Shortage of Hispanic Dentists National Hispanic Medical Association

Hispanic Health Congressional Briefing Series

“Diversity in the Health Professions”

September 24, 2003

Ivonne Ganem, DDS, MPH

Temple University School of Dentistry

Hispanic Dental Association

Hispanics• Comprise almost 13.5 % of the population. Largest

minority in the U.S. Hispanic population grew nearly 4 times the rate of the U.S. population overall in the past 2 years.

• U.S Census defines Hispanic as people who originate from Spanish speaking countries or regions.

• Federal government considers Hispanic an “ethnicity”, not a race, Hispanic people can classify themselves as any race.

• The Latino population was spurred in large part by immigrants seeking jobs.

Hispanics• Census Bureau released the following

socioeconomic and demographic characteristics of Hispanics:

–2/3 are of Mexican descent–1/3 younger than 18, compared to 1/5 of non-Hispanic whites.–2 in 5 were born outside the country. –2 in 5 Hispanics age 25 and older- no high school degree. Hispanics with Puerto Rican and Cuban background were more likely to have a high school degree. –Poverty rate of 21% was 3 times greater than that of non- Hispanic whites

Hispanics

66%

14%

9%

4%7%

Mexican

Central & SouthAmericanPuerto Rican

Cuban

Other Hispanic

Shortage of Dental Faculty

• American Dental Education Association (ADEA) reported:

– No. unfilled faculty positions: 400 in yr. 2000 4% increase in the following year.

– From 1992- 2002, number of vacant budgeted faculty positions increased approx. 50% with an average of 6.5 vacancies in 2002.

– 75% vacancies are in clinical sciences (specialties).– 20% of positions have been vacant for 12 months

or longer in 2002

Shortage of Dental Faculty Why the separations of full-time dental faculty from

dental schools ? - Retirement – 34%. There is an estimate that in the next

decade there will be 800 - 1,200 faculty members retiring.

- Indebtedness – 45% of grads. average $100,000 in debt.

- Job changes - 33%- Death- 4% - Move to private practice – 18% - salary gaps.- Insufficient qualifications.

Shortage of Dental Faculty

Dental school faculty shortage is a problem or recruitment and retention.

Recommendations: – Fellowships and scholarships. – Loan Repayment Programs in DHPSA

(Dental Health Professional Shortage Areas) – Research grants.– Mentoring programs.

Shortage of Dentists

– Health Resources and Services Administration (HRSA) and the American Dental Association (ADA) project a continued decline of dentist to population ratio.

– 2020 projected ratio is : 52.7 per 100,000– By 2014- No. of retiring dentists will surpass

number of dental school graduates.– ADEA expects the trend to continue until 2031.

Dentistry and Hispanics

• Surgeon General Report states that members of ethnic and minority groups in the U.S. , including Hispanics, are experiencing disproportionate level of oral health problems.

• Disparities attributed to:– Language, culture, dietary patterns and access

to care

Dentistry and Hispanics

• Studies have shown that Hispanics feel more comfortable with Hispanic dental professionals.

• ADA Dentist Profile Survey in 1996, showed that race/ethnicity of dentists influence race/ethnicity of patients.

• Black and Hispanic dentists reported they treated the greatest proportion of patients whose annual family income were less than $15,000.

Dentistry and Hispanics

Facts:• HDA- Study that found that there were 11,789

Hispanic dentists in the US. 9,451 dentists not including Puerto Rico and Guam.

• 4% of nation’s dentist were Hispanic when compared to 13.5% of the population.

• 1 of 8 residents of the U.S. is Hispanic • 1of 17 dentists is Hispanic.• There are 26.8 dentists/100,000 pop.

Dentistry and Hispanics

Facts:• California and Texas have ½ the nation’s Hispanic

pop., but only 1/3 of Hispanic dentists. Ratio of 17.2 per 100,000. Both states rank as near the bottom in Hispanic dentists per capita.

• According to the JDE: - In 2000 class had only 227 Hispanics

(5.35% of all enrollees). - In 2000 only 6.5% of applicants to dental

schools in the U.S were Hispanic.

Dentistry and HispanicsU.S. Dentist-Population Ratio by

Race/Ethnicity(BHPr, HRSA, 1996)

Total Black Hispanic Asian White

Dent. 154,900 5,200 5,200 10,700 133,600

DMD: Pop1:1700 1:6000 1:5400 1:860 1:1450

Dentistry and Hispanics

Dentists & Patients by Race/Ethnicity

%Patients: White Hispanic Black Asian

Dentists

White 76.6% 8.5% 10.5% 3.2%

Hispanic 43.6% 45.4% 9.8% 3.0%

Black 27.0% 7.9% 61.8% 2.3%

Asian 47.5% 14.5% 11.5% 25.1%(ADA, 2000)

Dentistry and HispanicsFull time Dental Faculty as of 2001

Number Percentage Native American 22 0.5

Asian Pacific 427 9.0Black/AA 250 5.3Hispanic/ Latino 217 4.6

White 3,724 78.7Other/ Not reported 95 2.0

Total : 4,735

ADEA 2001

Dentistry and Hispanics Gender and Race/ Ethnicity

of Faculty Hispanic Basic

Sciences Clinical sciences

U.S. total without Puerto Rico

12

17 in P.R.

303 (6.4% is in Mainland)

106 in P.R.

U.S. Total(Includes Male and

Female)

29 409

ADEA 2001-02. Includes Full- time and Part-time faculty

Dentistry and HispanicsPercent of Professionally Active Dentists by Gender

and Race/Ethnicity Male 85.9% Female 14.1%Native American 0.1%Asian/Pacific Islander 6.9%

Black/African American 3.4%Hispanic/Latino 3.3%

White/Caucasian 86.3%

Source: American Dental AssociationBureau of Health Professions, HRSA

Dentistry and Hispanics Dentists’ Participation in Capitation and Preferred

Provider Dental Plans: 1999

50.0% Neither Plan

12.8% PPO & Capitation

34.8% PPO only

2.4% Capitation only

Hispanic Serving Institutions • Provide Hispanic Americans with access to college

education.• HIS’s are degree granting institutions where at least 25%

of full-time-equivalent undergraduates are who are U.S. citizens or resident aliens are Hispanic.

• According to the Pew Hispanic Center Report,drop out rate for Latinos declined from 15.2% in 1990 to 14% in 2000 - twice that of whites.

• Report reveals in the decade from 1990 to 2000 – dropout rate was a measure of immigration trends rather that how U.S. schools were performing.

Hispanic Serving Institutions Institution Total

Enrollment

Fall 2000

Hispanic Associate Degrees in

2000-01

Bachelor’s Degrees 2000-01

50 states 1,650,117 693,111(includes

undergrad. & post-

baccalaureate)

30,921 21,459

50 States & P.R.

1,831,872 874,270 37,049 37,186

Examples of State Efforts

• Improve dentist participation in Medicaid • Loan forgiveness programs• Scholarships• New dental schools• Tax incentives• Expand allied programs• Change licensure requirements• Primary school-based clinical care• Hospital-based programs