IJOMAHIP Published Article Details

Abstract Maintaining oral health is vital for overall well-being, yet immigrant communities in the United States continue to face inequalities in access to dental care. This research, which draws on data from the National Health Interview Survey conducted between 2008 and 2017, investigates dental coverage and delayed dental care utilization due to cost, stratified by citizenship status. By applying Andersen’s behavioral model of health services use, the study examines a representative dataset of 308,904 adults (weighted N ~ 100 million) through detailed descriptive statistics, trend analyses, and multivariable regressions. Results showed that non-citizens were consistently less likely to have dental coverage and more likely to delay dental care due to cost compared to U.S.-born citizens, although these disparities were largely explained by enabling factors such as income and insurance access. Naturalized citizens, despite improvements, still experienced notable disadvantages. Predisposing and need factors, including age, gender, health behaviors, and chronic conditions, also contributed to cost-related delays. However, structural socioeconomic barriers remained the most powerful determinants. Our findings underscore the urgent need for policies that expand affordable dental coverage and address systemic inequities. Strengthening enabling resources can significantly narrow disparities, ensuring that oral health access is equitable across citizenship groups. KEYWORDS: citizenship, social determinants of health, dental coverage, dental utilization, health disparities