Explaining racial/ethnic disparities in children's dental health: A decomposition analysis

Objectives: We measured racial/ethnic inequalities in US children's dental health and quantified the contribution of conceptually relevant factors. Methods: Using data from the 2007 National Survey of Children's Health, we investigated racial/ethnic disparities in selected child dental health and preventive care outcomes. We employed a decomposition model to quantify demographic, socioeconomic, maternal health, health insurance, neighborhood, and geographic effects. Results: Hispanic children had the poorest dental health and lowest preventive dental care utilization, followed by Black then White children. The model explanatory variables accounted for 58% to 77% of the disparities in dental health and 89% to 100% of the disparities in preventive dental care. Socioeconomic status accounted for 71% of the gap in preventive dental care between Black children and White children and 55% of that between Hispanic children and White children. Maternal health, age, and marital status; neighborhood safety and social capital; and state of residence were relevant factors. Conclusions: Reducing US children's racial/ethnic dental health disparities- which are mostly socioeconomically driven-requires policies that recognize the multilevel pathways underlying them and the need for household- and neighborhood- level interventions.