Tracking Firearm Violence and Impact on Dental Health
Higher firearm violence in neighborhoods is linked to lower rates of people going to the dentist and higher rates of total tooth loss, known as edentulism, according to Rutgers researchers.
Their study, published in the American Journal of Preventive Medicine, used data from the Centers for Disease Control and Prevention for dental care utilization and complete loss of teeth and data from the American Violence Project for firearm violence incidents. The researchers examined 20,332 census tracts within the 100 largest cities in the United States from 2014 to 2022 using data from the Behavioral Risk Factor Surveillance System and the American Communities Survey.
Findings from the study suggest that community firearm violence may influence community-level dental care usage and oral health through various pathways. Chronic exposure to violence can lead to a person’s fear for safety and stress that can impact their health.
First, such violence can instill a widespread sense of fear and insecurity, potentially discouraging individuals from seeking dental care because of safety concerns. Second, chronic exposure to violence may contribute to sustained stress that could lead to unhealthy behaviors such as smoking, poor sleep, physical inactivity and poor diet, which are risk factors for oral health issues. Third, the broader social and economic disruptions caused by community violence can reduce the financial means and logistical capacity to access dental care while limiting dental providers' availability in affected areas.
No studies to date have looked at how community gun violence affects health care use. In some cases, higher violence may increase health needs and drive up the use of care. In others, fear for personal safety may keep people from seeking care – especially dental care, which is often used less regularly than medical services.
“Firearm violence doesn’t just shape public safety, it shapes health behaviors, including whether people feel safe enough to seek care,” said Daniel Semenza, the director of research at the New Jersey Gun Violence Research Center and an associate professor in the Department of Sociology, Anthropology and Criminal Justice and the Department of Urban-Global Public Health. “This research underscores the importance of addressing violence as a public health crisis.”
On average, 60% of residents surveyed in each neighborhood reported receiving dental care in the past year, though this figure ranged widely – from as low as 18% to as high as 89%, depending on the neighborhood and year. Among adults ages 65 and older, about 15% reported complete tooth loss annually. In terms of gun violence, neighborhoods experienced an average of one shooting per year, but the numbers varied drastically: Some neighborhoods had none, while others recorded more than 100 shootings in a single year.
The measure of dental care use estimates how many adults visited a dentist in the past year – a crucial indicator of preventive health. Several indicators of community disadvantage were drawn from annual American Communities Survey data, including poverty, single-mother households, unemployment, public assistance, and rent burden. A combined disadvantage score was created using poverty, single-headed families and unemployment, while other factors were analyzed separately.
“Our study highlights how community violence extends beyond physical harm – it also creates barriers to essential health care like dental visits, which can have long-term consequences for oral health,” Semenza said.
