National
Perspectives on Oral Health Status and Access
Robert Sappington, DMD, MPH, Regional Dental Consultant,
Health Resources and Services Administration, Region
VI, Dallas, Texas
The
presentation will focus on a brief overview of the
current oral health status and access to dental
care in America, primarily as it relates to children.
Data will be cited from the Surgeon Generals
Report on Oral Health, the Healthy People 2000 Oral
Health Progress Review, CDC, the American Dental
Education Association, HCFA, and others. National
and some state initiatives to addressing the access
to oral health care problem will be discussed. Federal
strategies and lessons learned from other states
for improving access to oral health will be presented.
The
main points to be reviewed include: |
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Oral
health access remains one of the top identified
priorities across all 50 states |
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Focus
shifting from federal to state and local emphasis
for moving oral health access forward |
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Interdisciplinary
approach is essential in addressing the need |
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Collaboration
between private and public sectors crucial
for success |
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Partnering
to expand and stretch existing resources is
key |
Texas
Perspectives on Status of Oral Health and Access
Issues for Adults
Carolyn Marshall, MPH, PhD, Associate Director,
South Texas Geriatrics Center, University of Texas
Health Science Center at San Antonio, Dental School,
San Antonio, Texas
On
the national level, Oral Health in America: A Report
of the Surgeon General released in 2000, was a most
significant step in announcing to the public what
those of us in Public Health have realized for many
years - that oral health means much more than healthy
teeth. The good news is that the Report recognized
and publicized the fact that oral health and general
health are inseparable. New research points to associations
between chronic oral infections and heart and lung
diseases and stroke.
In
the past 50 years, great progress has been made
in understanding and treating common oral diseases
resulting in improvements in the nations oral
health. The bad news is that not all Americans are
achieving the same degree of oral health. A "silent
epidemic" of oral diseases is affecting groups
of our most vulnerable citizens. One of those groups
is adults, including the elderly, whose access to
care is limited for any number of reasons, including
perception of need.
Results
from the Texas Risk Factor Report, Behavioral Risk
Factor Surveillance System (BRFSS) "Oral Health
in Texas: 1995 Survey Data" will address both
access and status. The BRFSS report "Oral Cancer
Risk Behaviors: 1995-1996 Survey Data" will
address tobacco and alcohol use among adults, as
well as dental care utilization. A brief look at
Review of the Texas Oral Health Program: Final Report
will examine both strengths and shortcomings. Of
interest to this group is the Community-Determined
Health Related Issues: Final Report from the Long-Range
Extension Program 1995-1999, from the Texas Agricultural
Extension Service, Texas A&M University. The
Report from New Federalism: National Survey of Americas
Families, Health Insurance Coverage of the
Near Elderly compares Texas to National coverage.
Finally, to end on a very positive note, time will
be given to the Dental Oncology Education Program,
sponsored by the Texas Cancer Council, which provides
education both to dental and non-dental health professionals.
Texas
Perspectives on Status of Oral Health and Access
Issues for Children
John P. Brown, BDS, PhD Professor and Chairman,
Department of Community Dentistry, University
of Texas Health Science Center at San Antonio,
Dental School, San Antonio, Texas
See "Make
Your Smile Count!" Texas Dental Health Survey.
Legislative Strategies Developed in Other Initiatives
for Oral Health
James J. Crall, DDS, ScD, Director, Maternal
and Child Health Bureau (MCHB) Oral Health Policy
Center, Division of Community Health, School of
Dental and Oral Surgery, Columbia University,
New York, NY
Federal
and state legislative activities can have
profound effects on policies, resources and
programs that impact oral health. Recognition
of significant disparities in oral health
and access to dental services has prompted
increased Congressional and state legislative
attention and efforts to address to a variety
of related issues. This presentation will
propose a framework for strategic plan development,
review key legislative functions, and summarize
recent federal and state legislative initiatives
directed toward: |
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Health
professions workforce adequacy and distribution, |
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Medicaid
and State Childrens Health Insurance
Program (SCHIP) financing and administration, |
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Public
health and delivery systems capacity and integration,
and |
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Innovative
approaches for improving oral health for vulnerable
segments of the population. |
Making Change Happen: Lessons
for Advocates
Kay Johnson, MPH, EdM, Johnson Group Consulting,
Hinesburg, Vermont
This
presentation will review strategies for making
change happen and advocacy that have been
successful in the past. The lessons learned
and recommendations described are presented
under the following headings: |
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Defining
the problem and identifying barriers in order
to tailor recommendations; |
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Reducing
financial barriers to access; |
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Reducing
system (non-financial) barriers to access; |
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Improving
system capacity and performance; |
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Changing
knowledge, attitudes and practices; and |
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Setting
priorities and charting a course for change. |
Setting
Priorities and Charting a Course for Change |
1 |
Better
define the problem and its components, identifying
those which are most important based on consensus
about priorities. |
2 |
Develop
an action agenda supported by consensus among
key stakeholders. |
3 |
Identify
issues that require community-level action
and engage national organizations with local
members and affiliates to tackle them. |
4 |
Identify
remedies that can be addressed through public
policy and rank them according to level of
importance, urgency, and viability. |
5 |
Develop
plans for action, using the Surgeon General's
Workshop as a point of departure. |
6 |
Continue
to inform and engage state policy makers,
particularly those legislators who make decisions
regarding health policy and financing. |
7 |
Provide
the Bush Administration and state executive
offices with evidence of the problem and practical
policy solutions. |
8 |
Translate
the new science and compelling evidence about
the problem into clear messages and materials
targeted to various audiences, including the
general public, elected officials, families
in the childbearing years, non-dental professionals,
the media, and others.
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