Disparities in Oral Health

Oral health disparities are profound in the United States. Despite major improvements in oral health for the population as a whole, oral health disparities exist for many racial and ethnic groups, by socioeconomic status, gender, age and geographic location

Some social factors that can contribute to these differences are lifestyle behaviors such as tobacco use, frequency of alcohol use, and poor dietary choices. Just like they affect general health, these behaviors can affect oral. The economic factors that often relate to poor oral health include access to health services and an individual’s ability to get and keep dental insurance.

Vulnerable Populations

Some of the oral health disparities that exist include the following:

  • Overall. Non-Hispanic blacks, Hispanics, and American Indians and Alaska Natives generally have the poorest oral health of any racial and ethnic groups in the United States.
  • Children and Tooth Decay. The greatest racial and ethnic disparity among children aged 2–4 years and aged 6–8 years is seen in Mexican American and black, non-Hispanic children.
  • Adults and Untreated Tooth Decay. Blacks, non-Hispanics, and Mexican Americans aged 35–44 years experience untreated tooth decay nearly twice as much as white, non-Hispanics.
  • Tooth Decay and Education. Adults aged 35–44 years with less than a high school education experience untreated tooth decay nearly three times that of adults with at least some college education.  In addition, adults aged 35–44 years with less than a high school education experience destructive periodontal (gum) disease nearly three times that of adults with a least some college education.
  • Adults and Oral Cancer. The 5–year survival rate is lower for oral pharyngeal (throat) cancers among black men than whites (36% versus 61%).

Note:  Be sure to visit the Oral Health in Massachusetts and Reports and Research – Oral Health Access pages to find out more about affected Massachusetts communities and populations.

Healthy People 2010 as a Framework for Improving the Health of all People in the United States

In January 2000, the Department of Health and Human Services launched Healthy People 2010, a comprehensive, nationwide health promotion and disease prevention agenda. Healthy People 2010 contains 467 objectives designed to serve as a framework for improving the health of all people in the United States during the first decade of the 21st century.  Released online October 2011, the Healthy People 2010 Final Review presents a quantitative end-of-decade assessment of progress in achieving the Healthy People 2010 objectives and goals over the course of the decade.

Healthy People 2010 builds on similar initiatives pursued over the preceding two decades. Two overarching goals—to increase quality and years of healthy life and to eliminate health disparities—served to guide the development of objectives that would be used to measure progress. Each objective has a target to be achieved by the year 2010. These objectives are organized into 28 focus areas, each representing an important public health area. A selected set of objectives, known as the Leading Health Indicators, was created to help identify sentinel measures of public health, and to encourage wide participation in improving health in the next decade. These indicators were chosen based on their ability to motivate action, the availability of data to measure their progress, and their relevance as broad public health issues.

Healthy People 2020

In December 2010, the Department of Health and Human Services launched Healthy People 2020External Web Site Icon, which has four overarching goals:

  • Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death;
  • Achieve health equity, eliminate disparities, and improve the health of all groups;
  • Create social and physical environments that promote good health for all; and
  • Promote quality of life, healthy development, and healthy behaviors across all life stages.

Leading Health Indicators

Healthy People 2020 provides a comprehensive set of 10-year, national goals and objectives for improving the health of all Americans. Healthy People 2020 contains 42 topic areas with nearly 600 objectives (with others still evolving), which encompass 1,200 measures.  A smaller set of Healthy People 2020 objectives, called Leading Health Indicators, has been selected to communicate high-priority health issues and actions that can be taken to address them.  Oral Health has been identified (for the first time) by the Department of Health and Human Services as a Leading Health Indicator.  

Great strides have been made over the past decade: life expectancy at birth increased; rates of death from coronary heart disease and stroke decreased. Nonetheless, public health challenges remain, and significant health disparities persist.

The Healthy People 2020 Leading Health Indicators place renewed emphasis on overcoming these challenges as we track progress over the course of the decade. The indicators will be used to assess the health of the Nation, facilitate collaboration across sectors, and motivate action at the national, State, and community levels to improve the health of the U.S. population.

 Healthy People 2020 also includes a new Foundation section which addresses several important health topics:  General Health StatusExternal Web Site Icon, Health-Related Quality of Life and Well-BeingExternal Web Site Icon, Determinants of HealthExternal Web Site Icon, and DisparitiesExternal Web Site Icon

Visit the following Web sites for more information on oral health disparities:

Related Links

The Office of Minority Health
Unnatural Causes: Is Inequality Making Us Sick?
Office of Minority Health & Health Disparities (CDC)

Page updated on 12/21/11.