Native Hawaiian, Other Pacific Islander, Filipino, and Poverty Status Are Associated with Decreased Utilization of Dental Care: BRFSS 2012

BACKGROUND:    Oral Health plays a critical role in general health and well-being along the life span.  Native Hawaiian and Other Pacific Islander populations are known to be at increased risk for poor health indicators. Population based surveillance data identifying subgroups at greatest risk for not receiving regular dental care can lead to specific programmatic efforts to improve oral health in these populations. This analysis seeks to determine if receiving dental care in the past year vary among the diverse population subgroups and by federal poverty level (FPL) in Hawaii.

METHODS:   We examined data from the 2012 Hawaii Behavioral Risk Factor Surveillance System (BRFSS) to assess the prevalence of a dental visit in the past year among 7,476 adult respondents. We calculated adjusted prevalence ratios (APR) for a dental visit in the past year in relation to race and FPL. Analyses were adjusted for age, sex, and federal poverty level status. 

RESULTS:   An estimated 29.6% of respondents did not receive dental care in the past year. Native Hawaiian (APR=1.5; 95%CI=1.2-1.7), Other Pacific Islander (1.6; 1.3-2.2), Filipino (1.2; 1.0-1.5), and Other (1.3; 1.1-1.7) race groups were more likely to not have received dental care compared to white adults in the adjusted analysis. Additionally, those living in households below 100% FPL (APR=2.1; 95%CI=1.5-2.8), 100-199% FPL (2.0; 1.5-2.6); 200-399% FPL (1.4; 1.1-1.9), and those that refused to report income (2.0; 1.6-2.6) were also more likely to not have received dental care compared to those in households at 400% FPL or higher.

CONCLUSIONS:   Nearly one-third of adults did not receive dental care in the past year with Native Hawaiian, Other Pacific Islander, Filipino, and those of lower federal poverty levels at highest risk. Identifying specific population groups that do not receive regular dental care can inform program efforts to promote healthy behaviors through targeted outreach programs to increase use of dental services. Information on reasons these populations don’t seek regular dental care and documentation of clinical impact (e.g., cavities,  tooth loss, and comorbid conditions) of poor oral health in these populations is also helpful to inform specific programmatic efforts to improve oral health in Hawaii.