Evaluating access to pediatric oral health care in the southeastern states

• Published in: The Journal of the American Dental Association (1939) Vol. 153; no. 4; pp. 330 - 341.e12
• Main Authors: Serban, Nicoleta, Ma, Simin, Pospichel, Katrine, Yang, Lisha
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01.04.2022
• Subjects: Child; community dentistry; decision making; dental public health; Health care access; Health Services Accessibility; Humans; Insurance Coverage; Insurance, Health; Medicaid; Oral Health; pediatric dentistry; Rural Population; Texas; United States; United States; Texas; dental public health; CHIP; RUCC; BOD; FTE; decision making; pediatric dentistry; community dentistry; Health care access; HPI-ADA; NPPES; IKN
• ISSN: 0002-8177; 1943-4723
• DOI: 10.1016/j.adaj.2021.09.005

In this article, the authors addressed shortcomings in existing research on pediatric oral health care access using rigorous data and methods for identifying statistically significant disparities in oral health care access for children. The study population included children, differentiated by insurance status (Medicaid, Children’s Health Insurance Program, private, none). The authors measured provider-level supply as the number of oral health care visits, stratified by provider type and urbanicity-rurality. The authors defined demand as the number of dental visits for children and derived demand and supply mainly from 2019 and 2020 data. Using statistical modeling, the authors evaluated where disparities in travel distance across communities or by insurance status were statistically significant. Although Dental Health Professional Shortage Areas are primarily rural, this study found that the proportions of rural, suburban, and urban communities identified for access interventions ranged from 24% through 66% and from 8% through 86%, respectively. For some states (Florida, Louisiana, Texas), rural and suburban communities showed a need for interventions for all children, whereas in the remaining states, the lack of Medicaid and Children’s Health Insurance Program access mainly contributed to these disparities. Variations in access disparities with respect to insurance status across states or by urbanicity-rurality were extensive, with the rate of communities identified for reducing disparities ranging from 1% through 100%. All states showed a need for access interventions and for reducing disparities due to geographic location or insurance status. The sources of disparities were different across states, suggesting need for different policies and interventions across the 10 states. The study findings support the need for policies toward reducing disparities in oral health care access.