Disparities in dental care use and expenditures of Asian Americans

Objective: This study examines racial and ethnic disparities in dental care use and expenditures among children and adults, while focusing on Asian Americans. Methods: Data from the 2006 Medical Expenditure Panel Survey were used to estimate dental care use and expenditures. We used a standard two-part model approach to examine total accrued dental expenditures and logit models to study dental check-ups. All results were weighted to be nationally representative. Results: Although a larger percentage of Asian adults had private or public dental insurance (63% for Asian, 56% White, 62% Black, 48% Hispanic), after controlling for covariates, they had the lowest odds of incurring any dental expenditures among all groups: OR=0.47 (95% CI: 0.39 0.56), compared to White adults. However, when Asian adults did seek dental care, they spent approximately same amount as Whites. Asian adults also had the lowest odds of having two dental check-ups among all four groups (OR=0.53, 95% CI: 0.44 0.63, compared to Whites). Similarly, Asian children had a significant (32%) reduced odds of incurring any dental care expenditure relative to White children, but when they did seek dental care, they spent comparable amounts. Black and Hispanic children also had lower odds than White children of incurring any dental expenditures (OR=0.72, 95% CI: 0.61 0.85; OR=0.69, 95% CI: 0.60 0.80, respectively), and they also spent significantly less when they sought dental care. Asian children had the lowest odds of having two dental check-ups among all four groups (OR=0.60, 95% CI: 0.45 0.80, compared to Whites). Conclusions: Asians, Blacks and Hispanics were less likely to incur any dental care expenditures or to have dental check-ups, than Whites. Our results suggest that financial barriers are likely to contribute to differences in dental care use between Blacks/Hispanics and Whites, while non-financial barriers limit use of dental care among Asians.