Methods. Using a sample of Medicaid enrollees aged 18 and older drawn from the 2017 California Health Interview Study (CHIS; N = 4779), the present study examined the rates of discriminatory healthcare experiences and use of dental services, as well as the effect of discriminatory experiences on dental service use. A logistic regression model of dental service use was tested to estimate the odds associated with discriminatory experiences after adjusting for covariates (age, gender, marital status, race/ethnicity, education, English proficiency, and self-rated teeth condition).
Results. More than 60% of Medicaid enrollees were female, about 75% were unmarried, and more than half (51.1%) reported an education of high school graduation or less. Nearly 64% of the sample reported having been treated unfairly when getting medical care over their entire life, and about 60% used dental service in the past year. Prior experience of discrimination reduced the odds of using dental service by 18% (Odds Ratio = 0.82, 95% Confidence Interval = 0.72−0.93, p < .01). Being female, Hispanic or African American (vs. White), married, and more educated increased the odds of using dental service, whereas limited English proficiency and fair/poor ratings of teeth condition reduced the odds.
Conclusions and Implications. The study identified prior experiences of healthcare discrimination as a service barrier that decreases the odds of Medicaid enrollees using their entitled dental benefits. Findings provide implications for promoting the use of dental care services among adults who are often socially disadvantaged and determining more efficient management of public healthcare expenditures.