Increasing dental health-care utilisation for all: understanding individual factors and place factors in Hawaii.

INTRODUCTION: Dental service utilisation is an important global health problem. Studies report that when people are able to access oral health care, they are more likely to receive basic preventive services than emergency care. Previous studies also report that dental-care utilisation varies according to individual patient and place factors. However, studies on the interplay of individual and place factors are limited. This study investigated the associations of dental-care utilisation according to urban/rural setting and individual patient factors, such as demographic, health care, health behaviour and financial autonomy. METHODS: The association of dental-care utilisation according to individual factors and place was investigated by analysing information obtained from the Hawaii Behavioral Risk Factor Surveillance Survey (BRFSS). The BRFSS is a health-related telephone survey system that collects state data on US residents regarding their health-related risk behaviours, chronic health conditions and use of preventive services. RESULTS: We found that health care, behaviours and financial autonomy were not substantially different between urban sites and rural sites in terms of the odds of dental-service utilisation. Our results showed that individual factors, such as financial autonomy, were more consistently associated with dental-service utilisation. DISCUSSION: Financial autonomy, as well as socio-economic factors, need to be considered to improve dental-service utilisation in Hawaii.