MassGeneral Hospital Center for Child and Adolescent Health Research and Policy, 15th Floor, C100, 100 Cambridge St, Boston, MA 02114, USA.
Pediatrics. 2012 Aug;130(2):306-14. doi: 10.1542/peds.2011-0838. Epub 2012 Jul 2.
Research that has repeatedly documented marked racial/ethnic disparities in US children's receipt of dental care at single time points or brief periods has lacked a historical policy perspective, which provides insight into how these disparities have evolved over time. Our objective was to examine the im-pact of national health policies on African American and white children's receipt of dental care from 1964 to 2010.
We analyzed data on race and dental care utilization for children aged 2 to 17 years from the 1964, 1976, 1989, 1999, and 2010 National Health Interview Survey. Dependent variables were as follows: child's receipt of a dental visit in the previous 12 months and child's history of never having had a dental visit. Primary independent variable was race (African American/white). We calculated sample prevalences, and χ(2) tests compared African American/white prevalences by year. We age-standardized estimates to the 2000 US Census.
The percentage of African American and white children in the United States without a dental visit in the previous 12 months declined significantly from 52.4% in 1964 to 21.7% in 2010, whereas the percentage of children who had never had a dental visit declined significantly (P < .01) from 33.6% to 10.6%. Pronounced African American/white disparities in children's dental utilization rates, whereas large and statistically significant in 1964, attenuated and became nonsignificant by 2010.
We demonstrate a dramatic narrowing of African American/white disparities in 2 measures of children's receipt of dental services from 1964 to 2010. Yet, much more needs to be done before persistent racial disparities in children's oral health status are eliminated.
有研究多次记录表明,在美国,儿童在单一时间点或短期接受牙科护理存在显著的种族/民族差异,但这些研究缺乏历史政策视角,而这一视角可以深入了解这些差异是如何随时间演变的。我们的目标是研究从 1964 年到 2010 年,国家卫生政策对非裔美国儿童和白人儿童接受牙科护理的影响。
我们分析了 1964 年、1976 年、1989 年、1999 年和 2010 年全国健康访谈调查中年龄在 2 至 17 岁的儿童种族与牙科护理利用的数据。因变量为以下两个方面:儿童在过去 12 个月内接受牙科就诊的情况和儿童从未接受过牙科就诊的情况。主要自变量为种族(非裔美国人/白人)。我们计算了样本患病率,并且通过年份比较了非裔美国人/白人的患病率,采用卡方检验。我们对估计值进行了年龄标准化,使其与 2000 年美国人口普查数据相匹配。
在过去 12 个月内没有接受过牙科就诊的美国非裔美国儿童和白人儿童的比例从 1964 年的 52.4%显著下降到 2010 年的 21.7%,而从未接受过牙科就诊的儿童比例也显著下降(P<.01),从 33.6%下降到 10.6%。1964 年,儿童牙科利用率的非裔美国人和白人之间的差异明显且具有统计学意义,而到 2010 年,这种差异明显减弱且不再具有统计学意义。
我们展示了从 1964 年到 2010 年,儿童接受牙科服务的 2 项措施中,非裔美国人和白人之间的差异明显缩小。然而,在消除儿童口腔健康状况方面持续存在的种族差异之前,还有很多工作要做。