At a time when the minority population is rapidly growing and minority dentists are increasingly needed, dental school enrollment is moving in the opposite direction, according to a new report released today by Community Voices: HealthCare for the Underserved.
The Big Cavity: Decreasing Enrollment of Minorities in Dental Schools finds that African Americans, Hispanic Americans, and Native Americans make up only about 10 percent of all students enrolled in dental schools, part of a steady 10-year downward trend that could have a devastating impact on the dental health of minority populations. After a slight increase in enrollment through the mid-90s, just 810 African Americans, 913 Hispanic Americans, and 99 Native Americans were enrolled in dental schools during the 1999-2000 academic year, the report notes.
Minorities are also underrepresented in practice, with African Americans making up 2.2 percent of dentists, Hispanic Americans accounting for 2.8 percent, and Native Americans representing 0.2 percent. Future prospects are not promising. Many dentists are cutting back working hours and several are nearing retirement. “There are not enough future minority practitioners in the pipeline to replace those currently in practice,” notes Dr. Jeanne Sinkford, Director of the Division of Equity and Diversity at the American Dental Education Association.
The paucity of minority dentists could lead to significant health and lifestyle impacts, as minority populations are disproportionately burdened by oral health problems. African American and Mexican American children, for example, have twice as many cavities and more unmet treatment needs as their white and non-Hispanic American counterparts. Moreover, 80 percent of decayed and missing teeth in children age five to 17 are found in minority and low-income children. In low-income groups, 50 percent of decayed teeth have never been filled, and 33 percent of low-income people over age 35 have no teeth.
Increasing the number of minority practitioners is vital. “If given a choice, people tend to select health providers from their own racial group. Therefore, increasing the number of minority dentists will be critical to serving the oral health needs of underserved communities,” the report explains. Absent a minority provider who is culturally attuned to their problems, many neglect basic oral health needs.
Part of the reason for declining dental school enrollments for minorities is cost, with dental graduates averaging $100,000 in debt before advanced training. For minorities, the load is even greater. “The reality is minority dental graduates carry a double burden,” says Dr. Hazel Harper, former president of the National Dental Association. “They must pay off the loans and they have the responsibility of practicing in underserved communities where they know their ability to earn the income their white counterparts are going to be earning is much less.”
While the federal government, private foundations, and health professional associations have developed programs to try to address the declining enrollments, there has been little impact on the overall problem. Efforts have included scientific training programs for teachers, student mentoring programs, recruitment initiatives, and partnerships with schools and community education projects.
One suggestion outlined in The Big Cavity is beginning recruitment efforts early by targeting minority elementary school students with an aptitude in science and math. The report also suggests the use of tax incentive programs to encourage minority populations to return to underserved communities, collaborations with lending institutions to help practitioners finance practices in underserved communities, and community-supported scholarships for students committed to practicing in their home communities.
The W.K. Kellogg Foundation’s Community Voices: HealthCare for the Underserved initiative is a multi-year effort targeted at ensuring the survival of safety-net providers and strengthening community support services. The 13 communities involved in Community Voices are: Alameda County/Oakland, California; Albuquerque, New Mexico; Ingham County/Lansing, Michigan; Baltimore, Maryland; California Native Americans (29 tribes); Denver, Colorado; Detroit, Michigan; El Paso, Texas; Miami, Florida; North Carolina; Northern Manhattan, New York; Washington, D.C.; and West Virginia.
To obtain your free copy of The Big Cavity: Decreasing Enrollment of Minorities in Dental Schools, call 1-800-819-9997 and request item # 498, or download the report from the Community Voices web site at www.communityvoices.org.
