County-level determinants of dental utilization for Medicaid-enrolled children with chronic conditions: How does place affect use?

Donald, L.

doi:10.1016/j.healthplace.2012.07.007

Cited by 20 publications

(26 citation statements)

References 61 publications

(60 reference statements)

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“…Our finding from the multivariable model that children living in rural areas were less likely to receive dental care agrees with previous research (Beil et al, 2012;Chi et al, 2010;Chi and Leroux, 2012). However, the interesting associations seen between race and utilization of dental care hint at complex relationships that are worth further investigation.…”

Section: Discussionsupporting

confidence: 90%

“…One recent study of dental expenditures among Medicaid-enrolled children found higher rates of preventive visits in counties with higher dentist supplies (Beil et al, 2012). Another recent study of dental utilization among Medicaid-enrolled children with chronic conditions found that utilization of dental services was lower in counties with dental Health Professional Shortage Area (HPSA) designations (Chi and Leroux, 2012). While both studies examined the role of county urbanicity, other measures should be considered in order to evaluate the role of spatial accessibility.…”

Section: Spatial Accessibility Is Influenced By Dentist Availability mentioning

confidence: 99%

“…The most common approach to examine variation in access to dental care is the use of fixed geopolitical boundaries, such as counties (Klauss et al, 2005;Krause et al, 2005;Mayer, 1999;Saman et al, 2010;Chi and Leroux, 2012;Susi and Mascarenhas, 2002). Using geopolitical units to approximate service areas offers several advantages, including ready availability of data.…”

Section: Service Areas Describe Regional Variations In Utilizationmentioning

confidence: 99%

See 2 more Smart Citations

Geographic variation of dental utilization among low income children

McKernan¹,

Kuthy²,

Hanley³

et al. 2015

Health & Place

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Section: Discussionsupporting

confidence: 90%

Section: Spatial Accessibility Is Influenced By Dentist Availability mentioning

confidence: 99%

Section: Service Areas Describe Regional Variations In Utilizationmentioning

confidence: 99%

See 1 more Smart Citation

Geographic variation of dental utilization among low income children

McKernan¹,

Kuthy²,

Hanley³

et al. 2015

Health & Place

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“…This finding is different from those in previous studies in which investigators examined dental care utilization among children and adolescents to find a statistically significant effect of community poverty. 16,17 The results from our study imply that dental care utilization in poor communities is lower because of the individual-level characteristics of residents in the community rather than because of neighborhood effects.…”

Section: Discussionmentioning

confidence: 67%

“…For example, investigators in one study found that every increase of 10,000 unemployed people in the community was associated with a 1.2 percent decrease in preventive care utilization among the population with dental insurance in the Seattle area. 15 Similarly, investigators in other studies have found that a higher level of neighborhood poverty was associated with lower dental care utilization among adolescents 16 and Medicaid-enrolled children 17 even after they accounted for individual characteristics. A lower supply of dentists in a community also has been associated with a higher proportion of disadvantaged people in a community—namely, minorities and low-income people.…”

mentioning

confidence: 78%

Community factors predicting dental care utilization among older adults

Lee¹,

Kim²,

Albert³

et al. 2014

The Journal of the American Dental Association

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Background Few investigators have studied the influence of community factors on dental care utilization among older adults. The authors’ objective in this study was to investigate the effect of community factors on dental care utilization after adjustment for individual factors. Methods Using data from a cross-sectional survey of Ohio residents, the authors assessed dental care utilization in a sample of 2,166 adults aged 65 years or older. They linked individual-level dental care utilization, predisposing factors (age, sex, race or ethnicity, marital status, education), enabling factors (poverty, dental insurance) and need-related factors (physical and mental health problems) with county-level data (socioeconomic environment and health resource environment) from the 2010 Area Health Resource Files (from the U.S. Department of Health and Human Services) and the American Community Survey (from the 2006–2010 U.S. Census). Using multilevel logistic regression models, the authors evaluated the association between dental care utilization and community factors after adjustment for individual factors. Results The results indicated that individual factors such as being female, married and nonpoor and having a higher educational level and private dental insurance were associated with higher odds of having utilized dental care. Furthermore, older adults living in a county with a higher dentist-to-population ratio were more likely to use dental services even after the authors adjusted the results for the individual-level factors (odds ratio = 1.10, P = .03). Conclusions County-level dentist-to-population ratio has independent effects on older adults’ dental care utilization even after adjustment for individual-level characteristics. Practical Implications A comprehensive policy plan is required to intervene at both the individual and community levels to improve dental care utilization among older adults. By understating the factors influencing dental care utilization among older adults, U.S. dentists will be better positioned to meet the dental needs of this population.

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County-Level Social Vulnerability and Breast, Cervical, and Colorectal Cancer Screening Rates in the US, 2018

et al. 2022

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ImportanceArea-level factors have been identified as important social determinants of health (SDoH) that impact many health-related outcomes. Less is known about how the social vulnerability index (SVI), as a scalable composite score, can multidimensionally explain the population-based cancer screening program uptake at a county level.ObjectiveTo examine the geographic variation of US Preventive Services Task Force (USPSTF)–recommended breast, cervical, and colorectal cancer screening rates and the association between county-level SVI and the 3 screening rates.Design, Setting, and ParticipantsThis population-based cross-sectional study used county-level information from the Centers for Disease Control and Prevention’s PLACES and SVI data sets from 2018 for 3141 US counties. Analyses were conducted from October 2021 to February 2022.ExposuresSocial vulnerability index score categorized in quintiles.Main Outcomes and MeasuresThe main outcome was county-level rates of USPSTF guideline-concordant, up-to-date breast, cervical, and colorectal screenings. Odds ratios were calculated for each cancer screening by SVI quintile as unadjusted (only accounting for eligible population per county) or adjusted for urban-rural status, percentage of uninsured adults, and primary care physician rate per 100 000 residents.ResultsAcross 3141 counties, county-level cancer screening rates showed regional disparities ranging from 54.0% to 81.8% for breast cancer screening, from 69.9% to 89.7% for cervical cancer screening, and from 39.8% to 74.4% for colorectal cancer screening. The multivariable regression model showed that a higher SVI was significantly associated with lower odds of cancer screening, with the lowest odds in the highest SVI quintile. When comparing the highest quintile of SVI (SVI-Q5) with the lowest quintile of SVI (SVI-Q1), the unadjusted odds ratio was 0.86 (95% posterior credible interval [CrI], 0.84-0.87) for breast cancer screening, 0.80 (95% CrI, 0.79-0.81) for cervical cancer screening, and 0.72 (95% CrI, 0.71-0.73) for colorectal cancer screening. When fully adjusted, the odds ratio was 0.92 (95% CrI, 0.90-0.93) for breast cancer screening, 0.87 (95% CrI, 0.86-0.88) for cervical cancer screening, and 0.86 (95% CrI, 0.85-0.88) for colorectal cancer screening, showing slightly attenuated associations.Conclusions and RelevanceIn this cross-sectional study, regional disparities were found in cancer screening rates at a county level. Quantifying how SVI associates with each cancer screening rate could provide insight into the design and focus of future interventions targeting cancer prevention disparities.

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County-level determinants of dental utilization for Medicaid-enrolled children with chronic conditions: How does place affect use?

Cited by 20 publications

References 61 publications

Geographic variation of dental utilization among low income children

Geographic variation of dental utilization among low income children

Community factors predicting dental care utilization among older adults

County-Level Social Vulnerability and Breast, Cervical, and Colorectal Cancer Screening Rates in the US, 2018

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