Dental Health Care
About
Dental Health Care measures the rate of dental health care providers per 100,000 population in a county. Individuals from all races and ethnicities are included. Adequate access to dental health care is essential for preventing oral health diseases, improving overall health, and reducing disparities in oral health outcomes. Poor oral health in certain population groups is partially attributed to persistent health disparities 1. For example, as of 2024, approximately 57 million Americans live in a dental health professional shortage area, and about 67% of those shortage areas are in rural communities 2. Efforts to reduce oral health disparities are crucial for advancing health equity, ensuring that everyone has a fair and just opportunity to attain their highest possible level of health 3,4.
Why is Dental Health Care important to the Structural Racism and Discrimination (SRD) Index?
Lack of access to dental health care highlights systemic inequities in overall access to quality healthcare, which disproportionately impacts minority racial and ethnic populations. Barriers such as geographic disparities, financial constraints, and a lack of culturally competent providers, which are the impacts of long-standing racist and discriminatory health and economic policies, result in higher rates of untreated dental conditions among Black Americans and other marginalized groups 5,6. Moreover, structural racism limits the protective effects of economic resources and health insurance coverage among black-poor families to afford quality oral healthcare for Black children 7,8. Including dental health care in the SRD Index underscores the need to address the lack of equitable quality healthcare and promote oral health equity.
What is the expected relation to Structural Racism and Discrimination?
A lower rate of dental health care providers represents a higher need for medical resources in a county. A higher rate of dental health care providers contributes to the lower score of the SRD Index.
How is Dental Health Care calculated?
Data Source
We obtained data from the Health Resources & Services Administration (HRSA) 9. The data is publicly available.
Data
We used the following two variables at the county level.
| Variables* | Year | Unit |
|---|---|---|
| Total population | 2010 | 2020 | Number |
| Number of Dentists with National Provider Identifier (NPI) | 2010 | 2020 | Number |
Methodology
We calculated Dental Health Care using a ratio formula:
$$
RTotDentist = \left( \frac{TotDentist}{TotPop} \right) \times 100000
$$
Where:
RTotPCphy: Rate of dental care providers per 100,000 population (all races and ethnicities)
TotDentist: Number of Dentists w/NPI
TotPop: Total Population
Missing Data
Missing values were filled using the median value of the adjacent neighbors. The adjacent neighbors were identified using the PolygonNeighbors tool in Python’s arcpy.analysis module 10. The adjacency is defined by any common boundary or vertex between two counties. After imputing missing data, 11 counties (island counties) remained without data for 2020, and no counties were missing data for the year 2010.
Limitations
Data is not available for the years 1990 and 2000. Dental care data disaggregated by race, i.e., how many Black Americans sought dental care in a county, was not available from this data source.
References
1. U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (2022). Health equity and health disparities environmental scan. U.S. Department of Health and Human Services. Accessed December 18, 2024.
2. Health Resources & Services Administration. (n.d.). Health workforce shortage areas: Explore HPSAs. U.S. Department of Health and Human Services. Accessed December 18, 2024.
3. Centers for Disease Control and Prevention. (n.d.). What is health equity. U.S. Department of Health and Human Services. Accessed December 18, 2024.
4. Braveman, P., Arkin, E., Orleans, T., Proctor, D., & Plough, A. (2017). What is health equity? And what difference does a definition make? Robert Wood Johnson Foundation. Accessed December 18, 2024.
5. Smith, P. D., Wright, W., & Hill, B. (2021). Structural racism and oral health inequities of Black vs. non-Hispanic White adults in the US. Journal of Health Care for the Poor and Underserved, 32(1), 50-63.
6. Borrell, L. N., Reynolds, J. C., Fleming, E., & Shah, P. D. (2023). Access to dental insurance and oral health inequities in the United States. Community dentistry and oral epidemiology, 51(4), 615-620.
7. Okuji, D., Wei, T., & Lee, M. (2023). Family Income and Utilization Disparities for Dental Access of Minority Children: A Cross-Sectional Study. medRxiv, 2023-02.
8. Assari, S., & Hani, N. (2018). Household income and children’s unmet dental care need; Blacks’ diminished return. Dentistry journal, 6(2), 17.
9. Health Resources and Services Administration. (n.d.). Area Health Resource File (AHRF) county-level data. U.S. Department of Health and Human Services.
10. Virtanen, P., Gommers, R., Burovski, E., Oliphant, T. E., Weckesser, W., Cournapeau, D., … & Feng, Y. (2021). scipy/scipy: SciPy 1.6. 0. Zenodo.