"Use of oral health care services in the United States: unequal, inequitable—a cross-sectional study"
- Maiya Varma
- May 29
- 3 min read
This study provides a nuanced statistical and conceptual evaluation of how dental care access in the United States is shaped by social and structural forces, offering important insights when viewed through an anthropological lens. Rather than presenting disparities in dental visiting as isolated data points, the authors trace how education and income systematically pattern both the likelihood of visiting a dentist and the fairness with which care is distributed. Anthropology interprets these findings not as mere inequalities in behavior but as manifestations of deeper inequities embedded in the social fabric of American life.
The analysis distinguishes between inequality and inequity, a critical anthropological distinction. Inequality reflects measurable differences across groups, while inequity introduces the ethical and structural dimensions of fairness. Using statistical models that account for health-related need, the study demonstrates that individuals with lower education and income are not only less likely to visit the dentist but are also receiving less care than would be expected based on their level of need. This misalignment directly challenges the idea of equal opportunity in health and reinforces the anthropological understanding that access to care is mediated by more than personal choices. It is shaped by an individual’s location within systems of privilege and deprivation.
Anthropologists emphasize that oral health should not be seen in isolation but as part of a person’s broader social environment. The findings show that individuals who report pain, embarrassment, or functional difficulty related to oral health are still less likely to visit the dentist if they are poor or have low education. This disconnect reveals how structural conditions, such as lack of insurance, geographic inaccessibility, and cultural or linguistic barriers, undermine people’s capacity to act on their own health needs. The fact that those with the greatest burden of disease are the least likely to access care reflects a failure not of individual initiative but of public health systems to equitably allocate resources.
Language, citizenship, and race were also closely associated with lower dental visiting rates. These results echo longstanding anthropological critiques of how the healthcare system in the United States marginalizes immigrants, non-English speakers, and racially minoritized populations. The article’s data suggests that these populations face cumulative disadvantage, both in the social determinants that shape oral health and in their ability to secure treatment. The concept of structural violence becomes especially relevant here, as these individuals are not directly harmed by an individual actor, but by the way systems distribute care unequally based on social position.
The finding that wealthier and more educated individuals are more likely to receive dental care than their level of need would suggest, while poorer individuals receive less care despite greater need, speaks to a broader anthropological critique of biomedical individualism. Access to oral health care is too often framed as a matter of personal responsibility, yet this study reveals that people’s ability to act on health behaviors is deeply constrained by their structural realities. Education not only influences literacy but signals class status and social capital, which shape a person’s navigation of and inclusion within healthcare institutions.
The authors’ conclusion, that reducing disparities requires action in the social and political spheres, aligns with the anthropological call to address root causes rather than only downstream effects. Structural interventions, such as public dental insurance, inclusive care models, and culturally responsive outreach, are essential for closing gaps that are otherwise perpetuated by ignoring the role of systemic disadvantage.
This study ultimately demonstrates that dental visiting patterns in the United States are not random but socially structured. Anthropology situates these patterns within a broader critique of how modern health systems continue to mirror and reproduce inequalities along lines of class, race, education, and citizenship. In this context, oral health inequity is not simply an outcome to be measured. It is a window into how justice is or is not delivered through healthcare.
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