The provision of dental care to emergency shelter users corresponds to lower shelter use over time among typical users

Abstract

ABSTRACT Using linked data from emergency shelters and a dental program in Canada, we sought to determine whether dental care is associated with fewer emergency shelter stays in this retrospective cohort study. We can observe when an individual accessed free dental care and how emergency shelter use changed over four years of follow-up, matching participants to comparable controls. We estimate difference-in-differences effects for each year since receipt of dental care. We estimate models for the typical user (M-estimation) and the average user (OLS regression). We found that in years 2, 3, and 4 after care, the typical user experienced a net result of fewer shelter stays than controls. The estimated average user stayed more nights in shelter than controls over the four years after dental care, likely driven by outliers that used substantially more shelter stays than the typical user. These results are consistent with the idea that participants benefit in the long-term from dental care received while at an emergency shelter after an initial stabilization period. That is likely due to both the permanent nature of the intervention and the lack of access to publicly-funded dental care in Canada.