Update: Access to dental care

This is an addition for archival purposes of a post that originally appeared at Scienceblogs

A couple of days ago, I talked about the link between a potentially massive hepatitis B outbreak in West Virginia and the lack of access to primary dental care. I was mushy qualitatively descriptive, ahem, about the number of people who lack access to dental insurance.

Comes now the CDC to save the day. In a statistical brief posted today, the National Center for Health Statistics gives a concise but thorough overview of the state of dental insurance in the US. Short version: Ain't pretty.

Crude preliminary population math:

• There are currently 309 million Americans.
• Based on census tables from last summer, 39 million are 65 or older (i.e., eligible for Medicare).
• Based on other census tables from last summer, 52 million are 17 or younger (of which some percentage, based on family income, would be eligible for Medicaid).
• That leaves, with wiggle room, about 218 million working adults.

According to the NCHS:

• 172 million non-elderly Americans have private health insurance. (NB, leaving 46 million non-elderly with no health insurance, which matches the usually accepted figures.)
• Of them, 45 million have no dental coverage -- which, added to the 46 million with no insurance at all, means that more than 90 million Americans have no dental coverage at all. (I believe the technical term for a number that large is a crapton. Maybe a metric crapton.)

In addition:

• If you have employer-provided health insurance, your chances of having dental coverage are pretty good: 80%.
• If you have privately purchased insurance of any kind, not so much: 30%.

So, reinforcing Monday's point: There are multiple millions of Americans who get no assistance paying for dental care, which is a largely cash-only business. (And judging from my own experience -- thanks to my childhood in the UK, I have teeth like chalk and consume more than my share of dental care -- dental insurance negotiates discounts. So self-pay dental care is relatively more costly.) And therefore, it is not surprising that thousands of people attended that free dental clinic in northeastern West Virginia, and were potentially exposed to hepatitis B as a result.