Factors associated with use of preventive dental and health services amongUS adolescents

Purpose: To examine adolescents' use of preventive medical and dental servi ces and its relationship to demographic characteristics and other variables reflecting access to and need for care. Methods. Self- and parent-reported data from a sample of 5644 adolescents a ged 11 to 21 years from the National Longitudinal Study of Adolescent Healt h (Add Health). Variables studied include the influence of both the adolesc ents' demographic and socioeconomic characteristics (age, race/ethnicity, p lace of birth, acculturation, insurance status, and perception of health), as well as those of their parents (race/ethnicity, income, level of educati on, place of birth) on their lifetime use and use within the past year of m edical and dental services. Bivariate and logistic regression analyses were conducted using SAS and SUDAAN. Results: Approximately 32% of respondents had not had a physical examinatio n in the year before the survey, and the same percentage had not had a dent al examination. Approximately 2% reported never having had either a physica l or a dental examination. Logistic regression reveals that lack of insuran ce, low family income, and low parental education level are significantly a ssociated with the lack of preventive medical care. Lack of an annual denta l visit was associated with male gender; black, Hispanic, or mixed race/eth nicity; and lack of insurance. Never having had a dental visit was the only dependent variable found to be associated with place of birth. Conclusions: Health insurance and family income are most consistently relat ed to adolescents' use of preventive medical and dental care. However, the relationship between lack of dental care and place of birth emphasizes the need to improve access to dental services for immigrant teens. These findin gs are particularly relevant as states design systems of care for adolescen ts under the State Children's Health Insurance Program. (C) Society for Ado lescent Medicine, 2001.