Colorado’s Oral Health Unit

1. Colorado’s Oral Health Unit Katya Mauritson, DMD, MPH (c) Oral Health Unit Director Colorado Department of Public Health and Environment Katya.Mauritson@state.co.us

3. Oral Health Unit • Mission: To improve the oral health of all Coloradans, especially vulnerable populations. • 6 members of the OHU team: • Dental Director • OH Workforce Manager • Sealant Coordinator, health educator • Water Fluoridation Expert • OAP Dental Program • Program Assistant

4. Oral Health Unit What is the OHU doing to move the needle?

5. 1. Assessment Monitor Health Status   - Surveys • CHS, BRFSS, PRAMS, YRBSS • Phone Interview • LPHA surveys • ASTDD survey - Screenings • BSS (Basic Screening Survey) • Kindergarten & 3rd graders • Head Start • Older Adults Communication of Data   • Chew on This: Burden Document • COHID http://www.chd.dphe.state.co.us/cohid/Default.aspx

6. 2. Policy Development • Educate: public, providers, partners, decision makers • Support policies and plans for individual and community health efforts • Research solutions to health problems • Medicaid/CHP+ Reimbursement • Promote Healthy Environment • Promote oral health equity • School sealant programs • CWF • Links to obesity prevention, chronic disease mgmt

7. 3. Assurance • Prevention Services: • Community Water Fluoridation • School Dental Sealant Program • School Fluoride Varnish Program • PANDA • MCH: Cavity Free at Three • Treatment Services: • Dental Loan Repayment Program • Old Age Pension Dental Assistance Program • Colorado School Of Dentistry Mobile Van • Medicaid Enrollment

8. Winnable Battles Initiative • Key public health and environmental issues where progress can be made in the next five years • Colorado’s greatest opportunities for ensuring the health of our residents and visitors and the improvement and protection of our environment

9. Colorado’s Winnable Battles: Comparing CDC and Colorado CDCs Winnable Battles Food safety HIV Motor vehicle injuries Nutrition, physical activity, obesity Teen pregnancy Tobacco Healthcare-associated infections http://www.cdphe.state.co.us/hs/winnable.html • Safe food • Infectious disease prevention • Injury prevention • Obesity • Unintended pregnancy • Tobacco • Oral health • Mental health and substance abuse • Clean water • Clean air

10. Colorado’s Winnable Battles were • chosen because: • They are important – large health impact • We have an ability to impact these areas • There is capacity to impact these areas

11. Colorado’s Winnable Battles • Data driven • Health equity • New Governor’s Cabinet desire for common metrics and framework • State agency leadership

14. Prioritizing oral health: How chosen: • Understanding the consequences • Cross-cutting causes • Leadership wanted to focus on three • Convincing data Key Decision Makers: • Bipartisan legislators • Data experts • Public health officials

15. The Cost of Doing Nothing…. In FY09-10, 6,076 Colorado children received hospital-based dental care costing Medicaid

16. More Oral Health Opportunities • Public Health Improvement Act • Hygiene practice act • Medicaid reimbursement for medical providers • Foundation/grant initiatives • Oral Health Improvement Project • Healthy Teeth, Healthy Babies • Cavity Free at Three • Early Childhood Systems Building • Dental Loan Repayment • Workforce and access surveys • MCH Oral Health Priority

17. Measuring our successes: • Increase age one dental visits. • Increase sealants on permanent teeth. • Increase rates of community water fluoridation.

19. Colorado Oral Health Policy Work • Medicaid Children’s Dental ASO • Adult Dental Benefit • Universal Health Care Coverage • Oral Health Winnable Battle • Oral Health Plan • MCH Community Toolkit

23. Oral Health Plan • All Coloradans have access to, and use, patient-centered comprehensive oral health care and education. • 6 Focus Areas • 7 Role Icons • Annual Updates • http://www.oralhealthcolorado.org/oralhealthplan/

24. Toolkit for Promoting Maternal and Child Oral Health in Colorado Communities http://www. oralhealthcolorado.org/ new-toolkit-for-promoting-oral- health-in-colorado-communities

26. Budget • CDC Cooperative Agreement • CDC Preventive Health & Health Services • HRSA Oral Health Workforce • HRSA NHSC • State • Foundation

29. Colorado’s Community Water Fluoridation • Voluntary Program • 72% of Colorado’s population has access to optimally fluoridated water • About 60 water systems adjust their natural level of fluoride to reach an optimal level for oral health • Many systems in Colorado are naturally optimal • OHU provides support through • Monitoring monthly reports • Enter data and update CDC database • Inspections • Trainings • Technical assistance

30. Health Equity An Explanatory Model for Conceptualizing the Social Determinants of Health NATIONAL INFLUENCES GOVERNMENT POLICIES U.S. CULTURE & CULTURAL NORMS LIFE COURSE SOCIAL DETERMINANTS OF HEALTH + HEALTH FACTORS = POPULATION OUTCOMES Public Health’s Role in Addressing the Social Determinants of Health • Advocating for and defining public policy to achieve health equity • Coordinated interagency efforts • Creating organizational environments that enable change • Data collection, monitoring and surveillance • Population based interventions to address health factors • Community engagement and capacity building Colorado Department of Public Health - Social Determinants of Health Workgroup

31. Metal Mouth

32. Results of dental screening among children in kindergarten.Colorado Children’s Oral Health Screening, 2003–2004, 2006–2007, and 2011–2012Colorado Department of Public Health and Environment

33. Results of dental screening among children in kindergarten by percent of students in the school who are eligible for free or reduced price meal program (FRL).Colorado Children’s Oral Health Screening, 2003–2004, 2006–2007, and 2011–2012 Colorado Department of Public Health and Environment

34. Why Oral Health Matters Preventable diseases Inequitable burden Sustainable change