Access to Dental Care for Rural Veterans

Background and Purpose  Rural residents are overrepresented in the military; however access to Veteran services is limited in rural areas.  There is a need to identify rural Veteran healthcare utilization.  This study addresses that need and has two purposes:  1) to determine if there is an association between rural dwelling and Veteran utilization of dental services; and, 2) to determine if there is an association between rural dwelling and the oral health outcome of missing teeth. 

Methods Data from the 2014 Behavioral Risk Factor Surveillance Survey (BRFSS) were used in this study.  Chi square and logistic regression analyses were conducted.

Results Rural Veterans were less likely to have a dental visit during the previous year as compared with metropolitan Veterans in unadjusted analysis (Odds Ratio = 0.71, 95% Confidence Interval, 0.64, 0.77) and in adjusted analysis (0.87 [95% Confidence Interval, 0.78, 0.96]).  In cases in which all teeth were missing, rural Veterans had an unadjusted odds ratio of 1.79 [95% Confidence Interval, 1.55, 2.08] and an adjusted odds ratio of 1.37 [95% Confidence Interval, 1.17, 1.62] as compared with metropolitan Veterans. 

Conclusions and Policy Implications  The Veterans Health Administration develops policies for establishing centers for care for Veterans both in the VA as well as through the Choice Act to allow Veteraens to be seen in the community.  The policy development should take into consideration that rural veterans have not been as likely as urban Veterans to utilize dental services and have poorer oral health outcomes. Social workers need to be aware that Veterans are not all eligible for VA care and they may fall between the cracks of the healthcare system.