The Latino Dentist Shortage, California, 2000
David E.
Hayes-Bautista
Iya Kahramanian
Cristina Gamboa
Paul Hsu
Sonia Molina
Robert M. Stein
Latino Dentists
Of the 25,273 dentists licensed to practice in the state of
California in 2000, only 1,161 were Latino. Latino dentists represented a mere
4.6 percent of all dentists in the state. By way of comparison, the 10.9
million Latinos in the state that same year accounted for nearly one-third (32.4
percent) of the state’s total population. Figure 1 shows the relative
proportion of the state’s dentists, and the state’s population, who are Latino.
If there were no problems in the state’s educational system
— from elementary to high school to university to health professional school —
one could reasonably expect that roughly one-third of the state’s dentists
should have been Latino. The fact that Latino dentists are found at less than
one-sixth the rate of Latino population presence indicates that there are some
major problems in the state’s educational system.
This finding should not be construed to mean that only
Latino dentists can, or should, see Latino patients, but rather this finding
indicates a serious lack of access to higher education. The American Dental
Education Association has adopted as a core value that “those who populate
dental education — students, faculty, staff, administrators and patients —
should reflect the diversity of our society.”
Clearly, in light of this core value, the California dental
supply is crucially lacking in Latino dentists.
Population-to-Dentist Ratios
The effect of this lack of Latino presence in the dental
profession can be appreciated in the ratio of population per dentist. In
California, there are 950 non-Latino Californians for every non-Latino dentist.
However, for Latinos, the population-to-dentist ratio is much, much worse. For
every Latino dentist, there are 9,446 Latinos, nearly ten times the ratio seen
in the non-Latino population. Please see figure 2 for a comparison of the
ratios in the non-Latino and Latino populations.
The Latino Dentist Shortage
The magnitude of the shortage can be presented in another
way: The “Latino dentist shortage” will refer to the number of Latino dentists
that would be needed if the Latino population were to experience the same
population-to-dentist ratio as non-Latino California.
If there were one Latino dentist for every 950 Latinos in
the state’s population, there would have been 11,544 Latino dentists, nearly
one-third of the state’s total dentists. The difference between the number of
dentists that should have been present (11,544) if there had not been any
problems in the access to higher education, and the number we actually found
(1,161) is the Latino dentist shortage.
For 2000, there was a Latino dentist shortage of 10,383
Latino dentists. See figure 3.
Implications for the State
The Latino dentist shortage is the product of years of
neglect. The shortage was not created overnight, and the problems created by
this shortage will likewise not be resolved overnight. The major implication
for the state is that Latino dentists are far more likely than non-Latino
dentists to locate their practices in heavily Latino areas, and to speak
Spanish. (These findings are taken from a preliminary analysis of language and
practice location; this analysis is being completed as of this writing).
While any dentist can make the
decision to practice in a shortage area, and
to learn to speak Spanish, the fact is that most non-Latino dentists choose not
to do so, while most Latino dentists do choose to do so. Access to dentists in
heavily Latino areas can be increased most effectively by increasing the number
of Latino dentists.
Three areas can fruitfully use focused program activities to
begin to address the Latino dentist shortage.
- The
number of Latino dentists needs to be increased. As Latino dentists are
more likely to practice in shortage areas and speak Spanish, an effective
use of the state’s limited dental education resources would be to increase
greatly the number of Latino dental students. This can be accomplished by
increased recruitment, admissions, curricular and retention efforts. Such
efforts have been undertaken before, and had a resounding success. Prior
to 1970, the state’s dental schools graduated an average of 2 to 3 Latino
dentists per year. Recruitment and admissions programs raised that total
to a high point of 43 Latino graduates by 1982. Since then, the number has
declined drastically, to less than 20 per year during the 1990s.
The types of efforts begun in the 1970s need to be
reinstituted and modified for the 21st‑century dental supply.
- Non-Latino
dentists should be given incentives to choose to learn to speak Spanish
and to practice in shortage areas. While it is important to increase the
number of Latino dentists, it also is important to train non-Latino
dentists in culturally effective ways of providing dental services. Latino
patients can present what appear to be a number of paradoxes and enigmas to
dentists who are not trained to manage them. Cultural effectiveness
training should begin in the undergraduate, pre-dental school years, then
should be built into the dental school core curriculum.
- International
dental graduates should be considered as a temporary bridge out of the
severe dental shortage the state currently experiences.
Conclusion
The Latino dentist shortage is tremendous, yet offers the
state’s educational institutions a spur to resolving the issue of poor access
to dental care. The solutions to the problem will best be found in a
cooperative working arrangement between the dental associations (local and
state), the universities and dental schools, the dental insurance industry, and
the pharmaceutical industry. All will benefit from an increase in Latino access
to dental care.
-UCLA-
