Access to Dental Care and Health Disparities: The Digital Divide and Other Divides in Dental X-Rays and Treatment

Abstract

The United States Department of Health and Human Services describes oral disease and tooth decay as a silent epidemic plaguing the poor. Poor oral health is negatively associated with several other physical health measures and even mental wellbeing. Current literature clearly establishes disparities in oral health between black and white Americans and between classes. Typically, this stream of literature uses health behavioral models to explain relationships between social characteristics and oral health outcomes, which often confound personal choice and the influence of structure on behavioral decisions. In this manuscript, the author attempts a different approach by focusing on the supply of healthcare care services to a heterogeneous population. Specifically, variations in the allocation of dental services by race and class are examined using two data sources: a survey collected in Metro Nashville Davidson County during the summer of 2012 and the Medical Expenditure Panel Survey (MEPS). Some differences in service delivery between patients could potentially exacerbate the oral health gap between advantaged and disadvantaged members of society. Based on Pearson correlations and logistic regressions, the effects of race and class vary dramatically by the type of services received in dental office settings. Mixed results indicate that the ways in which race and class affect service delivery are complex, thus more nuanced research is necessary. Moreover, some results in this study suggest that differences in technology and equipment may be one relatively unexplored area useful for understanding the maintenance of health disparities.