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Original research
Race disparities in dental care use from adolescence to middle adulthood in the USA
  1. Alexander Testa1,
  2. Luis Mijares1,
  3. Karyn Fu2,
  4. Dylan Jackson3,
  5. Carmen Gutierrez4,
  6. Reed DeAngelis5,
  7. Kyle Ganson6,
  8. Jason Nagata7,
  9. Rahma Mungia8
  1. 1 Department of Management, Policy and Community Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA
  2. 2 Rice University, Houston, Texas, USA
  3. 3 Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  4. 4 Department of Public Policy, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
  5. 5 Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
  6. 6 Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
  7. 7 Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
  8. 8 School of Dentistry, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
  1. Correspondence to Dr Alexander Testa; alexander.testa{at}uth.tmc.edu

Abstract

Background This study examines the longitudinal patterns of dental care use from adolescence to middle adulthood (ages 11–43) and investigates racial and ethnic disparities in these patterns.

Methods Data from Waves I through V of the National Longitudinal Study of Adolescent to Adult Health (1993–2018; ages 11–43). Semiparametric group-based trajectory model identified distinct dental care use trajectories. Multinomial logistic regression was used to estimate membership in these trajectory groups by race/ethnicity while accounting for covariates, including socioeconomic status, biological sex, nativity and unmet healthcare needs.

Results The analysis identified four distinct dental care use trajectories (1): Intermittent decreasing dental care use (37.9%), (2) intermittent increasing dental care use (22.5%), (3) high dental care use (22.5%) and (4) low dental care use (17.0%). Non-Hispanic black and Hispanic respondents were more likely than non-Hispanic white respondents to belong to low dental care use and intermittent decreasing dental care use groups relative to high dental care use. Additionally, non-Hispanic black respondents were more likely than non-Hispanic white respondents to belong to the Intermittent Increasing Dental Use group. Higher socioeconomic status was inversely associated with low and intermittent use group membership. Males and those with unmet healthcare needs at Wave I were also more likely to belong to trajectories with low and intermittent dental care use.

Conclusions Findings reveal persistent racial disparities in dental care use from adolescence into adulthood. Further research is needed to understand the individual and structural factors perpetuating racial disparities in dental care use over the life course.

  • DENTISTRY
  • EPIDEMIOLOGY
  • HEALTH SERVICES
  • ORAL HEALTH

Data availability statement

Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available. Data are from the National Longitudinal Study of Adolescent to Adult Health and can be requested from: https://addhealth.cpc.unc.edu/data/Code used for the study can be requested from the authors upon request.

https://doi.org/10.1136/jech-2024-223202

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    Data availability statement

    Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available. Data are from the National Longitudinal Study of Adolescent to Adult Health and can be requested from: https://addhealth.cpc.unc.edu/data/Code used for the study can be requested from the authors upon request.

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    Footnotes

    • Contributors AT generated the idea for the paper. AT and LM conducted the analysis. AT, KF, DJ, RD, CG, KG, JN and RM drafted the text, contributed to the interpretation of the results and critical revisions of the paper. AT is the paper guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.