Promising Programs in Racial and Ethnic Disparities in Health and Health Care Addressing... researched and compiled by Sarah McCloskey, Erin Kennedy, and Michele Sloan December 2004 and updated November 2007
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California | Colorado | Missouri | Ohio | Oregon | Washington
Background
Tooth decay is one of the most prevalent and preventable chronic diseases in
the United States. Incidence of tooth decay in children is five times more
common than asthma. By the time children reach 18 years of age, 80 percent
have had some form of dental decay. Conditions leading to tooth decay can
develop during early childhood, especially in minorities, as 60 percent of
minority elementary school children do not receive proper dental care. In a
1999-2002 NHANES data survey, it was found that 55 percent of Mexican
American children had tooth decay, compared to 43.3 percent of African
Promising Programs to Eliminate Racial and Ethnic Health Disparities 23
American children and 38 percent of white children. Among African-American
and Hispanic adults, 41.5 percent have untreated tooth decay, compared to 18.4
percent of whites.* Similarly, 20 percent of African Americans and 11 percent
of whites have untreated root decay. In Delaware in 2004, 80 percent of white
adults visited the dentist or a dental clinic, compared to only 63 percent of
African Americans.**
*"Surveillance for Dental Caries, Dental Sealants, Tooth Retention, Edentulism, and Enamel Fluorosis --- United States, 1988--1994 and 1999—2002” www.cdc.gov/mmwr/preview/mmwrhtml/ss5403a1.htm
**CDC: National Oral Health Surveillance System. Delaware Oral Health Profile. apps.nccd.cdc.gov/nohss/bystate.asp?stateid=10
State Programs
Many state programs promote proper dental care to prevent and treat conditions
detrimental to oral health. A variety of programs exist on the state, local, and
community level, mostly concentrating efforts on increasing access to dental
care for low-income and other high-risk groups.
CaliforniaCenter to Address Disparities in Children’s Oral health “CAN DO” – A center created by the University of California, San Francisco, CAN DO seeks to understand, prevent, and reduce oral health disparities, specifically ECC tooth decay in young children. They provide support for research which addresses the problem, training for health care professionals, and means for collaborative efforts in order to analyze and prevent oral health disparities particularly among Asians and Latinos. Projects enacted by this center include the Mother and Youth Access Program, which studies how mothers use preventative care on infants, and the Acceptability Study of Preventative Intervention for Reducing Early Childhood Caries (ASPIRE) which also studies how perceptive parents are to their child’s risk of tooth decay. www.ucsf.edu/cando
ColoradoChildren’s Oral Health Outcomes Partnership, Colorado Community Health Network – This program helps to improve the health care and dental health of poor and underserved communities by fighting a disease-specific disparity. Through a partnership among the local health departments, the Colorado Oral Health Network, the clinician’s advisory network, and the Caring Foundation, a health-services team educates and supplies kids with the needed prevention tools, including access to regular medical check-ups, screenings, and dentalcare supplies. A direct link to the Colorado Oral Health Network is www.cchn.org/activities/cohn.asp
MissouriHealth Access Incentive Fund – The fund is used for loan repayment, liability
insurance, start-up grants, and practice subsidies. Doctors who agree to practice
in areas where there is a need for care, regardless of the patients’ ability to pay,
receive the grants or subsidies for Medicaid payments as an incentive to
provide care. In addition, Missouri law states that the Department of Health
will recruit minorities for healthcare careers when implementing the program.
www.moga.mo.gov/statutes/C100-199/1910000411
OhioSchool-Age Sealant Program – In accordance with Healthy People 2010’s goal of having half of all eight-year-olds with sealants on their teeth, Ohio has implemented a sealant program in its schools. Sealants are plastic coatings applied to the chewing surfaces of teeth that help prevent tooth decay. Only 11 percent of African-American children and 10 percent of Mexican- American children have sealants, but in schools with sealant programs, 57 percent of minority students have sealants. School programs coordinate with dental health providers and allow states to reach high-risk populations. www.odh.ohio.gov/odhprograms/ohs/oral/schprg/schlprogs
OregonEarly Childhood Cavities Prevention Program – Oregon is working on expanding its preventative programs for low-income pregnant women and children to include oral health. This expansion comes from a million-dollar grant from the Robert Wood Johnson Foundation to improve oral health. This program offers risk assessment and fluoride varnish to children who are brought to a WIC appointment. The project has partnered with a wide range of public, volunteer, and professional members who are serving low-income families. They are working together to coordinate free and low-cost oral health services with the support of the Oregon Dental Association. Another component of the project is 24-hour “Baby Days” clinics for children 9–24 months of age. In its first five months, parents and their children made 725 visits, 701 children Promising Programs to Eliminate Racial and Ethnic Health Disparities 24 received fluoride varnish applications, and 29 received dental referrals. www.oregon.gov/DHS/ph/oralhealth/care/child View or download a progress report of this program (www.chcs.org/usr_doc/SAOHA_Report.pdf).
WashingtonABCD “E” Program – The Access to Baby and Child Dentistry “Expanded” Program provides dental care for high-risk children from when they grow their first tooth until the age of 19. The primary goal of the program is to reduce dental decay and oral health diseases through preventative care. Partnerships among the Department of Health, doctors, and universities, allow dentists to identify high-risk children and go to them to provide preventative dental care. Primary-care physicians and Head Start programs are also educated on basic oral health, oral-assessment techniques, and fluoride application. www.smileabcd.org/abcde
For more information, contact Eric Jacobson (302-831-1711).
photo on this page courtesy of the Administration on Aging
