Factors Influencing Interstate Variation in Tooth Loss Joshua Hall Beloit College 700 College St Beloit, WI 53511 The term for the loss of all natural permanent teeth is edentulism. In 2004, the Centers for Disease Control and Prevention (CDC) released data on the edentulism rate by state for the year 2002. Measured as a percentage of state residents over the age of sixty-five, the edentulism rate for the average state was 22.1 percent. West Virginia had the highest rate of complete tooth loss at 42.8 percent and Connecticut had the lowest rate at 13.5 percent. The high edentulism rate in West Virginia is surprising given that the state has fluoridation rates well above the national average. According to the CDC, 91.5 percent of West Virginians live in areas with fluoridated water compared to 70 percent in the average state. This suggests that other factors besides access to fluoridated water must be contributing to the high rate of edentulism in West Virginia. The medical literature points at several possible reasons for tooth loss in addition to water fluoridation. Income, poverty status, limited access to dental care due to geography, poor attitudes towards dental care, and smoking have all been linked to tooth loss. A review of the literature found no studies examining the determinants of interstate variation in edentulism. To better investigate the role of each of these factors in determining why some states have high rates of tooth loss and others do not, I regressed the edentulism rate by state against the following variables: the percentage of adults with a bachelor’s degree or higher, the elderly poverty rate, state per capita personal income, percentage of state population in urban areas, percentage of residents that are everyday

smokers, and the percentage of the population with fluoridated water. (Complete data, sources, and results are available at: http://joshua.c.hall.googlepages.com/). The adjusted r-squared of the regression was 0.66. The most surprising result is the statistical insignificance of water fluoridation (t-stat = 0.09). The two statistically significant variables are the percentage of everyday smokers (t-stat = 3.82) which is positively related to the edentulism rate and the percentage of state residents living in urban areas (t-stat = -2.46) which is negatively related. These results suggest that the primary reason why endentualism is so prevalent in West Virginia is because of its high rate of everyday smokers (21%) and poor geographic access to dental care due to its rural nature (only 46.1 % urban). (JEL I18).

Factors Influencing Interstate Variation in Tooth Loss

a bachelor's degree or higher, the elderly poverty rate, state per capita personal income, percentage of state population in urban areas, percentage of residents ...

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