Table 3.
Bivariate Analysis of the Association of Racial/Ethnicity with Medical and Oral Health, Access to Care, and Use of Services among U.S. Adolescents
| Mean or Proportion | |||||||
|---|---|---|---|---|---|---|---|
| Characteristic | White | Latino | African American | Asian/Pacific Islander | American Indian/Alaska Native | Multiracial | P |
| Medical and oral health status | |||||||
| Health status (%)* | |||||||
| Excellent | 66.1 | 37.9 | 47.3 | 65.2 | 54.1 | 58.3 | <.0001 |
| Very good | 23.4 | 23.0 | 28.6 | 22.2 | 26.1 | 28.9 | |
| Good | 8.8 | 28.6 | 19.6 | 11.5 | 17.5 | 10.5 | |
| Fair | 1.5 | 9.9 | 3.9 | 0.8 | 1.9 | 2.1 | |
| Poor | 0.3 | 0.7 | 0.6 | 0.3 | 0.4 | 0.3 | |
| BMI class (%)† | |||||||
| Underweight | 4.9 | 4.0 | 4.6 | 10.8 | 2.7 | 4.8 | <.0001 |
| Normal | 68.5 | 58.4 | 54.3 | 62.6 | 55.3 | 64.4 | |
| Overweight | 14.7 | 18.7 | 17.7 | 13.0 | 21.7 | 15.6 | |
| Obese | 12.0 | 18.9 | 23.4 | 13.6 | 20.3 | 15.3 | |
| Asthma (%) | 14.0 | 12.7 | 18.6 | 11.7 | 20.0 | 16.8 | .0001 |
| Diabetes (%) | 0.6 | 0.5 | 0.3 | 0.0 | 1.0 | 0.5 | .0423 |
| Headaches (%) | 7.8 | 8.9 | 10.1 | 5.2 | 12.3 | 10.7 | .0476 |
| Hearing/vision problems (%) | 3.3 | 3.5 | 2.1 | 1.0 | 7.7 | 2.7 | <.0001 |
| Bone/joint/muscle problems (%) | 5.2 | 3.4 | 4.4 | 1.5 | 8.7 | 6.8 | .0001 |
| Allergies (%) | |||||||
| Respiratory | 18.8 | 11.5 | 17.4 | 13.3 | 20.0 | 22.7 | .0001 |
| Digestive | 3.1 | 3.0 | 3.3 | 2.7 | 3.2 | 4.4 | .75 |
| Skin | 7.5 | 6.9 | 12.7 | 5.6 | 11.9 | 9.9 | .0001 |
| ≥3 ear infections in past year (%) | 2.6 | 3.3 | 2.2 | 0.2 | 6.3 | 4.1 | .0002 |
| Needs more medical care than others (%) | 13.4 | 11.4 | 11.8 | 3.8 | 19.2 | 15.5 | <.0001 |
| Has limited abilities (%) | 6.3 | 5.4 | 9.3 | 6.9 | 17.2 | 7.8 | .0002 |
| Needs/gets special therapy (%)‡ | 4.8 | 5.4 | 5.1 | 1.7 | 7.2 | 6.6 | .01 |
| Difficulty with emotions, concentration, behavior, or interpersonal relations (%) | 19.5 | 17.5 | 26.2 | 8.3 | 23.8 | 25.5 | <.0001 |
| Behavior problems (%) | 5.9 | 5.7 | 9.6 | 2.6 | 7.2 | 6.8 | .0001 |
| Developmental delay (%) | 4.1 | 1.9 | 2.8 | 1.6 | 3.8 | 3.3 | .0001 |
| Speech problems (%) | 1.8 | 2.6 | 3.3 | 0.8 | 1.5 | 2.7 | .0006 |
| Emotional, developmental, or behavioral problems needing treatment or counseling (%) | 8.7 | 9.1 | 9.2 | 4.7 | 11.1 | 10.1 | .13 |
| Depression/anxiety (%) | 7.4 | 5.4 | 5.0 | 2.2 | 10.0 | 7.5 | .0001 |
| Learning disability (%) | 13.1 | 13.0 | 13.6 | 4.2 | 16.9 | 14.7 | .0001 |
| Teeth condition (%)§ | |||||||
| Excellent | 44.3 | 22.3 | 28.6 | 37.7 | 33.9 | 37.5 | <.0001 |
| Very good | 29.1 | 21.1 | 27.1 | 33.3 | 29.5 | 30.3 | |
| Good | 20.3 | 33.4 | 32.3 | 22.2 | 25.8 | 23.1 | |
| Fair | 5.0 | 18.4 | 10.0 | 4.3 | 6.0 | 6.8 | |
| Poor | 1.3 | 4.9 | 2.0 | 2.5 | 4.8 | 2.3 | |
| Access to medical and dental care | |||||||
| Insurance coverage at time of survey (%) | |||||||
| None | 6.4 | 23.8 | 9.2 | 8.1 | 13.4 | 8.2 | <.0001 |
| Public | 15.7 | 37.3 | 46.0 | 13.0 | 45.2 | 22.8 | |
| Private | 77.2 | 37.5 | 43.5 | 76.2 | 38.8 | 67.7 | |
| Insured, type unknown | 0.7 | 1.4 | 1.3 | 2.7 | 2.7 | 1.4 | |
| Sporadically insured in past year (%) | 8.7 | 16.0 | 14.1 | 12.8 | 16.0 | 11.1 | <.0001 |
| Has dental insurance (%) | 79.2 | 65.1 | 81.5 | 78.7 | 68.5 | 81.9 | <.0001 |
| Has PDN (%) | 88.0 | 65.0 | 74.6 | 85.4 | 68.4 | 81.1 | <.0001 |
| Received all needed medical care (%)¶ | 99.1 | 98.2 | 97.7 | 99.6 | 93.4 | 96.6 | <.0001 |
| Reason for unmet medical care need (%)** | |||||||
| Transportation barrier | 2.4 | 4.3 | 4.2 | 0 | 9.1 | 2.0 | .7665 |
| No insurance | 43.1 | 59.8 | 47.8 | 49.4 | 20.9 | 12.6 | .07 |
| No one accepts child's insurance | 3.3 | 3.5 | 4.2 | 0 | 1.8 | 4.5 | .98 |
| Treatment is ongoing | 2.6 | 3.8 | 0.7 | 0 | 11.3 | 4.1 | .21 |
| Doctor did not know how to provide care | 5.3 | 0.3 | 0.5 | 0 | 1.8 | 8.5 | .03 |
| Health-plan problem | 16.0 | 8.7 | 24.9 | 50.6 | 42.9 | 43.6 | .12 |
| Problems getting specialty care (%) | 20.8 | 36.1 | 25.1 | 48.0 | 48.4 | 23.8 | <.0001 |
| Did not receive all needed prescription medications in past year (%) | 2.3 | 3.4 | 5.3 | 0.9 | 2.6 | 1.8 | <.0001 |
| Received all needed dental care (%)§ | 97.5 | 95.4 | 94.6 | 98.7 | 97.0 | 95.3 | .0001 |
| Reason for unmet dental care need (%)** | |||||||
| Dentist did not know how to provide care | 0.9 | 0.5 | 2.4 | 0 | 0 | 1.1 | .0001 |
| No insurance | 32.6 | 39.9 | 27.1 | 17.2 | 15.4 | 23.1 | .08 |
| Did not know where to go for treatment | 3.9 | 7.2 | 2.3 | 0 | 1.5 | 5.5 | .53 |
| Health-plan problem | 8.9 | 17.6 | 6.6 | 7.3 | 1.3 | 10.3 | .02 |
| Use of medical and dental services | |||||||
| No physician visit in past year (%) | 25.7 | 36.3 | 24.2 | 36.1 | 34.1 | 26.0 | <.0001 |
| No. of ED visits in past year (%) | |||||||
| 0 | 84.0 | 87.7 | 81.8 | 93.7 | 79.5 | 81.3 | <.0001 |
| 1–2 | 14.3 | 10.9 | 15.4 | 5.7 | 17.4 | 16.7 | |
| ≥3 | 1.7 | 1.4 | 2.8 | 0.7 | 3.1 | 2.0 | |
| Received mental health care in past year (%) | 10.7 | 7.7 | 7.3 | 4.0 | 12.3 | 12.4 | <.0001 |
| Never seen dentist (%) | 0.6 | 4.1 | 1.5 | 0.6 | 0.8 | 1.5 | <.0001 |
| No preventive dental visit in past year (%)†† | 4.4 | 12.4 | 12.5 | 9.9 | 15.2 | 6.4 | <.0001 |
| Needs/uses prescription medication (%) | 26.1 | 16.0 | 21.4 | 14.4 | 23.0 | 26.9 | <.0001 |
| Used prescription medication in past year (%) | |||||||
| Yes | 52.6 | 60.9 | 64.8 | 75.7 | 61.5 | 59.7 | <.0001 |
| No, did not need to | 45.1 | 35.7 | 29.9 | 23.4 | 35.9 | 38.5 | |
| No, but needed to | 2.3 | 3.4 | 5.3 | 2.6 | 2.6 | 1.8 | |
*
By parental report.
†
BMI, body mass index; overweight was defined as a BMI = 85–94 percent for age and gender, and obese was defined as a BMI ≥ 95 percent for age and gender.
‡
Includes physical, occupational, or speech therapy.
§
Only if made a dental visit in past 12 months.
¶
Only if made a physician visit in past 12 months.
**
Only access barriers with significant racial/ethnic disparities listed; see text for other barriers.
††
Only among those who have ever made a dental visit.
Source. National Survey of Childhood Health.