Older adults in Los Angeles County are severely lacking dental insurance and many have cut back on oral healthcare because they cannot afford it, according to a broad new survey of men and women age 60 and older released this week.
Of almost 16,500 older residents polled by city and county agencies on aging, nearly two-thirds said they had inadequate or no dental insurance, nearly 20% said they lacked affordable dental care and almost a third had not had a dental exam in three years.
The results underscore the need for greater access to oral health coverage at a time when Gov. Arnold Schwarzenegger has proposed eliminating state-provided dental care for poor California adults to help cut a $17.2-billion state budget shortfall.
The poll also showed that nearly half of the Los Angeles County seniors surveyed lacked prescription drug insurance, nearly 20% lacked transportation to medical appointments and a third had not had a recommended flu shot.
"We know about flu shots and in-home care, but dental insurance wasn't one that we had really thought about," said Cynthia Banks, director of community and senior services for Los Angeles County.
"That was the most surprising" finding, she said, in what the agencies involved describe as a "groundbreaking" study.
The Los Angeles area is home to nearly a third of California's older adults, and the survey was designed to help local government better serve a population that is about 1.4 million today and will probably more than double by 2030.
It marked the first time that the county Community and Senior Services Department, Commission on Aging and city Department of Aging joined forces to poll the region's older residents directly.
The questionnaires were filled out between October 2006 and June 2007 -- before the housing market imploded, the stock market dropped, oil topped $125 a barrel, the economy began flirting with recession and the governor suggested cutting what little government dental coverage exists for older adults.
With more Californians in precarious financial shape today, the situation "is absolutely going to get worse" if the Denti-Cal program is cut, said Liz Snow, chief strategy officer for the California Dental Assn. "There's no question about it."
Dr. Roseann Mulligan, an expert in geriatric dentistry at USC, said she was not surprised to learn that so many older Angelenos were lacking in dental coverage and care.
"They're on a limited income," she said. "They have to pick and choose. . . . Dental insurance for seniors is virtually nonexistent, and unless you're able to pay out of pocket, you frequently don't get dental care."
Mulligan and the survey results pointed out the danger of making broad generalizations about people 60 and over. At the younger end of the spectrum, many are still working.
"Los Angeles County's residents age 60-74 expressed needs in preventive categories," said a report called "L.A. County Seniors Count!" that accompanied the survey.
"In the general area of health, they wanted affordable health insurance, health information, preventive services, physical exercise and, to a lesser extent, prescription drug affordability," the report said.
In contrast, older respondents reported greater isolation and frailty and said they needed help with basic daily activities and home maintenance.
"These needs, although affecting a smaller number of older residents, have more serious impact on overall quality of life," the report said.