David E. Hayes-Bautista
Robert M. Stein
Division of General Internal Medicine and Health Services Research
School of Medicine
The Latino Dentist Shortage, California, 2000
David E. Hayes-Bautista
Robert M. Stein
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.
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 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.
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 types of efforts begun in the 1970s need to be reinstituted and modified for the 21st‑century dental supply.
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.