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Dental service utilization and neighborhood characteristics in young adults in the United States: a multilevel approach. J Public Health Dent 2015;75(4):282-90 PMID: 25929275

Pubmed ID



OBJECTIVE: To investigate the association between neighborhood level factors and dental visits in young adults in the United States after adjusting for individual level factors.

METHODS: The National Longitudinal Study of Adolescent Health Wave 1 (1994-1995) to Wave III (2001-2002) was analyzed. The primary outcome of having had at least one dental visit in the previous 12 months was analyzed via a multilevel random-effects logistic model accounting for geographic clustering in Wave III and survey design clustering from Wave I. Neighborhood level covariates were defined at the census tract level.

RESULTS: Overall rate of dental visits was 57 percent, highest among 18-20 year olds (65 percent) and lowest in 23-26 year olds (52 percent). Increased proportion of African-Americans (≤5 percent to ≥20 percent) and Hispanics (≤5 percent to ≥20 percent) in a neighborhood corresponded with a decrease in dental visits (60 percent versus 52 percent) and (58 percent versus 51 percent), respectively. Neighborhoods with a high proportion of college-educated residents had a higher percentage of dental visits. Similar differences were found when comparing the lowest and highest tertiles defined by poverty level and unemployment with dental visits. Neighborhood education was significantly associated with dental service utilization after adjustment for individual level factors and dental utilization in adolescence (Waves I and II) in the random effects model.

CONCLUSIONS: This study demonstrates that the education level of residents within a neighborhood was associated with dental service utilization in young adults in the United States.

Author List

Okunseri C, Garcia RI, Okunseri E, Visotcky A, Szabo A


Christopher Okunseri DDS,MS Associate Professor and Director in the Clinical Services department at Marquette University
Aniko Szabo PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin


2-s2.0-84959151977   3 Citations

MESH terms used to index this publication - Major topics in bold

Dental Health Services
Residence Characteristics
United States
Young Adult
jenkins-FCD Prod-299 9ef562391eceb2b8f95265c767fbba1ce5a52fd6