A FOCUS ON THE ORAL HEALTH OF THE AFRICAN CHILD IMMIGRANT IN CANADA

ABSTRACT Background: The healthy immigrant effect (HIE) is a phenomenon where immigrants often arrive in a new country with better health compared to their native-born counterparts. However, this advantage tends to decline over time. While the HIE has been extensively studied, most research has not focused on immigration and oral health as critical health indicators. There is a clear connection between an individual's oral health and overall health. A person's general health outcomes can often be inferred from their oral health status. Therefore, it is essential to gain a better understanding of how African immigrant parents in Saskatchewan influence their children's oral health practices, mitigate oral health risks, and access oral health care services. Objectives and Methodology: The researcher collaborated with two African communities in Saskatchewan (SK) to explore African immigrant parents' experience and understanding of oral health and to highlight their experiences in accessing oral healthcare for their children in SK. The Conceptual Framework for Child Flourishing in Canada (CFCFC) which served as the theoretical foundation for this study was adapted to better reflect the cultural and social realities of African Child Immigrants (ACIs) in Canada. By integrating cultural considerations at all levels, and access and equity to the world around the child and the world at large, the revised framework offers a culturally relevant and socially responsive tool for addressing oral and overall health within this population. Individual interviews were held with ten African immigrant parents with children over three years old. A qualitative exploratory research design and a community-based participatory research approach informed the design of interview guides, the purposive sampling approach, recruitment, and analysis. Data was analyzed using an inductive thematic approach with the CFCFC guiding the analysis, the discussion, and grounding the study. Findings: Five themes emerged from the data. The themes included oral health practices of African immigrant families in Saskatchewan, parental perspectives on the oral health needs of ACIs, parental experiences in accessing oral health care for their children, the influence of migration on oral health, and strengths and suggestions from parents. While there were some (non-)preventive cultural nuances in the oral care practices of certain families, overall, socio-economic factors, parental knowledge, and experiences significantly influenced the oral health of ACIs. Conclusion: This study highlighted the perspectives of African immigrant parents in Saskatchewan regarding their children’s oral healthcare. Generally, as supported by literature, the oral health of immigrant families, particularly children, declines as their stay in the host country progresses, but this small study suggests otherwise. Several families had adopted good oral health practices upon getting to Saskatchewan. The study findings highlight the need for further exploration of the HIE on the oral health of ACIs and support the need to prioritize oral health promotion of ACIs through parental and community engagement. A key finding was the low use of dental services due to a lack of perceived oral health needs, indicating a need for oral health literacy and for oral health and non-oral health professionals to reach out to these communities to encourage regular visits. Additionally, the cost of dental care impeded access for immigrant families. High out-of-pocket expenses frequently resulted in delayed or foregone treatment and rendered routine care unaffordable. This situation contributes to existing oral health disparities, highlighting the need for more affordable dental services and improved navigation of public benefits, such as the Canadian Dental Care Plan, which most immigrant parents were unaware. The participants perceived the plan as potentially beneficial when they were enlightened about it, they required more education on how to utilize this package to foster positive oral health outcomes among the ACIs. The research also emphasized the importance of oral health promotion, including parental education and awareness. While oral health insurance and improved access to dental services are important, alone, they are not enough. This research supports a comprehensive approach and is needed to enhance children’s oral health, focusing on parental education and awareness through strategies like school-based initiatives and religious outreaches to influence and inform parents on best oral health practices approved by the Canadian Dental Association to foster better oral hygiene and health habits.