ArticleCommunity dentistry and oral epidemiology2017
Dental workforce availability and dental services utilization in Appalachia: a geospatial analysis.
Article in Community dentistry and oral epidemiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- A Cross-Sectional Investigation of Rural Dental Practice as Related to Gender, Hometown, and Career Stage.Journal of public health dentistry · 2026Article
- Spatial econometric analysis of health workforce distribution and its influencing factors in Inner Mongolia, China.PloS one · 2026Article
- Applications of spatial autocorrelation in global dentistry: a scoping review.BMC oral health · 2025Article
- Understanding inequitable health care: methodological approaches, challenges, and opportunities.American journal of epidemiology · 2025Article
- Comparison of the distribution of the dental hygienist workforce and population in Ontario: a geospatial analysis.BMC oral health · 2025Article
- The uneven playing field: provider participation and regional disparities in oral health examination rates in Korea.Epidemiology and health · 2025Article
- Identification and assessment of factors that impact the demand for and supply of dental hygienists amidst an evolving workforce context: a scoping review.BMC oral health · 2024Article
- The role of mesolevel characteristics of the health care system and socioeconomic factors on health care use - results of a scoping review.International journal for equity in health · 2024Article
- Characteristics of Medical Deserts and Approaches to Mitigate Their Health Workforce Issues: A Scoping Review of Empirical Studies in Western Countries.International journal of health policy and management · 2023Article
- The impact of out-of pocket payments of households for dental healthcare services on catastrophic healthcare expenditure in Iran.BMC public health · 2021Article
- Regional Inequality in Dental Care Utilization in Japan: An Ecological Study Using the National Database of Health Insurance Claims.The Lancet regional health. Western Pacific · 2021Article
- County-level correlates of dental service utilization for low income pregnant women. Ecologic study of the North Carolina Medicaid for Pregnant Women (MPW) program.BMC health services research · 2021Article
- Geographic Information Systems in Spatial Epidemiology: Unveiling New Horizons in Dental Public Health.Journal of International Society of Preventive & Community DentistryReview
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Authors and funding
3 authors.
Funding
Abstract
objectivesThere is considerable variation in dental services utilization across Appalachian counties, and a plausible explanation is that individuals in some geographical areas do not utilize dental care due to dental workforce shortage. We conducted an ecological study on dental workforce availability and dental services utilization in Appalachia.
methodsWe derived county-level (n = 364) data on demographic and socioeconomic characteristics and dental services utilization in Appalachia from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) using person-level data. We obtained county-level dental workforce availability and physician-to-population ratio estimates from Area Health Resources File and linked them to the county-level BRFSS data. The dependent variable was the proportion using dental services within the last year in each county (ranging from 16.6% to 91.0%). We described the association between dental workforce availability and dental services utilization using ordinary least squares regression and spatial regression techniques. Spatial analyses consisted of bivariate local indicators of spatial association (LISA) and geographically weighted regression (GWR).
resultsBivariate LISA showed that counties in the central and southern Appalachian regions had significant (P < 0.05) low-low spatial clusters (low dental workforce availability, low percent dental services utilization). GWR revealed considerable local variations in the association between dental utilization and dental workforce availability. In the multivariate GWR models, 8.5% (t-statistics > 1.96) and 13.45% (t-statistics > 1.96) of counties showed positive and statistically significant relationships between the dental services utilization and workforce availability of dentists and dental hygienists, respectively.
conclusionsDental workforce availability was associated with dental services utilization in the Appalachian region; however, this association was not statistically significant in all counties. The findings suggest that program and policy efforts to improve dental services utilization need to focus on factors other than increasing the dental workforce availability for many counties in Appalachia.
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