Geospatial access to oral health care in Virginia: Insights from driving and public transit analysis

Abstract

Background. The authors aimed to investigate whether driving and public transit access to dental clinics differ for all dental clinics vs those participating in Medicaid, and whether sociodemographic factors are associated with driving and public transit accessibility in Virginia. Methods. Six regions in Virginia were selected for this study on the basis of the availability of transportation data. A modified two-step floating catchment area method considering vehicle ownership was applied to measure geospatial accessibility scores for the overall dental clinics and those participating in Medicaid. Inequality in accessibility among census block groups was analyzed using Gini coefficients. Spatial error models were used to estimate associations between sociodemographic variables and accessibility scores. Results. Public transit accessibility to oral health care services is lower than driving, regardless of Medicaid acceptance. Driving also provides more equitable access than public transit. Spatial error models revealed region-specific associations. Conclusions. Access to oral health care services is more challenging using public transportation than driving, especially in smaller regions of and among Medicaid beneficiaries in Virginia. The exploration of the associated factors emphasizes the need for tailored interventions according to region. Practical Implications. To improve access to oral health care in Virginia, efforts should focus on encouraging dentists to accept Medicaid, establishing new dental clinics near public transportation hubs and major roads, using ride-sharing support, and advocating for the development of robust public transportation systems.