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Outreach efforts are needed to enroll more poor children in Medicaid and boost their use of dental care

Poor children have significantly fewer preventive dental visits than those with higher incomes, according to a study supported by the Agency for Healthcare Research and Quality (HS10129). This underscores the need for more health promotion outreach efforts to increase enrollment of eligible children in Medicaid and the State Children's Health Insurance Program (SCHIP) to improve their access to and use of dental care, according to the University of Maryland Dental School researchers who conducted the study.

Richard J. Manski, D.D.S., M.B.A., Ph.D., who is also a Senior Scholar with AHRQ's Center for Cost and Financing Studies, and his colleagues analyzed data from the 1996 Medical Expenditure Panel Survey (MEPS) on use of preventive dental care by children and adolescents. They calculated national estimates for visits in which preventive dental procedures (such as dental prophylaxis and fluoride and sealant applications) were completed for children in each of several socioeconomic and demographic categories. Preventive dental visits for both poor (annual income of about $16,500 for a family of four) and near-poor youths were only about half as likely as they were among of young people in middle or high income groups across racial/ethnic groups (about 16 percent vs. 26 percent for blacks, 18 percent vs. 33 percent for Hispanics, and 25 percent vs. 46 percent for non-Hispanic whites).

No other studies have found differences in dental preventive care by income. Overall, the proportion of Medicaid-insured children who had received preventive care was unexpectedly low, given that coverage for pediatric dental services has been part of the Medicaid program for more than three decades. Poor and near-poor families may not know how to use available resources effectively, suggest the researchers. They conclude that educating families eligible for Medicaid and SCHIP programs about how to enroll and access the system may be essential for the success of these programs.

See "The impact of income on children's and adolescents' preventive dental visits," by Maria Rosa Watson, D.D.S., M.S., M.P.H., Dr. Manski, and Mark D. Macek, D.D.S., Dr.P.H., in the November 2001 Journal of the American Dental Association 132, pp. 1580-1587.

Reprints (AHRQ Publication No. 02-R034) are available from the AHRQ Publications Clearinghouse.

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