The Economic Toll of Inequitable Dental Care Access: A Welfare Analysis of Racial and Ethnic Disparities
Chunxi Guo, John A. RizzoABSTRACT
Objective
To conduct a formal welfare analysis quantifying the economic costs of racial and ethnic disparities in dental care access among Hispanic and non‐Hispanic Black, Asian, and multiracial adults relative to non‐Hispanic White individuals in the United States.
Study Setting and Design
Cross‐sectional, observational study using pooled nationally representative data from the 2014 to 2023 Medical Expenditure Panel Survey (MEPS). Two‐part models were employed: generalized linear model (GLM) with log link for the probability of any dental visit and generalized linear gamma regression models with log link for modeling visit frequency, total annual expenditures, and expenditure per visit among users.
Data Sources
MEPS Full‐Year Consolidated Data Files, 2014–2023. The final pooled cross‐sectional analytic sample included 205,894 respondents aged 18 and older, representing a survey‐weighted annual population of 251,029,718 US adults. Dollar figures are in constant 2023 US dollars.
Principal Findings
All examined minority groups experienced lower dental care access and higher expenditure per visit compared with White individuals. Estimated aggregate annual welfare losses ranged from $8.23 to $12.93 billion for Hispanics, $6.44 to $9.84 billion for non‐Hispanic Blacks, $2.82 to $4.30 billion for Asians, and $1.57 to $2.57 billion for individuals of other or multiple racial identities (total $19.06–$29.64 billion).
Conclusions
Dental care disparities persist after adjusting for socioeconomic, demographic, and health characteristics, generating large aggregate welfare losses for minority communities. Addressing provider diversity, cultural competency, and structural barriers is essential to reducing these inequities.