Method: Data was obtained from a nationally representative sample of adults ≥16 year-old who participated in the 2011 South African Social Attitude survey (n=3,002). Main outcome measure: Reporting intention to make a PDV within the following 12 months. Information obtained included demographic data, measures of participants’ SEP, self-reported oral health, illness beliefs and past dental visit patterns. Using principal component analysis, index scores derived from best fitting items measuring SEP were summed up and then ranked in tertiles (α=0.75). Multi-level logistic regression analysis was conducted to determine the predictors of intention to make a PDV, following which an Oaxaca decomposition analysis was conducted.
Result: Of the respondents, 10.2% reported past yearly PDV (25.6% whites vs. 8.2% non-Whites; p<0.001) and 57.8% had never visited a dentist. Intention to make a PDV was more frequently reported among Whites than non-Whites (52.2% vs. 36.5%; p<0.001). Similarly, private health insurance enrolment was more common among Whites than non-Whites (74.8% vs. 16.5%; p<0.001). Intention to make a PDV was significantly associated with self-oriented cause-of-illness belief (OR=1.22; 95%CI=1.00-1.50), being in the higher SEP ranking (OR=1.34; 95%CI=1.00-1.79), having a private health insurance (OR=1.74; 95%CI=1.36-2.21) and reporting past regular PDVs (OR=7.19; 95%CI=5.28-9.78). Health insurance enrolment and past regular PDVs respectively accounted for 28.4% and 59.2% of the observed White/non-White gap in intention to make a PDV.
Conclusion: Interventions directed at expanding health insurance coverage for non-White South Africans are likely to significantly reduce racial disparities in PDVs in South Africa.