State-Level Racial Inequity in Children's Dental Care Use in the U.S. and Association with State-Level Structural Racism.

INTRODUCTION

The aims of this study were to estimate state-level racial inequities in dental care use among children in the U.S., overall and by insurance type, and to examine relationships between inequities and state-level structural racism.

METHODS

Pooled 2017-2019 data from the National Survey of Children's Health were used to estimate racial inequities in dental care use. Independent variables included state-level structural racism indicators and other factors.

RESULTS

There was substantial variation in the degree and direction of inequities across states and by insurance type. Inequities were not associated with overall structural racism indices. However, one dimension of structural racism-the Black-White incarceration index-was significantly associated with the Black-White disparity (p=.040).

CONCLUSION

Racial inequities in dental utilization among children varied across states and by insurance status. More research is needed to explore more granular geographic levels of structural racism and relationships with additional dental care access indicators.