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The Economic Toll of Inequitable Dental Care Access: A Welfare Analysis of Racial and Ethnic Disparities

  • Stony Brook University

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To conduct a formal welfare analysis quantifying the economic costs of racial and ethnic disparities in dental care access among Hispanic and non-Hispanic Black, Asian, and multiracial adults relative to non-Hispanic White individuals in the United States. Study Setting and Design: Cross-sectional, observational study using pooled nationally representative data from the 2014 to 2023 Medical Expenditure Panel Survey (MEPS). Two-part models were employed: generalized linear model (GLM) with log link for the probability of any dental visit and generalized linear gamma regression models with log link for modeling visit frequency, total annual expenditures, and expenditure per visit among users. Data Sources: MEPS Full-Year Consolidated Data Files, 2014–2023. The final pooled cross-sectional analytic sample included 205,894 respondents aged 18 and older, representing a survey-weighted annual population of 251,029,718 US adults. Dollar figures are in constant 2023 US dollars. Principal Findings: All examined minority groups experienced lower dental care access and higher expenditure per visit compared with White individuals. Estimated aggregate annual welfare losses ranged from $8.23 to $12.93 billion for Hispanics, $6.44 to $9.84 billion for non-Hispanic Blacks, $2.82 to $4.30 billion for Asians, and $1.57 to $2.57 billion for individuals of other or multiple racial identities (total $19.06–$29.64 billion). Conclusions: Dental care disparities persist after adjusting for socioeconomic, demographic, and health characteristics, generating large aggregate welfare losses for minority communities. Addressing provider diversity, cultural competency, and structural barriers is essential to reducing these inequities.

Original languageEnglish
Article numbere70155
JournalHealth Services Research
Volume61
Issue number4
DOIs
StatePublished - Aug 2026

Keywords

  • consumer surplus
  • dental care expenditures
  • dental care utilization
  • economic efficiency
  • two-part models
  • welfare analysis

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