Liu Jihong, Probst Janice C, Martin Amy B, Wang Jong-Yi, Salinas Carlos F
Arnold School of Public Health, University of South Carolina, Columbia, South Carolina 29208, USA.
Pediatrics. 2007 Feb;119 Suppl 1:S12-21. doi: 10.1542/peds.2006-2089D.
We sought to understand disparities in dental insurance coverage and dental care among US children by race/ethnicity, urban/rural residence, and socioeconomic status.
Linked data from the National Survey of Children's Health and Area Resource File were analyzed (N = 89 071). Multiple logistic regression analysis was used to adjust for confounders.
A total of 22.1% of US children lacked parentally reported dental insurance coverage in the preceding year, 26.9% did not have a routine preventive dental visit, and 5.1% had parentally perceived unmet need for preventive dental care. US-born minority children were less likely to lack dental insurance than US-born white children; however, foreign-born Hispanic children were more likely to be uninsured. Rural children were more likely to be uninsured than urban children. Children with health insurance were more likely to have dental coverage. Children who lacked dental insurance were less likely to have received preventive care and more likely to have unmet need for care. Compared with US-born white children, all minority children were less likely to receive preventive care. These disparities were exacerbated among foreign-born children. Fewer race-based disparities were found for unmet need for dental care. Only black children, both US- and foreign-born, had higher odds of unmet need for preventive services than US-born white children. Poor dental health was strongly associated with unmet need. Disparities in dental insurance coverage and dental care are also evident by family socioeconomic status.
Poor and minority children were less likely to receive preventive dental care, even when insurance status was considered. Rural children were less likely to have dental insurance than urban children. Foreign birth affected insurance status for Hispanic children and use of preventive services for all minority children.
我们试图了解美国儿童在种族/族裔、城市/农村居住情况以及社会经济地位方面的牙科保险覆盖范围和牙科护理差异。
对来自全国儿童健康调查和地区资源文件的关联数据进行分析（N = 89071）。采用多重逻辑回归分析来调整混杂因素。
共有22.1%的美国儿童在前一年没有家长报告的牙科保险覆盖，26.9%没有进行常规预防性牙科就诊，5.1%的家长认为存在未满足的预防性牙科护理需求。美国出生的少数族裔儿童比美国出生的白人儿童更不容易缺乏牙科保险；然而，外国出生的西班牙裔儿童更有可能没有保险。农村儿童比城市儿童更有可能没有保险。有健康保险的儿童更有可能有牙科保险覆盖。缺乏牙科保险的儿童接受预防性护理的可能性较小，且未满足护理需求的可能性更大。与美国出生的白人儿童相比，所有少数族裔儿童接受预防性护理的可能性较小。这些差异在外国出生的儿童中更为明显。在未满足的牙科护理需求方面，基于种族的差异较少。只有美国出生和外国出生的黑人儿童未满足预防性服务需求的几率高于美国出生的白人儿童。口腔健康状况差与未满足的需求密切相关。牙科保险覆盖范围和牙科护理的差异在家庭社会经济地位方面也很明显。
贫困和少数族裔儿童接受预防性牙科护理的可能性较小，即使考虑保险状况也是如此。农村儿童比城市儿童更不容易有牙科保险。外国出生影响西班牙裔儿童的保险状况以及所有少数族裔儿童对预防性服务的使用。
