Refraining from seeking dental care among the Sámi in Sweden: a cross-sectional study

• Published in: International journal for equity in health 2024-10, Vol.23 (1), p.222-8, Article 222
• Main Authors: Yekkalam, Negin, Mienna, Christina Storm, Stoor, Jon Petter Anders, Sebastian, Miguel San
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Analysis; Cross-Sectional Studies; Demographic aspects; Dental Care - statistics & numerical data; Economic aspects; Female; Health aspects; Health behavior; Health care disparities; Health Services Accessibility - statistics & numerical data; Humans; Indigenous; Male; Middle Aged; Oral health; Patient Acceptance of Health Care - statistics & numerical data; Public opinion; Refraining from dental care; Social aspects; Socially handicapped; Socioeconomic Factors; Surveys and Questionnaires; Sweden; Sámi; Sápmi; Young Adult
• ISSN: 1475-9276; 1475-9276
• DOI: 10.1186/s12939-024-02305-1

While equity in health care is the core of the Swedish health system, social inequalities in accessing health care, particularly regarding dental care, exist. There is however no information on how the Sámi population is affected. This study aimed to assess the prevalence and risk factors for refraining from seeking dental care among the Sámi in Sweden. A Sámi sample was constructed from three pre-existing registers. Among the 9,249 invitations for individuals aged 18-84 years old, 3,779 answered the survey during February-May 2021. We first calculated frequencies and proportions of the independent variables in terms of socio-economic, socio-demographic, and cultural-related factors as well as the outcome, refraining from dental care. Then, we summarized the magnitude of the association between the independent variables and self-reported refrain from dental care with the prevalence difference (PD) using the 95% confidence interval (95% CI) for inferential purposes. Overall, 17.5% of the participants refrained from seeking dental care despite self-reported need in the last three months, with almost the same proportion between men and women. Among the socio-demographic factors, being in the 30-44 years group (PD = 8.0; 95% CI: 3.59, 12.48), in the 45-64 group (PD = 7.3; 95% CI: 2.96, 11.61) and in the 65-84 group (PD = 5.4; 95% CI: 0.92, 9.78) as well as being divorced/widow-er (PD = 6.7; 95% CI: 2.73, 10.70) and unmarried (PD = 3.1; 95% CI: 0.23, 6.04) were statistically significantly associated with refraining from seeking dental care. Among the socio-economic variables, those in the middle-income quintile (PD = 5.3; 95% CI: 1.28, 9.35), in the poor (PD = 8.1; 95% CI: 3.64, 12.51) and poorest (PD = 8.0 95% CI: 3.48, 12.50) quintiles, and especially those experiencing economic stress once (PD = 9.2; 95% CI: 2.93, 15.48) and several times (PD = 26.5; 95% CI: 19.50, 33.43), were strongly associated with refraining. Approximately one in six of the Sámi participating in this study refrained from seeking dental care despite self-reported need in the last three months. Those who experienced economic difficulties were the most affected group. To achieve equity in dental health care in Sweden, policies removing economic barriers to access dental health care should be implemented.