Predictors of dental care utilization among working poor Canadians.
OBJECTIVE
This study used the Gelberg-Andersen Behavioral Model for Vulnerable Populations to identify predictors of dental care utilization by working poor Canadians.


METHODS
A cross-sectional stratified sampling study design and telephone survey methodology was used to collect data from a nationally representative sample of 1049 working poor individuals aged 18 to 64 years. Working poor persons worked > or = 20 h a week, were not full-time students and had annual family incomes <$34,300. A pretested questionnaire included sociodemographic items, self-reported oral health measures and two dental care utilization outcomes: time since their last dental visit and the usual reason for dental visits.


RESULTS
Hierarchical stepwise logistic analyses identified independent predictors associated with visiting the dentist >1 year ago: male gender (OR = 1.63; P = 0.005), aged 25-34 years (OR = 2.05; P = 0.02), paying for dental care with cash or credit (OR = 2.31; P < 0.001), past welfare recipients (OR = 1.65; P = 0.03), <21 teeth (OR = 4.23; P < 0.001) and having a perceived need for dental treatment (OR=2.78; P < 0.001). Sacrificing goods or services to pay for dental treatment was associated with visiting the dentist within the past year. The predictors of visiting the dentist only when in pain/trouble were lone parent status (OR = 4.04; P < 0.001), immigrant status (OR = 1.72; P = 0.006), paying for dental care with cash or credit (OR = 2.71; P < 0.001), a history of an inability to afford dental care (OR = 1.62; P = 0.01), a satisfactory/poor/very poor self-rated oral health (OR = 2.10; P < 0.001), number of teeth <21 (OR = 2.58; P < 0.001) and having a perceived need for dental treatment (OR = 2.99; P < 0.001).


CONCLUSIONS
This study identified predisposing and enabling vulnerabilities that jeopardize the dental care-seeking practices of working poor persons. Dental care utilization was associated with relinquishing spending on other goods and services, which suggests that dental care utilization is a competing financial demand for economically constrained adults.
Muirhead
V E
VE
Faculty of Dentistry, Division of Oral Health and Society, McGill University, Montreal, QC, Canada. vanessa.muirhead@mail.mcgill.ca
Quiñonez
C
C
Figueiredo
R
R
Locker
D
D
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002170:Canada; D003430:Cross-Sectional Studies; D003729:Dental Care / Q000191:economics / Q000706:statistics & numerical data*; D054242:Emigrants and Immigrants; D004651:Employment; D005260:Female; D005382:Financing, Personal; D005544:Forecasting; D006301:Health Services Needs and Demand; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D009909:Oral Health; D011203:Poverty; D011632:Public Assistance / Q000191:economics; D012649:Self Concept; D012737:Sex Factors; D020954:Single-Parent Family; D013997:Time Factors; D016388:Tooth Loss / Q000145:classification; D035862:Vulnerable Populations; D055815:Young Adult