Nearly 25% of California children have never seen a dentist and disparities exist across race, ethnicity, and type of insurance when it comes to the duration between dental care visits, according to a new study (Health Affairs, July 2010, Vol. 29:7, pp. 1356-1363).
The study examines barriers to dental care among California children age 11 and younger, using data from the 2005 California Health Interview Survey.
Researchers from the University of California, Los Angeles (UCLA) Center for Health Policy Research and the California HealthCare Foundation found that Latino and African-American children with all types of insurance were less likely than Asian-American and Caucasian children to have visited the dentist in the previous six months -- or even in their entire lifetime.
Similarly, researchers found that Latino and African-American children in public insurance programs, including Medicaid and the Children's Health Insurance Program (CHIP), went to the dentist less often than Caucasian and Asian-American children with the same insurance coverage.
Overall, children with private insurance saw a dentist more often than those with Medicaid or CHIP.
"The findings suggest that having insurance isn't always enough," said study author Nadereh Pourat, Ph.D., director of research planning at the UCLA Center for Health Policy Research. "We need to address the other barriers that keep children from getting the help they need."
The findings raise concerns about Medicaid's ability to address disparities in dental care access, the authors noted. Ultimately, they observed, more strategic efforts are necessary to overcome systemic barriers to care, including raising reimbursement rates paid to dentists who serve the Medicaid population and increasing the number of participating Medicaid providers.
"These findings indicate that many poor children in California do not make routine dental visits or simply never receive any dental care," said author Len Finocchio, Dr.P.H., senior program officer at the California HealthCare Foundation. "Even with Medicaid coverage, there are tremendous barriers to getting services."
Despite the disparities, having any form of dental insurance significantly increases the odds of seeing a dentist on a regular basis, the authors noted. The studied showed that 54% of privately insured children and 27% of publicly insured children had seen the dentist during the previous six months, compared with 12% of children without dental coverage.
"The data tell us that Medicaid and CHIP have improved children's ability to get dental care," Pourat said. "However, both programs need to do more to reduce disparities."
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