Oral Health Inequities among CALD and Non-CALD Older Australians: A Decomposition Analysis

Background: Among Australia’s older population, the burden of oral disease is disproportionality borne by culturally and linguistically diverse (CALD) communities. This study aims to examine changes in untreated decay surfaces (DS) between 2004–2006 and 2017–2018 among older CALD and non-CALD Australians. Methods: Data were sourced Australian national oral health surveys conducted in 2004–2006 and 2017–2018. An Oaxaca–Blinder decomposition analysis was used to assess the contribution of socio-demographics and dental behaviours. Results: A total of 246 CALD and 2853 non-CALD dentate participants aged 60+ years took part in 2004–2006, and 363 and 4278 in 2017–2018, respectively. There were increases in mean DS for both CALD (0.74 to 1.42) and non-CALD (0.72 to 1.50) groups between 2004–2006 and 2017–2018. The decomposition model showed that, for CALD participants in 2004–2006 with untreated DS, 40% of the contribution was from not having dental insurance; nearly three-quarters of the contribution was from last dental visit being over one year ago (72.9%) in 2017–2018. Among non-CALD participants in 2017–2018 with untreated DS, 42.5% of the contribution was from the last dental visit being over one year ago. Conclusions: Our findings suggest that social determinants, including increased access to dental insurance, could mitigate the oral health inequities observed.