Gains in Dental Care Use Not Shared by Minority Elders

Americans have steadily increased their reported use of dental services over the past 30 years. Persons aged 65 years and older have made the greatest gains, from 16 percent in 1957–58 to 43 percent in 1989. This article reviews national data on reported use of dental care over the past three decades, focusing on differences in rates of utilization on the basis of age, race, and national origin. In addition, differences in sample selection, definitions of race and national origin, and data collection methodology were reviewed to identify systematic sources of bias in comparing the data. Findings indicate that reported dental care use among minority elders has not increased parallel with elders of all races and national origins. In 1957–59, 17 percent of white elders versus 9 percent of nonwhite elders had seen a dentist within the past year. By 1989 percentages had improved to 45 percent of whites, but only 22 percent of blacks and 40 percent of Hispanics. In addition, reporting and recording race and national origin varied considerably during the three decades, hampering comparisons over time. Finally, published national data on usual correlates of dental care use (dentition status, insurance, age, income, and education) are inadequate to explain the causes of these discrepancies. More research is needed to identify barriers to use of dental care by all Americans, particularly those of African and Hispanic descent. Because these ethnic groups are aging faster than the rest of society, and because dental care use among Hispanic and African American elders lags behind use among all elders, dental and public health professions have a responsibility to investigate the barriers and to plan strategies for improving use of care.