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Dental workforce availability and dental services utilization in Appalachia: a geospatial analysis.
Xue Feng1, Usha Sambamoorthi1, R Constance Wiener2
1Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA.
Dental workforce availability impacts dental service use in Appalachia, but not uniformly. Many counties require solutions beyond just more dentists to improve access to care.
Area of Science:
- Public Health
- Health Services Research
- Rural Health
Background:
- Dental service utilization varies significantly across Appalachian counties.
- Dental workforce shortages are a potential explanation for underutilization of dental care in some areas.
Purpose of the Study:
- To investigate the association between dental workforce availability and dental service utilization in Appalachian counties.
- To identify geographical patterns in dental care access and workforce distribution.
Main Methods:
- Ecological study using county-level data (n=364) from the 2010 Behavioral Risk Factor Surveillance System (BRFSS).
- Data on demographic, socioeconomic characteristics, and dental service utilization were linked with dental workforce availability estimates.
- Spatial regression techniques, including bivariate local indicators of spatial association (LISA) and geographically weighted regression (GWR), were employed.
Main Results:
- Significant low-low spatial clusters of dental workforce availability and service utilization were observed in central and southern Appalachia.
- Geographically weighted regression (GWR) revealed substantial local variations in the workforce-utilization association.
- Multivariate GWR models indicated statistically significant positive relationships between dental service utilization and the availability of dentists (8.5% of counties) and dental hygienists (13.45% of counties).
Conclusions:
- Dental workforce availability is associated with dental service utilization in Appalachia, but this relationship is not consistent across all counties.
- Improving dental service utilization in many Appalachian counties may require addressing factors beyond simply increasing the dental workforce.
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