The military oral health care system as a model for eliminating disparities in oral health.
BACKGROUND
Healthy People (HP) 2010 is a national health promotion and disease prevention initiative of the U.S. Department of Health and Human Services. The HP 2010 report highlighted a range of racial/ethnic disparities in dental health. A substantial portion of these disparities appear to be explained by differences in access to care. Members of the U.S. military have universal access to care that also has a compulsory component. The authors conducted a study to investigate the extent to which disparities in progress toward achievement of HP 2010 objectives were lower among the military population and to compare the oral health of the military population with that of the civilian population.


METHODS
The participants in this study were non-Hispanic white and non-Hispanic black males aged 18 to 44 years. They were drawn from the Tri-Service Comprehensive Oral Health Survey (10,869 including 899 recruits who participated in the TSCOHS Recruit Study) and the Third National Health and Nutrition Examination Survey (4,779).


RESULTS
We found no disparities between black and white adults in untreated caries and recent dental visit rates in the military population. Disparities in missing teeth were much lower among military personnel than among civilians.


CONCLUSIONS
A universal access-to-care system that incorporated an aspect of compulsory treatment displayed little to no racial disparity in relevant oral health outcomes. This demonstrates that it is possible for large, diverse populations to have much lower levels of disparities in oral health even when universal access to care is not provided until the patient is 18 or 19 years of age.
Hyman
Jeffrey J
JJ
Office of Science Policy and Analysis, National Institute of Dental and Craniofacial Research, 45 Center Drive, Room 4AS-37K, MSC 4601, Bethesda, MD 20892, USA. jh393y@nih.gov
Reid
Britt C
BC
Mongeau
Susan W
SW
York
Andrew K
AK
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D004245:DMF Index; D003729:Dental Care / Q000592:standards* / Q000706:statistics & numerical data; D003731:Dental Caries / Q000453:epidemiology / Q000208:ethnology*; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008885:Military Dentistry / Q000706:statistics & numerical data*; D009749:Nutrition Surveys; D015588:Observer Variation; D009909:Oral Health; D016388:Tooth Loss / Q000453:epidemiology / Q000208:ethnology; D014481:United States / Q000208:ethnology; D044465:White People