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Comprehensive Oral Health Assessment: Bridging Access Disparities

Explore the RAPP project addressing dental access barriers in Greater Cincinnati with cost-effective solutions and community strategies to enhance oral health equity.

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Comprehensive Oral Health Assessment: Bridging Access Disparities

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  1. Greater Cincinnati, Northern Kentucky & Southeastern Indiana Oral HealthRegional Assessment & Planning Project(RAPP) 2002-2005

  2. October 10, 2000

  3. Cincinnati Enquirer 9/8/00

  4. What was the RAPP? • Rising interest in dental issues • Small funds available • United Way looking for initiatives • Planning process needed

  5. RAPP Process Created • United Way and Health Foundation funding • Oral Health Council project management • Advisory Council leadership • Broad community participation by stakeholders

  6. How the Process Worked

  7. What We Found

  8. Families @ 200% of the FPL Lack Access to Dental Care (~450,000) Multiple factors in the community contribute to poor dental access to care Economic Cultural conditions norms Historical Media trends messages Public sector Health care practices system practices Educational Private sector practices system practices Neighborhood System characteristics relationships Family Personal characteristics choices

  9. Multiple factors in the community contribute to poor dental access to care • Tooth decay is on the rise – more than 45% of inner city children have untreated decay • Emergencies cases have tripled at the Cincinnati Health Dept. Clinics over the past 8 years. • Existing dental clinics are at capacity

  10. Multiple factors in the community contribute to poor dental access to care • No sliding scale dental clinics in some counties; discounts often insufficient for working poor & others • Some areas have no prevention, education or treatment programs • Families choose rent, food, clothing over dental care

  11. Multiple factors in the community contribute to poor dental access to care • Impact on employment potential • Culture of poverty – --postpone treatment --poor appointment compliance • Perpetuating norms of tooth loss • Dental pain & infection is the #1 one reason why people go to the University Hospital Emergency Room.

  12. Recommendations What should each county have? • Treatment for pain & infection • Basic restorative care • Essential esthetics • Effective early prevention • Effective educational programs • Water fluoridation

  13. Recommendations • Improved Prevention sealants, use of pediatricians & ob/gyns, oral cancer exams, mouthguards • Increased Education health promotion & education on the importance of oral health community-wide • Expanded Access toTreatment Expand and build, lower fees, Urgent Care Center, dental vans

  14. Public Policy Provider Education Head Start & School Support MRDD Program Nursing Home Program Strategies for cultural competence/relevance Regionalized Efforts

  15. Public Policy Recommendations • Gain Public/government financing/support • Improving state Medicaid programs • Exploring new systems to provide care

  16. Strategies for addressing cultural needs & disparities Training for dentists & staffs Training in dental schools Mentoring programs for children from low income/minority families to develop dental careers.

  17. Early Accomplishments • Sealant Program in Northern Kentucky • Mobile van for Cincinnati Public Schools • UH GP residency program • Clermont County Head Start dental project • Babies Milk Fund/Rocking Horse fluoride varnish pilot in pediatric offices • October 6, 2002 Enquirer article • Expansion of Lincoln Hgts. Clinic • 2 school-linked dental programs • Northern Ky Clinic expansion • Fluoride varnish programs • Cincinnati Dental Society clinic

  18. Cost One tenth of 1% of the region’s total health care expenditures $13 million of $13 billion health expenditures per year in the region

  19. Shifts in priorities User taxes (sugar-based drinks, candy) Share of levies New levy Dental insurance underwriters assessment “Sales Tax” on dental fees Funding Possibilities

  20. An integrated, collaborative system with community involvement at the nucleus

  21. Current Status: Rebirth? • Internal changes at United Way= end of funding and support • 2 year gap prior to publication. • Some progress continues • Advisory Committee & Oral Health Council intend to continue with plan implementation.

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