Disparity in dental coverage among older adult populations: a comparative analysis across selected European countries and the USA

Abstract

Background Insurance against the cost risks associated with prevention and treatment of oral diseases can reduce inequalities in dental care use and oral health. The purpose of this study was to examine the extent of variation in dental insurance coverage for older adult populations within and between the United States and various European countries. Method The analyses relied on 2006/2007 data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) and 2004-2006 data from of the Health and Retirement Study (HRS) in the United States for respondents aged 51 years and older. A series of logistic regression models was estimated to identify disparities in dental coverage. Results The highest extent of significant insurance differences between various population subgroups was found for the United States. In comparison with countries belonging to the Eastern and Southern welfare state regimes, a lower number of significant coverage differences occurred for Scandinavian countries. Countries categorized as having comprehensive public insurance coverage showed a tendency towards less insurance variation within their populations than countries categorized as not having comprehensive public coverage, exceptions being Poland and Switzerland. Conclusions The findings of the present study suggest that significant variations in dental coverage exist within all elderly populations examined and the extent of inequalities also differs between countries. By and large, the observed variations corroborate the perception that population dental coverage is more equally distributed under public subsidy. This could be relevant information for decision makers who seek to improve policies towards more equitable dental coverage.

Periodontitis prevalence in adults ≥ 65 years of age, in the USA

“…Exacerbating the situation for US older adults ≥ 65 years of age is that a considerable proportion of this population segment lives in poverty, with over two‐thirds (69%) having incomes of < 400% of the Federal Poverty Level; lower‐income older adults had increased prevalence of periodontitis, with up to 17.7% of the poorest being affected by severe periodontitis and 80% by any periodontitis type. Income and education are also associated with dental visits among older adults . The highest prevalence of severe periodontitis occurred among those reporting having a dental visit in the previous 6 months, which might seem counterintuitive at first glance.…”

Disparities in dental healthcare utilization in China

“…Dissimilar health insurance coverage also made a contribution to inequality in dental care utilization. Insurance against the cost of preventing and treating oral diseases can reduce inequities in dental care utilization and oral health . Reliance on private financing, including out‐of‐pocket and private insurance, clearly generates a pro‐rich inequity in dental care utilization .…”

“…Insurance against the cost of preventing and treating oral diseases can reduce inequities in dental care utilization and oral health. 43 Reliance on private financing, including out-of-pocket and private insurance, clearly generates a pro-rich inequity in dental care utilization. 21,36 The UEBMI enrollees were more likely to seek dental care and were concentrated among the better-off.…”

Barriers to oral health across selected European countries and the USA

“…[10,11] Whereas the effect of dental coverage is universally positive, there does exist considerable variation among respondents reporting dental coverage by country ranging from the highest rates of coverage in Germany (98%), Czech Republic (96%), Denmark (92%) and Netherlands (87%) to Greece (57%), the USA (48%) and Spain (31%) in the middle and to the lowest rates of coverage in Switzerland (21%) and Italy (21%). [12]…”