Brandy J. Lipton (
Tracy L. Finlayson is a professor in the School of Public Health, San Diego State University.
Health Aff (Millwood). 2021 Nov;40(11):1731-1739. doi: 10.1377/hlthaff.2021.01135.
Although all state Medicaid programs cover children's dental care, Medicaid-eligible children are more likely to experience tooth decay than children in higher-income families. Using data from the 1999-2016 National Health and Nutrition Examination Survey and the 2003, 2007, and 2011-12 waves of the National Survey of Children's Health, we examined the association between Medicaid adult dental coverage (an optional benefit) and children's oral health. Adult dental coverage was associated with a statistically significant 5-percentage-point reduction in the prevalence of untreated caries among children after Medicaid-enrolled adults had access to coverage for at least one year. These policies were also associated with a reduction in parent-reported fair or poor child oral health with a two-year lag between the onset of the policy and the effect. Effects were concentrated among children younger than age twelve. We estimated declines in poor oral health among all racial and ethnic subgroups, although there was some evidence that non-Hispanic Black children experienced larger and more persistent effects than non-Hispanic White children. Future assessments of the costs and benefits of offering adult dental coverage may consider potential effects on the children of adult Medicaid enrollees.
尽管所有州的医疗补助计划都涵盖儿童的牙科保健，但符合医疗补助条件的儿童比高收入家庭的儿童更容易出现蛀牙。本研究使用了 1999-2016 年全国健康和营养检查调查以及 2003 年、2007 年和 2011-12 年全国儿童健康调查的数据，考察了医疗补助成人牙科保险（一种可选福利）与儿童口腔健康之间的关系。在医疗补助计划覆盖的成年人至少有一年的保险后，成人牙科保险与儿童未经治疗的龋齿患病率降低了 5 个百分点，具有统计学意义。在政策实施两年后，这些政策还与父母报告的儿童口腔健康状况较差相关，存在两年的滞后。这种影响主要集中在 12 岁以下的儿童中。我们估计，所有种族和族裔亚组的口腔健康不良率都有所下降，尽管有证据表明，非西班牙裔黑人儿童的影响比非西班牙裔白人儿童更大且更持久。未来对提供成人牙科保险的成本和效益的评估可能需要考虑其对成人医疗补助受保者子女的潜在影响。
