title: Insurance-related barriers to accessing dental care among African American adults with oral health symptoms in Harlem, New York City.
abstract: Although ability to pay is associated with dental care utilization, provision of public or private dental insurance has not eliminated dental care disparities between African American and White adults. We examined insurance-related barriers to dental care in interviews with a street-intercept sample of 118 African American adults in Harlem, New York City, with recent oral health symptoms. Although most participants reported having dental insurance (21% private, 50% Medicaid), reported barriers included (1) lack of coverage, (2) insufficient coverage, (3) inability to find a dentist who accepts their insurance, (4) having to wait for coverage to take effect, and (5) perceived poor quality of care for the uninsured or underinsured. These findings provide insights into why disparities persist and suggest strategies to removing these barriers to dental care.
authors.affiliation: Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA. es458@columbia.edu
authors.forename: Eric W
authors.initials: EW
authors.lastname: Schrimshaw
authors.forename: Karolynn
authors.initials: K
authors.lastname: Siegel
authors.forename: Natalie H
authors.initials: NH
authors.lastname: Wolfson
authors.forename: Dennis A
authors.initials: DA
authors.lastname: Mitchell
authors.forename: Carol
authors.initials: C
authors.lastname: Kunzel
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D003729:Dental Care / Q000191:economics / Q000706:statistics & numerical data*; D005250:Fees, Dental; D005260:Female; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D007347:Insurance, Dental; D008297:Male; D008484:Medicaid; D017057:Medically Uninsured; D008875:Middle Aged; D009519:New York City; D010510:Periodontal Diseases / Q000191:economics / Q000628:therapy; D014076:Tooth Diseases / Q000191:economics / Q000628:therapy; D014481:United States; D055815:Young Adult