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September 25, 2001

Shortage of Dentists in Rural, Poor Communities

A shortage of dentists in many communities may contribute to poor access to dental care for many California rural, low-income, and minority residents, according to a new study by UCSF researchers at the Center for the Health Professions.

"We have a crisis in access to care in our state. The numbers of children with untreated dental decay is alarming, particularly in underserved communities," said lead author Elizabeth Mertz, MPA, project director at the Center.

Even more disturbing are the findings that the communities most in need of services are the same communities least likely to have them, according to the study published in the summer quarterly issue of the Journal of Public Health Dentistry.

Access to dental services in California is a public health issue gaining increasing attention. Recent research on the extent of oral health problems has highlighted significant disparities by race and income, both in California and across the nation, Mertz said.

The racial and ethnic composition of the health care workforce is also a public health issue, as minority health care providers are more likely to practice in underserved communities.

The study found that two-thirds of communities without dentists are rural, at least 20 percent of California communities may have a shortage of dentists, and many of the same communities do not enjoy the benefits of fluoridated water.

The study also found that minority dentists are more likely to practice in minority communities, but are a small portion of the dental workforce. "Although this pattern has been previously demonstrated for doctors and nurses, the new study demonstrates this is also true for the dental profession," Mertz said.

Study objectives were to estimate the supply and geographic distribution of dentists in California and to examine the community characteristics associated with the supply of dentists. There were 19,801 dentists in the survey provided by a computerized file from the American Dental Association.

"The plight of rural communities in recruiting and retaining health professionals is not new," Mertz said. "Our research indicated that the under-supply of dentists in rural areas of California is extensive and is not adequately addressed by existing policies to recruit dentists to rural practice."

The report recommends that the issues of access to dentists and oral health care services should be addressed by public policy through programs such as expanded educational opportunities in dentistry for minority students, recruitment of students from rural backgrounds, and targeted dental service programs for the underserved.

"Policies to promote greater participation of underrepresented minorities in dentistry are essential for producing a dental workforce that is responsive to the needs of underserved populations," Mertz added.

Co-author of the report is Kevin Grumbach, MD, director of the UCSF Center for California Health Workforce Studies, and UCSF professor of family and community medicine.

Link:

Center for the Health Professions


 

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