Behavioral and Socioeconomic Correlates of Dental Problem Experience and Patterns of Health Care-Seeking

• Published in: The Journal of the American Dental Association (1939) Vol. 142; no. 2; pp. 137 - 149
• Main Authors: Cohen, Leonard A., DDS, MPH, MS, Bonito, Arthur J., PhD, Eicheldinger, Celia, MS, Manski, Richard J., DDS, PhD, MBA, Macek, Mark D., DDS, DrPH, Edwards, Robert R., PhD, Khanna, Niharika, MD
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01.02.2011; American Dental Association
• Subjects: Activities of Daily Living; Adult; Aged; Behavior; behavioral impact; CATI: Computer-assisted telephone interviewing; Cost of Illness; Cross-Sectional Studies; Dental care; Dental Care - statistics & numerical data; dental injuries; Dental Offices; Dental problems; Dentistry; dentists' offices; EDs: Emergency departments; Emergency Service, Hospital; Female; Health Services Accessibility; hospital emergency departments; Humans; Income; Low income groups; Male; Maryland; Middle Aged; Minority & ethnic groups; Minority Groups; Mouth Diseases - classification; Pain Measurement; Patient Acceptance of Health Care; Patient Satisfaction; Physicians' Offices; Poverty; race or ethnicity; Sex Factors; Social Class; Socioeconomic Factors; Tooth Diseases - classification; Young Adult; Maryland; dental injuries; physicians' offices; Dental problems; dentists' offices; CATI: Computer-assisted telephone interviewing; EDs: Emergency departments; hospital emergency departments; behavioral impact; race or ethnicity
• ISSN: 0002-8177; 1943-4723
• DOI: 10.14219/jada.archive.2011.0056

ABSTRACT Background To recognize and better understand barriers to dental care, the authors studied behavioral and socioeconomic factors specific to low-income and minority populations that contribute to patterns of professional health care-seeking. Methods A stratified random sample of 27,002 Maryland households participated in a cross-sectional telephone survey. The authors targeted respondents who were low-income non-Hispanic white, non-Hispanic black or Hispanic who had experienced a dental problem or injury during the previous 12 months, as well as similar people with higher incomes for comparison. A total of 94.8 percent (401 of 423) of eligible people completed the survey. Results Logistic regression modeling (95 percent confidence interval) revealed that the respondents' race or ethnicity and sex were associated with the number of dental problems experienced during the previous 10 years, and that having a regular source of medical care and the type of dental problem experienced were associated with earlier health care-seeking. The first choice of treatment site (physician's office, emergency department or dentist's office) was associated with the respondents' income, pain level, number of problems experienced in the past 10 years and the degree to which their problem was a burden. Conclusions The authors found that predisposing, enabling and need-based factors were associated with dental problem experience and patterns of professional health care service use. Practice Implications Health care providers should recognize barriers to the receipt of dental care sometimes experienced by low-income and minority groups.