Dental care declines in tough times

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When levels of unemployment climb, people tend to neglect their teeth, a study shows—even if insurance coverage is not an issue.

“We know that during an economic downturn, health and health care are going to suffer for those individuals who lose their insurance coverage,” said Dr. Brian C Quinn. However, “even for an insured population,” tough times can have a negative impact on health.

Quinn, at The Robert Wood Johnson Foundation in Princeton, New Jersey and colleagues estimated monthly unemployment rates over time for the metropolitan areas of Seattle and Spokane, Washington, using statistics from the Bureau of Labor and Washington’s Employment Security Department.

The team also assessed monthly preventive dental visits among people with dental insurance who lived in these areas between 1995 and 2004, using data from the largest dental insurer in the state.

Monthly increases in unemployment were associated with decreases in preventive dental visits, the researchers report in the journal Health Services Research.

In Seattle, every increase of 10,000 in the number of unemployed individuals corresponded with 1.24 percent fewer preventive dental visits during that month. A similar unemployment increase in the Spokane area correlated with 5.95 percent fewer preventive dental visits, Quinn’s group reports.

Moreover, these findings persisted when the investigators “changed the measure of unemployment from the number of unemployed individuals to the number of new unemployment insurance claims,” Quinn said.

The researchers conclude that unemployment may “distract” people from making preventive dental visits. Still, they highlight the need for further testing of this association during periods of varying unemployment among both insured and uninsured people living in other parts of the U.S.—so health professionals and policy-makers understand the negative impact an economic downturn can have on preventive health care.

“From a public health perspective,” Quinn commented to Reuters Health, “we want to encourage utilization of services—like preventive dental care—that are highly effective and relatively inexpensive.”

SOURCE: Health Services Research, February 2009.

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