Changes in Dental Care Use Following Marital Status Change in the Health and Retirement Study.

Background and objectives: Previous studies have indicated that married people are generally healthier than unmarried people, with lower mortality rates. Most work in this area has employed cross-sectional data, and few studies have examined change in marital status from married to unmarried as a potential social ecological determinant of dental health behavior. Here we used longitudinal data to examine change in dental behavior over time following marital status change, and to explore whether self-reported gender may play a modifying role in any behavioral change.

Research design and methods: Employing panel data from the Healthy Retirement Study (1996-2018) to follow all individuals who entered the study in married/partnered status, and using both two-way fixed effects and group-time average difference-in-difference models, we analyzed the association between any change in marital status and dental care use, compared to individuals who remained married. All analyses were stratified by gender.

Results: Both types of difference-in-difference analyses indicated that both widowhood and divorce were associated with a decrease in dental care use in both genders. Divorced men saw the greatest decrease in dental care use. We found gender had a moderating effect on strength of association in all analyses.

Discussion and implications: This research suggests that any change in marital status from married to unmarried has a detrimental effect on dental health behavior for both genders. Future research might investigate other potential barriers to dental care access these populations might face, in order to develop effective interventions.