The Effect of Insurance Coverage on Tennessee Children's Receipt of Preventive Dental Services and Oral Health

Abstract

BACKGROUND: This capstone has two parts - a policy brief and a secondary data analysis. The policy brief explains the importance of children's dental care and presents five policy recommendations to increase access to preventive dental care among children in Tennessee. The data analysis examines associations between parents' report of source of insurance, receipt of preventive dental services, and oral health. METHODS: This study performs a cross-sectional analysis using data from the 2011 National Survey of Children's Health. Data were divided into two samples: national (n=87,720) and Tennessee (n=1,752). Logistic regression, ordinary least squares regression, and chi-squared tests were used to estimate associations between source of insurance, receipt of preventive dental services, and self-reported oral health. Results from each sample were compared. RESULTS: The National and Tennessee samples had similar rates of insurance coverage, receipt of preventive dental care, and self-reported oral health status. Public (US: OR=3.92; TN: OR=1.98) and private insurance (US: OR=3.54; TN: OR=2.13) were associated with preventive dental care in both samples. The difference between mean oral health status between those with private insurance and those with no insurance changes from 1.12 (TN: 0.48) in the unadjusted model to 0.24 (TN: 0.1) in the adjusted model. CONCLUSION: While insurance is correlated with receipt of preventive dental care, a causative relationship is questionable. Those with insurance have a greater likelihood of receiving preventive dental services, but the exact mechanism of this relationship is unknown. The role of insurance on receipt of preventive dental services seems to be less influential in Tennessee than nationally. The correlation between source of insurance and oral health status is largely mediated through covariates.