Disparities in dental care associated with disability and race and ethnicity

Abstract Background Both racial and ethnic and disability-related disparities in dental care exist, yet little is known about the cumulative effect of these 2 characteristics. The purpose of this study was to determine how the combination of disability and race and ethnicity is associated with dental examinations, delays in receiving needed care, and inability to obtain needed care among noninstitutionalized working-age adults in the United States. Methods The authors conducted cross-sectional analyses of Medical Expenditure Panel Survey data pooled across the years 2002 to 2012, yielding a sample of 208,548. Multivariable logistic regression analyses were used to examine the association of disability (including physical, sensory, and cognitive limitations) and race and ethnicity with each of the dependent variables. Results Compared with non-Hispanic whites, other racial and ethnic groups were less likely to receive annual dental examinations. There were significant disparities for people with disabilities in receipt of examinations, delays in obtaining needed care, and being unable to obtain needed care. The combination of disability status and membership in an underserved racial or ethnic group was associated with a greater magnitude of disparity in all 3 areas, especially for American Indian, Alaska Native, and multiracial people with disabilities. Conclusions Community-dwelling adults with disabilities in underserved racial and ethnic groups have higher levels of delayed and unmet needs for dental care and lower receipt of routine dental examinations. Practical Implications As the United States population ages and grows more diverse, the population of people with disabilities in underserved racial and ethnic groups will expand. Dentists need to be aware of, and be prepared to address, the needs of these people.