Dental utilization by adult Hispanic agricultural workers in California's central valley

Objective: To examine past year dental visits among underserved, Hispanic farmworkers using the Andersen Behavioral Model of Health Services Utilization, which posits that predisposing, enabling, and need factors influence care-seeking behavior.

Methods: Oral health survey and clinical data were collected in 2006-7 from families in Mendota, California (Fresno County) as part of a larger, population-based study (USDHHS/NIH#U54DE14251, NIOSH#2U50OH007550-06 & California Endowment). Nested logistic regression analyses assessed effects of predisposing, enabling, and need factors on the likelihood of a dental visit among adults (N=195, initial subset with complete interview data). Predisposing variables included socio-demographic characteristics. Enabling factors included available resources to obtain services (like dental insurance, income). Need included perceived dental status, symptoms, and Oral Health Impact Profile (OHIP-14).

Results: Preliminary findings indicated that 40% had a prior year dental visit, 47% had a regular dental care source, and 64% lacked dental insurance. Most (70%) self-rated their oral health as fair/poor, 85% had dental needs, and on average, suffered 3.6 symptoms (of 11 queried).

Preliminary regression models indicated those with more dental symptoms were less likely to have a past year dental visit (Odds Ratio (OR) = 0.74, 95% confidence interval (CI) 0.64-0.89, p<.01). Those with greater subjective socioeconomic status (OR = 1.30, 95% CI 1.01-1.67, p<.05) and with a regular source of dental care (OR = 5.03, 95% CI 2.10-12.08, p<.01) were more likely to visit the dentist.

Conclusions: Dental symptoms were prevalent in this sample. Enabling factors were positively associated and need factors were negatively associated with dental visits.