A groundbreaking study led by a Harvard associate professor has identified numerous “dental deserts” across the United States, shedding light on the spatial inaccessibility to dental clinics in various regions. Published on December 23 in JAMA Network Open and announced by the university on January 22, the research found that 1.7 million Americans live more than a 30-minute drive away from a dental clinic. Additionally, the study revealed that 24.7 million people reside in areas experiencing dental care shortages, with rural and socioeconomically disadvantaged communities being hit hardest.
The study, conducted by Hawazin Elani, an assistant professor in oral health policy and epidemiology at Harvard School of Dental Medicine, is among the first to map the national accessibility to dental clinics in such granular detail. Using block group-level data from the U.S. Census Bureau, the researchers provided a comprehensive analysis of the geographic disparities in dental care.
“We were able to identify areas with limited access to dental care that may have been overlooked by previous studies,” said Md. Shahinoor Rahman, a co-author of the study.
By adopting a gravity-based method that considers clinician availability, population demand, and various socioeconomic factors, including race, ethnicity, age, income, education, and health insurance coverage, the research provided a more nuanced understanding of dental care shortages. The findings indicated that counties facing dental shortages had an average of 15.6% of their population living below the federal poverty level. Rural areas, with fewer dentists, also had higher levels of uninsured residents and greater disparities in dental care access compared to urban areas.
The study also highlighted racial and ethnic disparities. While rural areas with dental shortages tended to have a larger white population, Black and Hispanic populations in urban centers faced even greater challenges due to segregation and concentrated poverty. For individuals on Medicaid or Medicare, these barriers were even more pronounced, as low participation from dentists exacerbated the already significant disparities in care.
“This situation is likely even more dire for Medicaid and Medicare beneficiaries, who face additional barriers due to low dentist participation, worsening existing disparities. This can lead to people putting off much-needed care,” said Elani.
The study’s findings are expected to inform policy decisions and workforce planning at both federal and state levels. By highlighting the areas most in need of intervention, the research aims to encourage the redistribution of dental professionals to underserved regions and promote efforts to address the disparities in oral health access across the country.
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