“Oral health disparities: Racial, language and nativity effects”

This NHANES-based study offers a compelling case for viewing oral health not merely as an outcome of individual behavior, but as a socially patterned phenomenon shaped by structural forces. By examining oral health disparities through race, language, and nativity, the study aligns with anthropological perspectives that emphasize health as a product of broader social stratification systems.

The data show that Non-Hispanic Blacks and Spanish-speaking Hispanics report significantly worse oral health outcomes than Non-Hispanic Whites and English-speaking Hispanics, across three key indicators: self-rated oral health, dentist visit frequency, and number of missing teeth. These disparities are not random. They are the result of intersecting factors, education, income, immigration status, and citizenship, revealing how oral health is stratified along lines of race, class, and language.

Language emerges as a critical marker of social exclusion. Spanish-speaking Hispanics, many of whom are non-citizens and foreign-born, face compounded disadvantages. They are less likely to visit the dentist, more likely to rate their oral health as poor, and more likely to have missing teeth. From an anthropological standpoint, this speaks to how language proficiency operates as both a cultural and structural barrier. Language shapes access to care, ability to navigate bureaucratic systems, and perceptions of legitimacy within institutional settings. This aligns with theories of symbolic violence, where exclusion is enacted through institutionalized norms that privilege English-speaking, U.S.-born populations.

The study also challenges the homogeneity often assumed within racial and ethnic categories. By distinguishing between English- and Spanish-speaking Hispanics, the author moves beyond monolithic representations and instead acknowledges the internal diversity within ethnic groups. This approach is anthropologically significant, as it reflects the discipline’s insistence on specificity and the rejection of essentialist identity categories.

Moreover, the findings complicate assumptions about nativity and acculturation. Foreign-born Non-Hispanic Blacks and English-speaking Hispanics, for example, reported better oral health outcomes than their U.S.-born counterparts. This may reflect selective migration patterns or what scholars call the “healthy immigrant effect.” However, over time, the protective advantages of nativity often erode under the weight of systemic barriers. The paper hints at this through the example of Spanish-speaking Hispanics, whose foreign-born status intersects with low SES and limited English proficiency to produce some of the worst outcomes in the dataset.

The study’s conclusion, that structural determinants like education, income, and citizenship status exert different levels of influence depending on racial and linguistic group, reinforces the anthropological view that health disparities are not merely additive, but interactive. The effects of a high school diploma or stable income are not universally protective; their value is mediated by one's racialized and linguistic position in society. This finding challenges assumptions of universalism in public health interventions and supports calls for culturally and structurally responsive policy.

Ultimately, this article provides empirical backing for anthropological claims that health is socially embedded. It demonstrates how oral health outcomes reflect lived experiences of marginalization, shaped by policy decisions, institutional access, and broader sociopolitical hierarchies. Oral health, often overlooked in public discourse, becomes in this study a site where inequality is both embodied and reproduced. Through an anthropological lens, the study offers not just statistical data, but a portrait of how society values, neglects, and divides bodies, often along lines as seemingly mundane, yet deeply telling, as the condition of one's teeth.

https://www.sciencedirect.com/science/article/pii/S235282731930059X