|September 25, 2001
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,
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
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.
Center for the Health Professions