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Healthy People 2020 oral health goals key on access to care

Healthy People 2020 oral health goals key on access to care
Dr. Calnon

Washington—A broad-based coalition of dental and other health care advocates applauded Department of Health and Human Services “recognition” of oral health as a leading indicator of the overall health of the U.S. population and access to care as a chief objective for Healthy People 2020.

Healthy People 2020 sets 17 oral health goals

“The ability to access oral health care is associated with gender, age, education level, income, race and ethnicity, access to medical insurance and geographic location,” says the oral health section of the national goal-setting effort, Healthy People 2020.

“Addressing these determinants is key in reducing health disparities and improving the health of all Americans. Efforts are needed to overcome barriers to access to oral health care caused by geographic isolation, poverty, insufficient education and lack of communication skills.”

The leading health indicator among 17 oral health objectives for 2020, three of them measuring access to preventive services, is to increase the proportion of children, adolescents and adults who used the oral health care system in the past 12 months (OH-7). Other access goals:

  • (OH-8) Increase the proportion of low-income children and adolescents who received any preventive dental service during the past year;
  • (OH-9) Increase the proportion of school-based health centers with an oral health component.

The oral health topics and objectives area of Healthy People 2020 cites “a number of areas for public health improvement, including the need to:

  • Increase awareness of the importance of oral health to overall health and well-being;
  • Increase acceptance and adoption of effective preventive interventions;
  • Reduce disparities in access to effective preventive and dental treatment services.”

The Healthy People goal-setting effort provides science-based, 10-year national objectives by establishing benchmarks and monitoring progress for improving the health of all Americans. Oral health goals have been set in all three Healthy People decades but the 2020 effort is the first to single out an oral health goal as one of the leading health indicators. 

“Your decision marks the first time oral health has been acknowledged as a leading health indicator,” the 40-organization coalition told HHS Secretary Kathleen Sebelius in an Oct. 31 letter. “It recognizes the dramatic shift in the way people view oral health (as a part of overall health) and is a sign of progress in advancing the U.S. Surgeon General’s landmark report Oral Health in America (2000).”

The American Dental Association signed the coalition letter and in a separate communication, Dr. William R. Calnon, ADA president, thanked Secretary Sebelius “for including oral health among the leading health indicators (LHIs) used to evaluate the nation’s fundamental progress in achieving health promotion and disease prevention objectives outlined in Healthy People 2020.

“The ADA is committed to working with all stakeholders to repair and expand the oral health safety net and your recognition that oral health should be included as an LHI will help in that effort because the government and private organizations use LHIs when considering how to prioritize health resources. With recent research showing a significant connection between oral health and systemic health, spending on dental care, prevention and education can save money over the long run.”

Dr. Calnon, who assumed office Oct. 14 as the 148th president of the American Dental Association, offered principles “critical to improving the oral health of the underserved” in his letter to Secretary Sebelius, the administration’s top health official.

  • Prevention is essential. Simple, low-cost measures like sealing kids’ teeth, fluoridating municipal water supplies, educating families about taking charge of their own oral health, expanding the number of health professionals capable of assessing a child’s oral health and linking dental and medical homes will pay for themselves many times over.
  • Everyone deserves a dentist. Creating a separate tier of care for underserved populations will sap resources from solutions that already work and will do comparatively little to improve the oral health of those in greatest need. The existing system needs to be extended to more people.
  • Coordination is critical. Too many government and government-administered programs suffer from a failure to manage and exchange information about best practices for safety net operations. Technology and human capital are available to remedy this. Political will is key to better leveraging these resources.
  • Public-private collaboration works. Private practice dentists deliver the hands-on care to most of the population, regardless of payment mechanism. Public health and assistance programs can make it easier for dentists to deliver care by simplifying their administration and reducing red tape.
  • Silence is the enemy. Let’s take the ‘silent’ out of ‘silent epidemic.’ Virtually every shortcoming in the safety net has at its root a failure to understand or value oral health. When people, whether lawmakers, the media or the general public, learn about oral health and the consequences of oral disease, their attitudes and priorities change. Awareness is on the rise, but we have far to go before Americans know enough to make the personal and policy decisions that ultimately will create a real safety net, one that prevents oral disease and restores oral health in people who seek healthier and more productive lives.

State, national organizations applaud oral health indicator

“As a leading health indicator, oral health will receive substantially more attention as a critical health need,” 40 dental and other health organizations said in a “thank you” letter to Health and Human Services Secretary Kathleen Sebelius, the administration’s top health official.

“It will also renew interest in addressing other Healthy People 2020 topic areas that have an oral health component, such as access to health services, cancer, diabetes, educational and community-based programs, older adults and tobacco use,” said the coalition of state and national organizations representing dental and other health professionals and health care advocates.

“We commend you for identifying oral health as a leading health indicator and look forward to helping advance the national health goals outlined in Healthy People 2020,” said the letter, which includes an alphabetical listing of supporting organizations.

HHS announced the 26 leading health indicators in an online notice that offers further detail on the Healthy People 2020 oral health objectives.

The leading health indicators, “selected to communicate high-priority health issues and actions that can be taken to address them,” are organized under 12 topics: Access to health services; clinical preventive services; environmental quality; injury and violence; maternal, infant and child health; mental health; nutrition, physical activity and obesity; oral health; reproductive and sexual health; social determinants; substance abuse and tobacco.

The oral health section’s leading health indicator is “persons aged 2 years and older who used the oral health care system in the past 12 months.” HHS will track, measure and report on the Healthy People goals through the year 2020.