Prior Incarceration and Dental Insurance Trajectories throughout Older Adulthood

Objectives: This study examines the relationship between prior incarceration and dental insurance trajectories throughout older adulthood. Methods: A nationally representative sample of adults aged 55 y and older who participated in the 2012–2020 Health and Retirement Survey was analyzed (n = 6,383). Group-based trajectory modeling was used to identify distinct patterns of dental insurance coverage across the 8 survey waves. Multinomial logistic regression was used to assess the association between prior incarceration and dental insurance trajectory group membership. Results: Four dental insurance trajectories were identified: persistent dental insurance (30.0%), intermittent high insurance (16.4%), intermittent low insurance (20.4%), and no insurance (33.3%). Bivariate analyses revealed that formerly incarcerated older adults were significantly more likely to be in the intermittent low dental insurance (relative risk ratio [RRR] = 2.31, 95% confidence interval [CI] = 1.67–3.20) and no dental insurance (RRR = 1.51, 95% CI = 1.09–2.11) groups relative to the persistent dental insurance group. Covariate-adjusted models that accounted for sociodemographic, health, and economic covariates found a significant association between prior incarceration and membership in the intermittent low dental insurance group (RRR = 1.48, 95% CI = 1.03–2.11). Conclusions: Formerly incarcerated older adults were less likely to have consistent dental insurance coverage over time. Additional research is needed to understand why formerly incarcerated individuals are less likely to have consistent dental insurance over time and what policy and programmatic responses may increase access to dental care coverage for this population. Knowledge Transfer Statement: This study shows that formerly incarcerated older adults are more likely to experience periods without dental insurance over time. These findings can inform efforts by dental care providers, policymakers, and community health programs to improve dental care access by expanding insurance coverage and tailoring oral health services to meet the needs of individuals with incarceration histories.