RESUMEN
California children suffer more from dental disease than any other chronic childhood disease. Disparities in access and oral health are disproportionately represented among children from minority and low-income families. A comprehensive school-based/linked dental program is one essential ingredient in addressing these problems. Described here are the goals, program elements, and challenges of building a seamless dental services system that could reduce barriers care, maximize resources, and employ best practices to improve oral health.
Asunto(s)
Atención Odontológica Integral , Atención Dental para Niños , Accesibilidad a los Servicios de Salud , Servicios de Odontología Escolar , Adolescente , California , Niño , Defensa del Niño , Servicios de Salud del Niño/economía , Servicios de Salud del Niño/organización & administración , Protección a la Infancia/economía , Protección a la Infancia/legislación & jurisprudencia , Preescolar , Redes Comunitarias , Atención Odontológica Integral/economía , Atención Odontológica Integral/organización & administración , Atención Dental para Niños/economía , Atención Dental para Niños/organización & administración , Caries Dental/prevención & control , Organización de la Financiación/economía , Organización de la Financiación/legislación & jurisprudencia , Educación en Salud Dental/organización & administración , Prioridades en Salud , Recursos en Salud , Accesibilidad a los Servicios de Salud/economía , Accesibilidad a los Servicios de Salud/organización & administración , Necesidades y Demandas de Servicios de Salud , Disparidades en Atención de Salud , Humanos , Lactante , Grupos Minoritarios , Objetivos Organizacionales , Enfermedades Periodontales/prevención & control , Pobreza , Odontología Preventiva/economía , Odontología Preventiva/legislación & jurisprudencia , Desarrollo de Programa , Servicios de Odontología Escolar/economía , Servicios de Odontología Escolar/organización & administraciónRESUMEN
BACKGROUND: Insurance coverage can reduce financial barriers that constitute a significant deterrent to obtaining medical and dental care, especially for children who reside in low-income households. We present baseline information on the codistribution of medical and dental coverage among US children according to sociodemographic characteristics before the enactment of the State Children's Health Insurance Program (SCHIP). METHODS: Data for 27,059 children 0-17 years old from the 1995 National Health Interview Survey (NHIS) were analyzed to examine the distribution of medical and dental insurance coverage by sociodemographic characteristics. Prevalence estimates and adjusted odds ratios with 95 percent confidence intervals were calculated using SUDAAN. RESULTS: Overall, 14.1 percent children were uninsured for medical care and 36.4 were uninsured for dental care; thus, there were 2.6 times as many children uninsured for dental than for medical care. Near-poor and Hispanic children were most likely to be without medical or dental coverage. Near-poor children were more likely to be uninsured for dental care than for medical care (43.8% vs 22.5%). CONCLUSION: Our findings, coupled with previous reports, suggest that the most serious problem concerning lack of dental insurance is among near-poor children. SCHIP has the potential to address dental coverage among near-poor children.