Social and Behavioral Determinants of Dental Care Utilization among Homeless Pregnant Women in the United States.

INTRODUCTION

Despite modest research on oral healthcare during pregnancy, there is a dearth of evidence describing dental care among pregnant women experiencing homelessness. The purpose of this study was to examine associations between dental care utilization and social and behavioral determinants of health among United States (US) pregnant women who experienced homelessness relative to those who did not.

METHODS

This was a cross-sectional study that used data from the 2012-2018 Pregnancy Risk Assessment Monitoring System (PRAMS). The sample consisted of 5,939 homeless and 209,942 non-homeless women. Bivariable and multivariable analyses were conducted to determine associations between dental health-related measures and social and behavioral determinants of health based on whether a woman experienced homelessness 12 months prior to birth.

RESULTS

In this sample, 41.2% of homeless women saw a dentist for a problem while this was true for only 19.1% of women who were not homeless. Approximately 36.4% of women who experienced homelessness did not have their teeth cleaned before pregnancy compared to 25.7% of women who were not homeless. Lack of preventive care, smoking, older age, and experiencing multiple stressors during pregnancy were positively associated with seeing a dentist during pregnancy for both groups of women.

CONCLUSION

The results indicate the need for healthcare providers and policy officials to develop targeted interventions and policies to ensure that dental care is readily accessible for all pregnant women and especially those who are homeless.