Division of Oral Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA 30341. Email:
DB Consulting Group, Inc, Atlanta, Georgia.
Prev Chronic Dis. 2020 Jul 30;17:E71. doi: 10.5888/pcd17.190352.
Dental care among children has increased over the past decade, and racial/ethnic disparities have narrowed for some groups. We measured changes in racial/ethnic disparities in annual dental care for children and adolescents aged 2 to 17 years and conducted multivariate analysis to study factors associated with changes in disparities over time.
We used Medical Expenditure Panel Survey data to obtain crude prevalence estimates of dental care use and calculated absolute disparities and changes in disparities for 3 racial/ethnic groups of children and adolescents compared with non-Hispanic white children and adolescents relative to fixed points in time (2001 and 2016). We pooled all single years of data into 3 data cycles (2001-2005, 2006-2010, and 2011-2016) and used multivariate regression to assess the relationship between dental care use and race/ethnicity, controlling for the covariates of age, sex, parents' education, household income, insurance status, and data cycle (time).
Use increased by 18% only in low-income children and adolescents. Low-income Hispanic (adjusted prevalence ratio [aPR] = 0.98; 95% CI, 0.94-1.02) and Asian (aPR = 0.92; 95% CI, 0.83-1.02) participants showed no difference in dental care use relative to non-Hispanic white participants, but non-Hispanic black participants had significantly lower use (aPR = 0.84; 95% CI, 0.81-0.88). Public and private insurance were associated with a doubling of use among low-income children.
We saw a modest increase in dental care use and a narrowing of disparities for some low-income children and adolescents. Use among low-income Hispanic and Asian participants "caught up" with use among Hispanic white participants but remained well below that of children and adolescents in families with middle and high incomes. Disparities persisted for non-Hispanic black participants at all income levels.
在过去的十年中，儿童的牙科护理有所增加，一些群体的种族/民族差异已经缩小。我们衡量了儿童和青少年（2 至 17 岁）每年接受牙科护理的种族/民族差异的变化，并进行了多元分析，以研究随时间变化与差异变化相关的因素。
我们使用医疗支出面板调查数据获得了牙科护理使用的粗略流行率估计，并计算了 3 个种族/民族群体的儿童和青少年与非西班牙裔白人儿童和青少年相比，在相对于固定时间点（2001 年和 2016 年）的牙科护理使用的绝对差异和差异变化。我们将所有单一年份的数据汇总到 3 个数据周期（2001-2005 年、2006-2010 年和 2011-2016 年）中，并使用多元回归评估了牙科护理使用与种族/民族之间的关系，同时控制了年龄、性别、父母教育程度、家庭收入、保险状况和数据周期（时间）等协变量。
仅在低收入儿童和青少年中，使用率增加了 18%。低收入西班牙裔（调整后患病率比 [aPR] = 0.98；95%CI，0.94-1.02）和亚裔（aPR = 0.92；95%CI，0.83-1.02）参与者的牙科护理使用率与非西班牙裔白人参与者相比没有差异，但非西班牙裔黑人参与者的使用率明显较低（aPR = 0.84；95%CI，0.81-0.88）。公共和私人保险与低收入儿童使用率增加一倍有关。
我们看到一些低收入儿童和青少年的牙科护理使用量适度增加，差异也有所缩小。低收入西班牙裔和亚裔参与者的使用率“赶上”了西班牙裔白人参与者的使用率，但仍远低于中高收入家庭的儿童和青少年的使用率。非西班牙裔黑人参与者在所有收入水平上的差异仍然存在。
