Racial/Ethnic Disparities Among US Children and Adolescents in Use of Dental Care

ORIGINAL RESEARCH — Volume 17 — July 30, 2020

Valerie Robison, DDS, PhD, MPH1; Liang Wei, MS, MPH2; Jason Hsia, PhD3 (View author affiliations)

Suggested citation for this article: Robison V, Wei L, Hsia J. Racial/Ethnic Disparities Among US Children and Adolescents in Use of Dental Care. Prev Chronic Dis 2020;17:190352. DOI: http://dx.doi.org/10.5888/pcd17.190352.

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Summary

What is already known about this topic?

Dental care among children has increased over the past decade, and racial/ethnic disparities have narrowed for some groups.

What is added by this report?

We used crude prevalence estimates of dental care use to calculate absolute disparities and changes in disparities. We used multivariate analysis to determine factors associated with changes in disparities from 2001 through 2016. We included Asians, for whom many disparity studies have not had sufficient data.

What are the implications for public health practice?

Our study adds to the few long-term, controlled studies of dental care use by using a national data set representative of US children and adolescents.

Abstract

Introduction

Dental care among children has increased over the past decade, and racial/ethnic disparities have narrowed for some groups. We measured changes in racial/ethnic disparities in annual dental care for children and adolescents aged 2 to 17 years and conducted multivariate analysis to study factors associated with changes in disparities over time.

Methods

We used Medical Expenditure Panel Survey data to obtain crude prevalence estimates of dental care use and calculated absolute disparities and changes in disparities for 3 racial/ethnic groups of children and adolescents compared with non-Hispanic white children and adolescents relative to fixed points in time (2001 and 2016). We pooled all single years of data into 3 data cycles (2001–2005, 2006–2010, and 2011–2016) and used multivariate regression to assess the relationship between dental care use and race/ethnicity, controlling for the covariates of age, sex, parents’ education, household income, insurance status, and data cycle (time).

Results

Use increased by 18% only in low-income children and adolescents. Low-income Hispanic (adjusted prevalence ratio [aPR] = 0.98; 95% CI, 0.94−1.02) and Asian (aPR = 0.92; 95% CI, 0.83−1.02) participants showed no difference in dental care use relative to non-Hispanic white participants, but non-Hispanic black participants had significantly lower use (aPR = 0.84; 95% CI, 0.81−0.88). Public and private insurance were associated with a doubling of use among low-income children.

Conclusion

We saw a modest increase in dental care use and a narrowing of disparities for some low-income children and adolescents. Use among low-income Hispanic and Asian participants “caught up” with use among Hispanic white participants but remained well below that of children and adolescents in families with middle and high incomes. Disparities persisted for non-Hispanic black participants at all income levels.