{"title":"Trends in dental care utilization and cost-related access barriers among working-age adults with and without disabilities, 2019-2023.","authors":"Wei Lyu, Jae Chul Lee","doi":"10.1016/j.dhjo.2026.102137","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Adults with disabilities have long faced lower dental utilization and greater cost-related barriers than adults without disabilities, yet the impact of the COVID-19 pandemic on these disparities among working-age adults has not been examined at the population level.</p><p><strong>Objective: </strong>To examine whether disparities in dental care use and cost-related access barriers between working-age adults with and without disabilities changed during the COVID-19 pandemic.</p><p><strong>Methods: </strong>We analyzed nationally representative data from the 2019, 2020, 2022, and 2023 National Health Interview Surveys (adults aged 18-64). Disability was defined using the Washington Group Short Set. Outcomes were three past-12-month measures: dental visit (exam or cleaning) and cost-related delayed and forgone dental care. Stratified weighted logistic regressions estimated average marginal effects relative to 2019, adjusting for demographic and socioeconomic factors.</p><p><strong>Results: </strong>Among adults without disabilities, dental visits remained below 2019 levels in 2020, 2022, and 2023. Among adults with disabilities, dental visits declined in 2020 (-5.3 percentage points [pp]; 95% CI, -9.6 to -1.0) and 2022 (-4.8 pp; 95% CI, -9.2 to -0.5) but recovered by 2023; delayed care fell in 2022 (-4.6 pp; 95% CI, -8.4 to -0.9). Cost-related delayed and forgone care remained substantially higher among adults with disabilities throughout.</p><p><strong>Conclusion: </strong>COVID-19 was associated with larger short-term reductions in dental utilization among working-age adults with disabilities, but their utilization recovered by 2023 while disparities in cost-related unmet dental care persisted. Stabilizing dental care coverage and provider capacity, while protecting access during future public health emergencies, may help reduce these gaps.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"102137"},"PeriodicalIF":3.0000,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Disability and Health Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.dhjo.2026.102137","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Adults with disabilities have long faced lower dental utilization and greater cost-related barriers than adults without disabilities, yet the impact of the COVID-19 pandemic on these disparities among working-age adults has not been examined at the population level.
Objective: To examine whether disparities in dental care use and cost-related access barriers between working-age adults with and without disabilities changed during the COVID-19 pandemic.
Methods: We analyzed nationally representative data from the 2019, 2020, 2022, and 2023 National Health Interview Surveys (adults aged 18-64). Disability was defined using the Washington Group Short Set. Outcomes were three past-12-month measures: dental visit (exam or cleaning) and cost-related delayed and forgone dental care. Stratified weighted logistic regressions estimated average marginal effects relative to 2019, adjusting for demographic and socioeconomic factors.
Results: Among adults without disabilities, dental visits remained below 2019 levels in 2020, 2022, and 2023. Among adults with disabilities, dental visits declined in 2020 (-5.3 percentage points [pp]; 95% CI, -9.6 to -1.0) and 2022 (-4.8 pp; 95% CI, -9.2 to -0.5) but recovered by 2023; delayed care fell in 2022 (-4.6 pp; 95% CI, -8.4 to -0.9). Cost-related delayed and forgone care remained substantially higher among adults with disabilities throughout.
Conclusion: COVID-19 was associated with larger short-term reductions in dental utilization among working-age adults with disabilities, but their utilization recovered by 2023 while disparities in cost-related unmet dental care persisted. Stabilizing dental care coverage and provider capacity, while protecting access during future public health emergencies, may help reduce these gaps.
期刊介绍：
Disability and Health Journal is a scientific, scholarly, and multidisciplinary journal for reporting original contributions that advance knowledge in disability and health. Topics may be related to global health, quality of life, and specific health conditions as they relate to disability. Such contributions include:
• Reports of empirical research on the characteristics of persons with disabilities, environment, health outcomes, and determinants of health
• Reports of empirical research on the Systematic or other evidence-based reviews and tightly conceived theoretical interpretations of research literature
• Reports of empirical research on the Evaluative research on new interventions, technologies, and programs
• Reports of empirical research on the Reports on issues or policies affecting the health and/or quality of life for persons with disabilities, using a scientific base.
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