Impact of Dental Care Access on Children's Oral Health and Academic Outcomes

获得牙科护理对儿童口腔健康和学业成绩的影响

• 批准号: 10229530
• 负责人: Brandy Lipton
• 金额: $ 15.05万
• 依托单位: SAN DIEGO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-05 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10229530
• 关键词: Academic achievement; Accident and Emergency department; Adult; Affect; Characteristics; Child; Child Health; Childhood; Data Set; Data Sources; Databases; Dental; Dental Care; Dental caries; Dentists; Development; Emergency department visit; Ethnic Origin; Fluoride Varnishes; Fostering; Foundations; Health; Health Services Accessibility; Health Status; Income; Individual; Investments; Learning; Link; Literature; Longitudinal Studies; Low income; Measures; Medicaid; Methods; Mission; Modeling; National Health and Nutrition Examination Survey; National Institute of Dental and Craniofacial Research; National Longitudinal Survey of Youth; Natural experiment; Nursery Schools; Oral health; Outcome; Outcome Measure; Parents; Patient Self-Report; Performance; Period Analysis; Pit and Fissure Sealants; Policies; Primary Health Care; Productivity; Race; Records; Reporting; Research; Research Design; Research Support; Role; Schools; Services; Strategic Planning; Subgroup; Surveys; Testing; Time; Time trend; Tooth structure; Variant; Visit; Work; achievement test; age group; base; care providers; cognitive skill; cohort; design; disparity reduction; early childhood; experience; health disparity; health plan; human capital; improved; interest; kindergarten; novel; oral condition; payment; public health insurance; sex; skills; theories; young adult

PROJECT SUMMARY/ABSTRACT Poor oral health in childhood is correlated with more school absences and lower academic achievement. There is evidence to suggest that state-level Medicaid policies, including payment rates to dentists, adult dental coverage, and coverage of fluoride varnish (FV) application by non-dentist primary care providers, have meaningful effects on the likelihood that low-income children receive recommended dental services. However, little research has linked specific Medicaid policies that increase dental care access to measures of child oral health, and further, no rigorous, large-scale studies with plausibly causal research designs have examined the connection between these policies and academic performance. There is a critical need for rigorous evidence on the potential for state-level policies to achieve improvements in these outcomes. This proposal will provide novel evidence on the link between dental care access and measures of oral health and academic performance using a natural experiment design that leverages state-level variation in Medicaid payment rates to dentists, adult dental coverage, and FV policies during 1999-2016 and large-scale national datasets that include exam-based and administrative outcome measures. Our study period captures a substantial number of state-level changes while also representing a relatively recent time frame. Our analysis will also assess important subgroup differences by child sex, age group, and race and ethnicity. In Aim 1, we will examine the link between each policy and oral health measures including the parent-reported condition of teeth from the National Survey of Children’s Health (NSCH), exam-based objective measures of untreated caries and the presence of dental sealants from the National Health and Nutrition Examination Survey (NHANES), and administrative records of emergency department visits for oral conditions from the State Emergency Department Databases (SEDD). In Aim 2, we will assess the connection between each policy and academic outcomes including school absences, school contacts with parents, parental concern about learning pre-school skills, and grade retention from the NSCH, Peabody Individual Achievement Test scores and grade retention from the National Longitudinal Survey of Youth – Child and Young Adult Cohort (CNLSY), and school absences from the Early Childhood Longitudinal Study – Kindergarten Cohort (ECLS-K). This will be the first national study to estimate the plausibly causal link between increased access to dental care and academic performance among low-income children. This research will provide critical, timely, and policy-relevant new evidence on the effects of increased access to dental care and the role for public health insurance policy.

项目总结/文摘

项目成果

The Association Between Medicaid Adult Dental Coverage And Children's Oral Health.

• DOI: 10.1377/hlthaff.2021.01135
• 发表时间: 2021-11
• 期刊: Health affairs (Project Hope)
• 作者: Lipton BJ;Finlayson TL;Decker SL;Manski RJ;Yang M
• 通讯作者: Yang M

Association Between Medicaid Dental Payment Policies and Children's Dental Visits, Oral Health, and School Absences.

医疗补助牙科支付政策与儿童牙科访问，口腔健康和学校缺勤之间的关联。

• DOI: 10.1001/jamahealthforum.2022.3041
• 发表时间: 2022-09-02
• 期刊: JAMA HEALTH FORUM
• 作者: Lipton, Brandy J;Decker, Sandra L;Stitt, Brittney;Finlayson, Tracy L;Manski, Richard J
• 通讯作者: Manski, Richard J