Date of Conferral

10-17-2025

Degree

Ph.D.

School

Health Services

Advisor

Miriam Ross

Abstract

Oral health disparities continue to present a significant public health challenge for older adults in the United States, particularly among racial minority and low-income populations. Despite national discussions around healthcare equity, there remains limited empirical insight into how race and income influence dental service utilization among Medicare beneficiaries. In this quantitative, cross-sectional study, the extent to which these demographic factors predicted oral healthcare utilization, using nationally representative data from the 2021 Medicare Current Beneficiary Survey, was assessed. Guided by the social determinants of health framework, chi-square tests, binary logistic regression, and negative binomial regression were performed to analyze the data. Findings revealed that both race and income were significant predictors of whether older adults used dental care. Non-Hispanic Black beneficiaries had 49% lower odds of utilization compared to non-Hispanic White counterparts (OR = 0.51, p < .001), and those with household incomes below $25,000 had 70% lower odds of utilization compared to higher income adults (OR = 0.30, p < .001). Among utilizers, income remained significant, with higher income adults reporting more visits (Incidence Rate Ratio (IRR) = 1.37, p=.015), while race was not significant once access was established. These results highlight systemic inequities in access and underscore the need for policy reforms, such as expanding Medicare dental benefits and implementing culturally responsive outreach strategies, contributing to the evidence base needed to inform equitable health interventions for aging populations and promote positive social change.

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