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STATISTICAL BRIEF #295:
Dental Coverage of Adults Ages 21 to 64, United States, 1997 and 2007

October 2010

Richard J. Manski, DDS, MBA, PhD and Erwin Brown, Jr., BS

Highlights

Poor adults ages 21-64 were less likely to have private dental coverage and more likely to have no dental coverage in 2007 than 1997.
Low income and middle income adults ages 21-64 were more likely to have public dental coverage only in 2007 than in 1997.
Adults ages 21-64 without dental coverage were less likely to have a dental visit in 2007 than in 1997.

Introduction

The Medical Expenditure Panel Survey Household Component (MEPS-HC) is an annual household survey sponsored by the Agency for Healthcare Research and Quality (AHRQ) that provides useful information for evaluating trends in dental care use and dental coverage status. This Statistical Brief compares full-year estimates from the 1997 and 2007 MEPS-HC on the prevalence of dental coverage and the variation in use of dental services by dental coverage status for adults ages 21 to 64 in the U.S. civilian noninstitutionalized (community) population. Estimates are presented as part of a series of updates to Chartbook 17: Dental Use, Expenses, Dental Coverage, and Changes, 1996 and 2004. Only differences that are statistically significant at the 0.05 level are discussed in the text.

Findings

In 2007, nearly 60 percent of adults age 21-64 (approximately 105 million persons) had private dental coverage for all or part of the year (figure 1a). There was no significant difference in the proportion of adults age 21-64 with private dental coverage, public dental coverage only, and no dental coverage from 1997 to 2007. However, in 2007, a higher percentage of adults ages 21-44 had public dental coverage only than in 1997 (figure 1b). The percentage of adults ages 45-64 with private dental coverage increased from 58.7 percent in 1997 to 61.7 percent in 2007. In addition, there was a decrease in the percentage of adults ages 45-64 with no dental coverage from 1997 to 2007 (figure 1c).

Poor adults ages 21-64 were less likely to have private dental coverage (15.8 percent versus 20.3 percent), and more likely to have no dental coverage (60.6 percent versus 54.8 percent) in 2007 than in 1997 (figure 2a). Low income and middle income adults ages 21-64 were more likely to have public dental coverage only (10.4 percent versus 8.3 percent and 2.4 percent versus 1.5 percent) in 2007 than in 1997 (figures 2b and 2c). Conversely, high income adults were more likely to have private dental coverage (77.6 percent versus 74.5 percent) and less likely to have no dental coverage (21.9 percent versus 25.2 percent) in 2007 than 1997 (figure 2d).

Differences in dental coverage status between 1997 and 2007 did not vary significantly by race/ethnicity (figures 3a-d).

During 2007, adults 21-64 without dental coverage were less likely to have a dental visit in 2007 than in 1997 (21.5 percent versus 25.6 percent, respectively) (figure 4). In 1997 and 2007 there were no significant differences for adults in the same age group with private dental coverage or public dental only coverage.

Data Source

Estimates shown in this Statistical Brief are drawn from analyses of the following public use files: MEPS HC-020: 1997 Full Year Consolidated Data File and MEPS HC-113: 2007 Full Year Consolidated Data File.

Definitions

Dental visit
Dental visit refers to care by or visits to any type of dental care provider, including general dentists, dental hygienists, dental technicians, dental surgeons, orthodontists, endodontists, and periodontists.

Dental coverage variables
The variable for dental coverage indicates if a sample person was eligible to have payments made to a dental care provider on their behalf for dental care obtained for all or part of the year in 1997 and 2007. For a detailed explanation of the dental coverage variables please see MEPS Chartbook No. 17 Definition of Terms, http://www.meps.ahrq.gov/mepsweb/data_files/publications/cb17/cb17.shtml.

Income
Income categories are defined based on the ratio of the family's income to the federal poverty thresholds, which control for the size of the family and the age of the head of the family (see the 2007 U.S. Department of Health and Human Services Poverty Guidelines at http://aspe.hhs.gov/poverty/07poverty.shtml for more details). In this Brief, the following classification was used:

Poor: Persons in families with income less than or equal to 100 percent of the poverty line are considered poor.
Low income: Persons in families with income over 100 percent through 200 percent of the poverty line are considered low income.
Middle income: Persons in families with income over 200 percent through 400 percent of the poverty line are considered middle income.
High income: Persons in families with income over 400 percent of the poverty line are considered high income.

Population characteristics
In general, population characteristics were measured as of December 31st of the year of study (1997 or 2007), or the last date that the sample person was part of the civilian noninstitutionalized (community) population living in the United States prior to December 31st of that year.

Racial and ethnic classifications
New standards for racial and ethnic classifications were used by the Bureau of the Census in the 2000 decennial census. All other federal programs are to adopt the new standards by 2003. These changes conform to the revisions of the standards for the classification of federal data on race and ethnicity promulgated by the Office of Management and Budget (OMB) in October 1997.

For 1996 through 2002, racial and ethnic classifications were Hispanic; white non-Hispanic; black non-Hispanic; and other non-Hispanic. As of 2003, the racial and ethnic classifications are Hispanic or Latino; white non-Hispanic or Latino, single race; black non-Hispanic or Latino, single race; and other races/multiple race non-Hispanic or Latino.

About MEPS-HC

MEPS-HC is a nationally representative longitudinal survey that collects detailed information on health care utilization and expenditures, health insurance, and health status, as well as a wide variety of social, demographic, and economic characteristics for the U.S. civilian noninstitutionalized population. It is cosponsored by the Agency for Healthcare Research and Quality and the National Center for Health Statistics.

For more information about MEPS, call the MEPS information coordinator at AHRQ (301) 427-1656 or visit the MEPS Web site at http://www.meps.ahrq.gov/.

References

For a detailed description of the MEPS-HC survey design, sample design, and methods used to minimize sources of nonsampling errors, see the following publications:

Cohen, J. Design and Methods of the Medical Expenditure Panel Survey Household Component. MEPS Methodology Report No. 1. AHCPR Pub. No. 97-0026. Rockville, MD. Agency for Health Care Policy and Research, 1997. http://www.meps.ahrq.gov/mepsweb/data_files/publications/mr1/mr1.shtml

Ezzati-Rice, T.M., Rhode, F., Greenblatt J. Sample Design of the Medical Expenditure Panel Survey Household Component, 1998-2007. Methodology Report No. 22. March 2008. Agency for Healthcare Research and Quality, Rockville, MD. http://www.meps.ahrq.gov/mepsweb/data_files/publications/mr22/mr22.shtml

Manski, R.J., Brown, E. Dental Use, Expenses, Private Dental Coverage, and Changes, 1996 and 2004. Rockville, MD. Agency for Health Care Research and Quality, 2007. MEPS Chartbook No.17. http://www.meps.ahrq.gov/mepsweb/data_files/publications/cb17/cb17.shtml

Suggested Citation

Manski, R.J. and Brown, E. Dental Coverage of Adults Ages 21-64, United States, 1997 and 2007. Statistical Brief #295. October 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.meps.ahrq.gov/mepsweb/data_files/publications/st295/stat295.shtml

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AHRQ welcomes questions and comments from readers of this publication who are interested in obtaining more information about access, cost, use, financing, and quality of health care in the United States. We also invite you to tell us how you are using this Statistical Brief and other MEPS data and tools and to share suggestions on how MEPS products might be enhanced to further meet your needs. Please e-mail us at mepspd@ahrq.gov or send a letter to the address below:

Steven B. Cohen, PhD, Director
Center for Financing, Access, and Cost Trends
Agency for Healthcare Research and Quality
540 Gaither Road
Rockville, MD 20850

Figure data for accessible table follows the image

	Private dental coverage	Public dental coverage only	No dental coverage
Figure 1a. Percentage of adults ages 21-64 according to dental coverage status: U.S. civilian noninstitutionalized population, 1997 and 2007
1997	58.8%	4.5%	36.6%
2007	59.5%	5.0%	35.5%
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, MEPS HC-020: 1997 Full Year Consolidated Data File and MEPS HC-113: 2007 Full Year Consolidated Data File

	Private dental coverage	Public dental coverage only	No dental coverage
Figure 1b. Percentage of adults ages 21-44 according to dental coverage status: U.S. civilian noninstitutionalized population, 1997 and 2007
1997	58.9%	4.9%	36.2%
2007	57.7%	5.9%	36.4%
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, MEPS HC-020: 1997 Full Year Consolidated Data File and MEPS HC-113: 2007 Full Year Consolidated Data File

	Private dental coverage	Public dental coverage only	No dental coverage
Figure 1c. Percentage of adults ages 45-64 according to dental coverage status: U.S. civilian noninstitutionalized population, 1997 and 2007
1997	58.7%	3.9%	37.4%
2007	61.7%	3.9%	34.4%
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, MEPS HC-020: 1997 Full Year Consolidated Data File and MEPS HC-113: 2007 Full Year Consolidated Data File

	Private dental coverage	Public dental coverage only	No dental coverage
Figure 2a. Percentage of poor adults ages 21-64 according to dental coverage status: U.S. civilian noninstitutionalized population, 1997 and 2007
1997	20.3%	25.0%	54.8%
2007	15.8%	23.6%	60.6%
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, MEPS HC-020: 1997 Full Year Consolidated Data File and MEPS HC-113: 2007 Full Year Consolidated Data File

	Private dental coverage	Public dental coverage only	No dental coverage
Figure 2b. Percentage of low family income adults ages 21-64 according to dental coverage status: U.S. civilian noninstitutionalized population, 1997 and 2007
1997	38.5%	8.3%	53.3%
2007	35.3%	10.4%	54.2%
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, MEPS HC-020: 1997 Full Year Consolidated Data File and MEPS HC-113: 2007 Full Year Consolidated Data File

	Private dental coverage	Public dental coverage only	No dental coverage
Figure 2c. Percentage of middle family income adults ages 21-64 according to dental coverage status: U.S. civilian noninstitutionalized population, 1997 and 2007
1997	61.2%	1.5%	37.3%
2007	60.3%	2.4%	37.3%
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, MEPS HC-020: 1997 Full Year Consolidated Data File and MEPS HC-113: 2007 Full Year Consolidated Data File

	Private dental coverage	Public dental coverage only	No dental coverage
Figure 2d. Percentage of high income adults ages 21-64 according to dental coverage status: U.S. civilian noninstitutionalized population, 1997 and 2007
1997	74.5%	0.3%	25.2%
2007	77.6%	0.5%	21.9%
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, MEPS HC-020: 1997 Full Year Consolidated Data File and MEPS HC-113: 2007 Full Year Consolidated Data File

	Private dental coverage	Public dental coverage only	No dental coverage
Figure 3a. Percentage of black non-Hispanic adults ages 21-64 according to dental coverage status: U.S. civilian noninstitutionalized population, 1997 and 2007
1997	51.7%	8.6%	39.7%
2007	55.2%	8.4%	36.4%
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, MEPS HC-020: 1997 Full Year Consolidated Data File and MEPS HC-113: 2007 Full Year Consolidated Data File

	Private dental coverage	Public dental coverage only	No dental coverage
Figure 3b. Percentage of Hispanic adults ages 21-64 according to dental coverage status: U.S. civilian noninstitutionalized population, 1997 and 2007
1997	40.1%	8.1%	51.8%
2007	38.3%	8.2%	53.5%
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, MEPS HC-020: 1997 Full Year Consolidated Data File and MEPS HC-113: 2007 Full Year Consolidated Data File

	Private dental coverage	Public dental coverage only	No dental coverage
Figure 3c. Percentage of white non-Hispanic adults ages 21-64 according to dental coverage status: U.S. civilian noninstitutionalized population, 1997 and 2007
1997	62.9%	3.2%	33.8%
2007	64.5%	3.6%	31.9%
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, MEPS HC-020: 1997 Full Year Consolidated Data File and MEPS HC-113: 2007 Full Year Consolidated Data File

	Private dental coverage	Public dental coverage only	No dental coverage
Figure 3d. Percentage of other non-Hispanic adults ages 21-64 according to dental coverage status: U.S. civilian noninstitutionalized population, 1997 and 2007
1997	56.5%	6.3%	37.1%
2007	62.9%	6.2%	30.8%
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, MEPS HC-020: 1997 Full Year Consolidated Data File and MEPS HC-113: 2007 Full Year Consolidated Data File

	Overall	Private dental coverage	Public dental coverage only	No dental coverage
Figure 4. Percentage of adults ages 21-64 with a dental visit by dental coverage status: U.S. civilian noninstitutionalized population, 1997 and 2007
1997	42.9%	54.8%	27.0%	25.6%
2007	42.2%	55.6%	29.4%	21.5%
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, MEPS HC-020: 1997 Full Year Consolidated Data File and MEPS HC-113: 2007 Full Year Consolidated Data File

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STATISTICAL BRIEF #295: Dental Coverage of Adults Ages 21 to 64, United States, 1997 and 2007