Journal of Immigrant and Minority Health

, Volume 16, Issue 5, pp 926–933 | Cite as

Oral Health of Foreign Domestic Workers: Exploring the Social Determinants

  • Xiaoli Gao
  • Chi Wai Chan
  • Siu Lun Mak
  • Zevon Ng
  • Wai Hang Kwong
  • Ching Ching Shirley Kot
Original Paper


Foreign domestic helpers constitute a significant proportion of migrant workers worldwide. This population subgroup provides an opportunity for understanding social determinants of oral health in immigrant community. A random sample of 122 Indonesian domestic helpers in Hong Kong completed a questionnaire on their demographic background, social characteristics (competency in local languages, immigration history, living condition, social connections, and leisure activities) and oral health behaviours (knowledge, attitudes, practice and self-efficacy). Their tooth status and periodontal health were assessed. Participants tended to start flossing after settling in Hong Kong. Favourable oral health knowledge was found in more acculturated participants, as indicated by proficiency in local languages and immigration history. Engagement in social and/or religious activities and decent living condition provided by employers were associated with favourable oral health behaviours and/or better oral health. Social determinants explained 13.2 % of variance in caries severity. Our findings support the significant impact of social circumstances on oral health of domestic workers.


Social determinants Behaviours Oral health Immigrants Foreign workers 



Indonesian Consulate General in Hong Kong, Asosiasi PPTKI Hong Kong Limited (APPIH) and employment agencies have lent their generous support to this project. The authors are grateful to Mr. Cheuk Hin Ho, Miss Ling Yi Rei Kwok, Miss Wai Ting Sze-To, and Mr. Yin Tat Adrian Yu for their helps in this study.


  1. 1.
    International Labour Organization: 100th ILO annual Conference decides to bring an estimated 53 to 100 million domestic workers worldwide under the realm of labour standards. 2011.
  2. 2.
    Andolan Organizing South Asian workers, CASA of Maryland, Domestic Workers’ United, Global Rights, University of North Carolina School of Law Human Right Policy Clinic, Stefani Bonato, McKenna Coll, Eric Tars: Domestic workers’ right in the United States: A report prepared for the U.N. Human Right Committee. 2006.
  3. 3.
    U.S. Department of Health and Human Services: Healthy people 2020. 2010.
  4. 4.
    Van Hulst A, Séguin L, Zunzunegui MV, Vélez MP, Nikiéma B. The influence of poverty and social support on the perceived health of children born to minority migrant mothers. Ethn Health. 2011;16:185–200.PubMedCrossRefGoogle Scholar
  5. 5.
    World Health Organization: Challenges facing health of migrants to be tackled at key meeting. 2010.
  6. 6.
    Gao XL, McGrath C. A review on the oral health impacts of acculturation. J Immigr Minor Health. 2011;13:202–13.PubMedCentralPubMedCrossRefGoogle Scholar
  7. 7.
    Gao XL, McGrath C, Lin HC. Oral health status of rural-urban migrant children in South China. Int J Paediatr Dent. 2011;21:58–67.PubMedCrossRefGoogle Scholar
  8. 8.
    Tuomi K, Ilmarinen J, Eskelinen L, Järvinen E, Toikkanen J, Klockars M. Prevalence and incidence rates of diseases and work ability in different work categories of municipal occupations. Scand J Work Environ Health. 1991;17:67–74.PubMedCrossRefGoogle Scholar
  9. 9.
    Holroyd EA, Molassiotis A, Taylor-Pilliae RE. Filipino domestic workers in Hong Kong: health related behaviors, health locus of control and social support. Women Health. 2001;33:181–205.PubMedCrossRefGoogle Scholar
  10. 10.
    Marmot M. Social determinants of health inequalities. Lancet. 2005;365:1099–104.PubMedCrossRefGoogle Scholar
  11. 11.
    Watts RG. From victim blaming to upstream action: tackling the social determinants of oral health inequalities. Commun Dent Oral Epidemiol. 2007;35:1–11.CrossRefGoogle Scholar
  12. 12.
    Baelum V, Lopez R. Periodontal epidemiology: towards social science or molecular biology? Commun Dent Oral Epidemiol. 2004;32:239–49.CrossRefGoogle Scholar
  13. 13.
    Burt BA. Concepts of risk in dental public health. Commun Dent Oral Epidemiol. 2005;33:240–7.CrossRefGoogle Scholar
  14. 14.
    Holst D, Schuller AA, Aleksejuniené J, Eriksen HM. Caries in populations—a theoretical, causal approach. Eur J Oral Sci. 2001;109:143–8.PubMedCrossRefGoogle Scholar
  15. 15.
    Hong Kong labour department: importation of labour—foreign domestic helpers (FDHs). 2011.
  16. 16.
    Hong Kong immigration department: number of foreign domestic helpers in Hong Kong. 2010.Google Scholar
  17. 17.
    Hong Kong immigration department: employment contract for a domestic helper recruited from outside Hong Kong. 2007.
  18. 18.
    World Health Organization. Oral health surveys: basic methods. 4th ed. Geneva: World Health Organization; 1997.Google Scholar
  19. 19.
    Hong Kong Department of Health: Oral Health Survey 2001. tooth_club/survey_eng.htm. 2003.
  20. 20.
    Indonesian Ministry of Health. Oral Health Status in Indonesia, National Household Health Survey 1995. 1997.Google Scholar
  21. 21.
    Lo ECM, Baram DJ, Cheung MY, Chung CW, Ho SY, Lau CL, et al. Oral health of Filipino domestic helpers in Hong Kong. Community Health Project Report: University of Hong Kong; 2004.Google Scholar
  22. 22.
    Philippines Department of Health. National Monitoring and Evaluation, Dental Survey. 1998.Google Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Xiaoli Gao
    • 1
  • Chi Wai Chan
    • 1
  • Siu Lun Mak
    • 1
  • Zevon Ng
    • 1
  • Wai Hang Kwong
    • 1
  • Ching Ching Shirley Kot
    • 1
  1. 1.Dental Public Health, Faculty of DentistryThe University of Hong Kong, Prince Philip Dental HospitalHong KongChina

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