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Research to Reduce Oral Health Disparities and Inequalities

Center for Clinical Research and the
Behavioral and Social Sciences Research Branch
Division of Extramural Research

Oral health disparities research remains an important focus of the NIDCR, and this initiative strives to continue advancing this field of research. This initiative will support studies that have an overarching goal of significantly reducing the oral health disparities and inequalities that exist in numerous segments of the U.S. population. It is expected that multi-disciplinary teams with the necessary expertise (such as experts in oral health, population and public health sciences, social sciences, behavioral sciences, health communication sciences, health literacy, community engagement, basic sciences, epidemiology, social anthropology, health services and economics, health policy, biostatistics and/or clinical studies design) will be needed to design and conduct successful studies with community partners and other stakeholders. Many types of research including that which targets social determinants of health, explores contextual factors and community processes and systems in order to build appropriate research teams that may include representation from outside of the health sector, health services and policy research, or research on the impact of the Affordable Care Act (ACA) on oral health disparities and inequalities would be supported by this initiative.

The U.S. Surgeon General’s Report: Oral Health in America as well as epidemiologic studies document that numerous segments of the U.S. population experience disproportionate burdens of oral diseases such as dental caries, oral cancer, and periodontal diseases. This initiative will support research that focuses on reducing the disparities related to oral diseases for which there are previously established disparities. Vulnerable populations include African Americans; American Indians; Alaska Natives; Asians, Native Hawaiians and other Pacific Islanders; Hispanics/Latinos and their subpopulations, those living in medically/dentally underserved areas, low income rural or urban dwellers; the elderly, and those with developmental or acquired disabilities. Collaborations between institution(s) and the community(s) with known disparities are a requirement of this initiative.

Considerable progress has been made in the prevention, diagnosis and treatment of oral diseases in some segments of society. Yet much remains to be learned about the segments of the U.S. population that are most vulnerable, including why some are resilient and others are not. It is universally-recognized that the determinants of oral health disparities are numerous, and exist at levels ranging from the individual to the society, and from the biological to the policy level. Research that examines and intervenes upon determinants at multiple levels and uses mixed methods is needed, as well as research that focuses sharply on understanding individual causes of oral disease at a single level.

Health disparities and health inequalities research requires cross-cutting approaches including social science intervention research focused on the social determinants of health; empirical examination of the context and process of how communities are organized and what infrastructure they possess to in turn develop and test ecological, holistic prevention systems; studies that examine health services and health policy; studies that assess alternative preventive and care delivery models that evolve from the Affordable Care Act (ACA); basic research, behavioral research that explores, for instance, in-depth mechanisms of action, or theoretically and empirically driven tailoring; demonstration and/or dissemination/implementation research, and health literacy studies that seek to understand and catalyze the uptake of efficacious disease-preventive approaches by clinical providers, public health agencies, individuals, communities, and decision makers. Not all health disparities intervention research is amenable to randomized clinical trials (RCT). Other designs can provide essential information that informs clinical practice, public health policy, health care provision and community and individual action. Therefore, studies supported through this initiative could employ, for example, cross-sectional, longitudinal, case-control or more traditional RCT designs.

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This page last updated: February 26, 2014