6 missing (Mt), 4.9 filled (Ft), 17.2 DMF teeth, and a care index (CI) of 41.5%. Many (86%) perceived a dental need. Although more participants with dental insurance had a dental visit within the past 12 months, there were no differences in OH indices between those with or without dental insurance. After adjusting gender and recruitment site, social (barriers to care & length of DTES residence), behavioural (brush/floss), and personal (HCV/methadone) factors were identifiable explanatory factors for the CI level. Conclusion: DTES low-income have poor oral health status and many perceive a need for dental care. We identified several factors that may affect their levels of dental care; however, this community may inherited more complicated social issues. Further investigations to truly understand their challenges and needs are required for a better oral health promotion in this community.

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