The relationship between affordability and utilization of dental services: a secondary data analysis of 2015-2016 NHAMES data

Background: In the United States, oral health disparities are a public health concern as minority populations face barriers affording and utilizing dental services. Previous literature examines the relationship between racial/ethnic and socioeconomic inequalities and the utilization of dental services. However, there is a gap in literature pertaining to the ability to afford care. Methods: A cross-sectional analysis using the 2015-2015 National Health and Nutrition Examination Survey (NHANES) examined the ability to afford and utilize dental care in the past 12 months when care was needed. The analysis stratified the study population by race/ethnicity, socioeconomic status, and by both race/ethnicity and socioeconomic status. Respective racial/ethnic groups included White, Black, and Hispanic populations. Socioeconomic status was binary coded to include participants living under an annual household income of $34,999 and individuals living above an annual household income of $75,000. These respective cohorts were labeled “Under $34,999” and “Over $75,000”. The stratification of racial/ethnic groups by socioeconomic status included cohorts titled “White Under $34,999”, “White Over $75,000”, “Black Under $34,999”, “Black Over $75,000”, “Hispanic Under $34,999”, and “Hispanic Over $75,000”. The study also analyzed the descriptive statistics for the entire sample, stratifying by race/ethnicity and by socioeconomic status. Results: Racial/ethnic minorities and those with lower income (Black populations, Hispanic populations, and individuals under $34,999) were found to have higher rates of being unable to afford and utilize dental services in the past 12 months, especially when care was needed, in comparison to White populations and individuals living above $75,000. Lower socioeconomic groups representing all racial classes (“White Under $34,999”, “Black Under $34,999”, and “Hispanic Under $34,999”) and were found to have higher rates of being unable to afford and utilize dental services in the past 12 months, especially when care was needed, in comparison to their counterparts living at a higher socioeconomic level. Conclusion: Racial/ethnic groups and those with lower socioeconomic status were more likely to face challenges or barriers affording and utilizing dental services on an annual basis