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Citation Information

Type Conference Paper - IADR South African Division Meeting & Skills Transfer Workshop
Title Health insurance and preventive dental visit disparities in South Africa
Publication (Day/Month/Year) 2010
City Pretoria
Country/State South Africa
URL http://iadr.confex.com/iadr/saf10/preliminaryprogram/abstract_141228.htm
Objectives: To examine the socioeconomic disparities in preventive dental visits and to assess if enrollment in a private health insurance scheme eliminates socioeconomic disparities in preventive dental visits in a nationally representative sample of adult South Africans (n=8,115). Method: Data are from the South African Demographic and Health survey (SADHS) conducted during 2003-2004. Main outcome measure: reporting making routine yearly dental visits as a preventive measure. Regression analysis was used to assess socioeconomic disparities in preventive dental visits. Education and household crowding indicated socioeconomic position. Sex, age, ethnicity/race, perceived oral health problems, and having a private health insurance were adjusted for in the regression analyses. Regression models not adjusting and adjusting for health insurance were compared to assess the change in socioeconomic disparities in preventive dental visits. Results: Of the respondents, 14.5% reported having a health insurance, while only 4.7% reported making routine yearly dental visit. Health insurance coverage was most common among whites (68.2%) and least common among black South Africans (9.2%). Similarly, a yearly preventive dental visit was most frequently reported by whites (24.5%) and least reported among black South Africans (3%). Lower education, tobacco use and increasing household crowding were associated with lower odds of making yearly preventive dental visits. Compared to the uninsured, those insured were more likely to report preventive dental visits (OR=3.16; 95%CI=2.16-4.64). Having a health insurance eliminated the disparities in utilization of preventive dental care associated with household crowding. However, the observed racial disparities in utilization of preventive dental care although became attenuated, did not disappear even after controlling for insurance coverage. Conclusions: Widening health insurance coverage may lessen, but not eliminate disparities in oral health care, thus the need for broader social and policy interventions to address disparities in oral health among South Africans.

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