59: Estimating County-level Dental care Utilization in California: Multilevel Regression with Raking

Music City Center 

Regular dental visits are essential for oral health, yet disparities between regions exist due to socioeconomic and geographic factors. While national surveys provide valuable data on dental care utilization, they often lack sufficient sample sizes to generate reliable county-level estimates. Small area estimation (SAE) techniques help address this gap by producing robust estimates for smaller geographic areas. This study introduces a hybrid approach combining multilevel modeling with the raking procedure to estimate county-level dental care utilization among adults in California. Using Behavioral Risk Factor Surveillance System (BRFSS) and census data, our method accounts for individual- and area-level factors while overcoming data constraints that limit SAE methods like multilevel regression and post-stratification. We validate our estimates by comparing them with BRFSS direct estimates and available county-level estimates from the California Health Interview Survey. The findings demonstrate the feasibility of this approach in generating county-level estimates, supporting public health planning and targeted interventions to reduce disparities in dental care utilization.

Small area estimation

Raking

Multilevel regression

Dental care utilization 

Survey Research Methods Section