FHS professor wins award for outstanding research in health equity

by Sharon Mah

Congratulations go out to FHS Associate Professor João Luiz Bastos and his colleagues who won the 2024 Judith Albino Award for Outstanding Research in Health Equity for their paper, “The Relations between Systems of Oppression and Oral Care Access in the United States.”

The award – issued by The International Association for Dental, Oral, and Craniofacial Research – recognizes excellence in investigations that explore new manifestations or concepts related to inequities in oral health.

The paper – published in the Journal of Dental Research – relates the findings from an intersectional study conducted by Bastos and his co-authors that investigated the association between oral care access and state-level measures of structural racism, income inequality, and structural sexism in the US.

“Previous studies analyzing access to oral health services have tended to focus on individual socio-economic indicators rather than intersecting systems of oppression,” says Bastos. “We know from prior research that intersecting inequities stemming from racism, sexism and classism can result in Black populations experiencing whole tooth loss at a greater rate than White populations, with non-Hispanic Black men especially being impacted. There is little data available on the impact of structural forms of oppression on access to health, however, so we wanted to address this gap.”

Utilizing data from over 300,000 respondents, the paper reveals that individuals residing in U.S. states with both high levels of structural sexism and income inequality were 30 per cent more likely not to have seen a dentist in the previous year. This association was not observed in U.S. states with extended provision of oral health care through Medicaid, a nationwide health insurance program for people with low income or limited resources administered through a partnership between state and federal governments.

The study argues that, in addition to individual characteristics, broader social processes at the state level play a crucial role in determining access to oral health care. U.S. states, as important institutional actors, likely influence the accessibility of oral health services; states with more democratic and egalitarian policies are associated with a higher likelihood of the population accessing oral health services.

“Our article is an attempt to establish connections between oral health and the very conditions in which people live and work, the core concept of the social determinants of health framework,” concludes Bastos and colleagues. “The broader we can be at counteracting [racism, classism, and sexism]—by implementing an inclusive and comprehensive health care system, for example—the greater the likelihood that we will succeed at effectively promoting oral health equity in sustainable ways.”

Bastos and his team were recognized in a virtual award ceremony held on March 7,2024.