Navigating Disparities in Dental Health-A Transit-Based Investigation of Access to Dental Care in Virginia.

IF 1.8 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Community dentistry and oral epidemiology Pub Date : 2024-10-30 DOI:10.1111/cdoe.13015

Junghwan Kim, Shashank Karki, Tegwyn Brickhouse, Marko Vujicic, Kamyar Nasseh, Changzhen Wang, Mengxi Zhang

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Abstract

Objective: To identify vulnerable areas and populations with limited access to dental care in Virginia, the study aimed (1) to calculate travel time and accessibility scores to dental care in Virginia using a transit-based accessibility model for all dental clinics and dental clinics participating in the Medicaid dental program and (2) to estimate factors associated with accessibility to dental clinics participating in the Medicaid dental program in Virginia.

Methods: The study used building footprints as origins of transit trips to dental care services (or destinations). The study then computed transit-based origin-destination travel time matrices based on the detailed trip information, including in-vehicle and out-of-vehicle travel time. Accessibility scores were calculated by counting the number of dental clinics that can be reached within 60 min. Regression analysis was used to measure factors associated with accessibility scores to dental clinics participating in Medicaid.

Results: Residents in smaller regions spent longer travel time to dental clinics by public transit compared with those who resided in larger regions. Medicaid participants also faced longer travel time compared with the general population. Residents spent more than three-fourths of the time waiting for public transit and walking to clinics regardless of where they live and what type of insurance they have. Associations between sociodemographic factors and accessibility scores to dental clinics participating in the Medicaid dental program varied across regions.

Conclusions: Disparities in dental care accessibility exist depending on the size of regions and Medicaid participation in Virginia. The disparities in transit-based access to dental clinics and a disproportionate amount of time spent waiting for public transit and walking to dental clinics could be improved through tailored interventions taking into account the sociodemographic and geographic characteristics of each region.

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牙科保健中的差异导航--基于弗吉尼亚州牙科保健的公交调查。

目标：为确定弗吉尼亚州牙科保健服务有限的脆弱地区和人群，该研究旨在：（1）使用基于交通的可达性模型，计算弗吉尼亚州所有牙科诊所和参与医疗补助牙科项目的牙科诊所的旅行时间和牙科保健服务可达性得分；（2）估计与弗吉尼亚州参与医疗补助牙科项目的牙科诊所可达性相关的因素：方法：该研究使用建筑物足迹作为前往牙科保健服务（或目的地）的公交出行的起点。然后，研究根据详细的行程信息，包括车内和车外的旅行时间，计算出基于交通的起点-终点旅行时间矩阵。通过计算 60 分钟内可到达的牙科诊所数量，计算出了可达性得分。回归分析用于衡量与参与医疗补助计划的牙科诊所可及性得分相关的因素：结果：与居住在较大地区的居民相比，居住在较小地区的居民乘坐公共交通前往牙科诊所所花费的时间更长。与普通居民相比，医疗补助计划的参与者也需要花费更长的旅行时间。无论居民居住在哪里，也无论他们拥有哪种保险，他们都要花费四分之三以上的时间等待公共交通或步行前往诊所。不同地区的社会人口因素与参与医疗补助牙科项目的牙科诊所可及性得分之间的关系各不相同：在弗吉尼亚州，牙科保健可及性方面存在着差异，这取决于地区的大小和医疗补助计划的参与情况。考虑到各地区的社会人口和地理特征，可以通过量身定制的干预措施来改善牙科诊所交通可达性方面的差异，以及花在等待公共交通和步行前往牙科诊所上的过多时间。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Community dentistry and oral epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

4.40

自引率

8.70%

发文量

审稿时长

6 months

期刊介绍： The aim of Community Dentistry and Oral Epidemiology is to serve as a forum for scientifically based information in community dentistry, with the intention of continually expanding the knowledge base in the field. The scope is therefore broad, ranging from original studies in epidemiology, behavioral sciences related to dentistry, and health services research through to methodological reports in program planning, implementation and evaluation. Reports dealing with people of all age groups are welcome. The journal encourages manuscripts which present methodologically detailed scientific research findings from original data collection or analysis of existing databases. Preference is given to new findings. Confirmations of previous findings can be of value, but the journal seeks to avoid needless repetition. It also encourages thoughtful, provocative commentaries on subjects ranging from research methods to public policies. Purely descriptive reports are not encouraged, nor are behavioral science reports with only marginal application to dentistry. The journal is published bimonthly.