Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA.
Division of Gynecological Oncology, Brigham and Women's Hospital, Boston, MA, USA.
J Public Health Dent. 2019 Dec;79(4):324-333. doi: 10.1111/jphd.12334. Epub 2019 Aug 13.
To examine socio-demographic and economic predictors of dental care access among women in the United States.
A total of 52,493,940 women at the US national level aged 20-44 years were identified from the National Health and Nutrition Examination Survey, 2011 to 2016. Weighted multivariate logistic regression models were computed to identify predictors of dental care use, unmet dental-care need, and reported reasons for unmet need.
Young, Mexican-American, other minority race-ethnicities, less educated, and uninsured women were independently more likely to have never visited a dental clinic (P < 0.025). Mexican-Americanwomen with a poverty income ratio (PIR) <2.00 and less than excellent health status and those uninsured were independently more likely to have unmet dental need (P < 0.025). Women with PIR <1.00 and those uninsured were independently more likely to have an unmet need because of unaffordable cost (P < 0.0008) or lack of procedure coverage by insurance (P < 0.0008). Younger women were more likely to think that the dental problem would go away (P < 0.0001).
While young, less educated, and women from minority race-ethnicities were less likely to report ever use of dental care, only low income, poor health, and uninsured women were more likely to report unmet dental care need. Racial-ethnic minority, less educated, and young women may benefit from improved education about the value of dental care. Expanding insurance coverage for dental care and improving access for women with poor health may address racial-ethnic and education-level disparities in unmet dental care need.
探讨美国女性获得牙科保健的社会人口学和经济学预测因素。
本研究从美国国家健康和营养检查调查（2011 至 2016 年）中确定了年龄在 20-44 岁的美国全国范围内的 52493940 名女性。使用加权多变量逻辑回归模型来确定牙科保健使用、未满足的牙科保健需求以及未满足需求的报告原因的预测因素。
年轻、墨西哥裔美国、其他少数族裔、受教育程度较低和没有保险的女性更有可能从未去过牙科诊所（P<0.025）。贫困收入比（PIR）<2.00、健康状况不佳且没有保险的墨西哥裔美国女性以及没有保险的女性更有可能存在未满足的牙科需求（P<0.025）。PIR<1.00 和没有保险的女性更有可能因为负担不起费用（P<0.0008）或保险不涵盖治疗程序（P<0.0008）而存在未满足的需求。年轻女性更有可能认为口腔问题会自行消失（P<0.0001）。
尽管年轻、受教育程度较低和少数族裔女性报告使用牙科护理的可能性较低，但只有低收入、健康状况不佳和没有保险的女性更有可能报告未满足的牙科护理需求。种族和民族少数群体、受教育程度较低和年轻女性可能受益于加强对牙科护理价值的教育。扩大牙科保健保险覆盖范围并改善健康状况不佳的女性的获得途径，可能有助于解决未满足的牙科保健需求方面的种族和民族以及教育程度差异。
