Income-Related Inequalities in Access to Dental Care Services in Japan

Abstract

Background: This study aimed to evaluate whether income-related inequalities in access to dental care services exist in Japan. Methods: The subjects included beneficiaries of the National Health Insurance (NHI) in Chiba City, Japan, who had been enrolled from 1 April 2014 to 31 March 2015. The presence or absence of dental visits and number of days spent on dental care services during the year were calculated using insurance claims submitted. Equivalent household income was calculated using individual income data from 1 January to 31 December 2013, declared for taxation. Results: Of the 216,211 enrolled subjects, 50.3% had dental care during the year. Among those with dental visits, the average number of days (standard deviation) spent on dental care services per year was 7.7 (7.1). Low income was associated with a decreased rate of dental care utilization regardless of age and sex. However, there was a significant inverse linear association between the number of days spent on dental care services and income levels for both sexes. Conclusions: There were income-related inequalities in access to dental care services, regardless of the age group or sex, within the Japanese universal health insurance system.

Does public transportation reduce inequalities in access to dental care among older adults? Japan Gerontological Evaluation Study

“…The present findings regarding income inequalities in access to dental care are consistent with those of previous studies . A systematic review and meta‐analysis on access to dental care including 7 395 697 participants from 28 countries showed that dental utilization was higher among countries with a higher human developmental index (HDI) .…”

“…Finally, the present findings suggest a possible intervention policy to reduce income inequalities in access to dental care as mentioned above. While previous studies have reported inequalities in access to dental care and suggested financial/insurance‐related solutions for their reduction, our study presented another viewpoint.…”

“…Japan is a country with a high HDI and has the highest dental utilization, with wide dental care coverage provided by universal health insurance . However, there still exist income inequalities in access to dental care . A study analysing data on 216 211 people covered by the national health insurance scheme demonstrated a clear social gradient in dental care utilization .…”

Disparities in dental healthcare utilization in China

“…This may be explained by their knowledge of oral health and attitude towards dental care utilization, in that the highly educated have a better knowledge and awareness of dental health than the less educated . Factors such as inadequate knowledge of oral health and deficient health literacy may create barriers to utilizing dental care among low‐income groups and cause income‐related inequality . In addition, the highly educated tend to be richer and can better afford dental care than the less educated.…”

“…It has been found that limited access to dental care and economic barriers have strong effects on oral health and its equity . However, pro‐rich inequality in dental care utilization has been found in both developed and developing countries . The studies on trends in disparities in the dental care utilization found the improvement of affordability and dental health insurance coverage may be the drivers to reduce inequality .…”