Leading Health Indicators Webinar - Oral health - Part 1

DR. DON WRIGHT: Welcome to the eighth installment of the monthly series Who’s Leading the Leading Health Indicators? Each month, this series will highlight an organization, state or community addressing one of the Healthy People 2020 leading health indicators. This series includes a monthly webinar, email bulletin and active conversation via Twitter and LinkedIn. During today’s webinar you’ll hear from distinguished speakers. First of all, Assistant Secretary for Health, Dr. Howard Koh will introduce this month’s LHI topic, oral health. From the Maryland Department of Health and Mental Hygiene, Office of Oral Health, Dr. Harry Goodman will discuss the state’s experience with leveraging partnerships to bring about statewide changes in oral health. We are also joined by Rear Admiral William Bailey, Jane Casper, Daphene Altema-Johnson who will participate in today’s discussion and the question and answer portion of the webinar. Before we hear from the other speakers, let me give you a brief background on Healthy People and the Leading Health Indicators. For four decades Healthy People has provided a comprehensive set of national 10 year objectives that has served as a framework for public health activities at all levels and across the public health community. Healthy People is about understanding where we are now and taking informed action to get where we want to go over the next 10 years. The Leading Health Indicators, the focus for this series, represent critical health issues that if addressed appropriately will dramatically reduce the leading causes of preventable death and illnesses. These indicators are linked to specific Healthy People objectives. They’ve been selected to communicate high priority health issues to the public along with actions that can be taken to address them with the overall goal of improving the health of the entire population. There are 12 Leading Health Indicator topics, and this month we are focusing on oral health. For the complete list of the Leading Health Indicators and to view our past webinar presentations, visit http://www.HealthyPeople.gov. At this point, I’d like to turn the podium over to Dr. Howard Koh. DR. HOWARD KOH: Thank you, Dr. Wright for your leadership and many thanks to my colleagues at the Offices of Disease Prevention and Health Promotion for sponsoring yet another webinar and we want to thank the many across the country who are a part of this webinar to address the issues around oral health. Let me talk a little bit about the impact and context of this topic with respect to access and prevention, tooth decay and health disparities. And when we talk about oral diseases, that encompasses a wide range of conditions ranging from cavities to cancer which cause pain and disability for millions. Yet we know that oral disease are largely preventable, and we are concerned that nationally, even though annual dental visits help combat oral disease, about 108 million people have no dental insurance. And then furthermore when you see the overall impact of these conditions on society, particularly kids, we know that tooth decay affects more than one quarter of young U.S. kids age two to five and half of adolescents age 12 to 15. And then in addition, there are very disturbing disparities according to educational attainment, family income, race, ethnicity and other dimensions. So this is a critical public health issue and we’re very pleased to address it on this webinar. The next slide shows the indicator for oral health, which is persons aged 2 years and older who used the oral health care system in the past 12 months and the next slide shows the trend or lack of trend over the last 10 years with respect to dental visits in the past year for those aged 2 years and over. In short, you see an absolutely flat line with no increase in the percent of people who have dental visits in the past year from the baseline of about 43 percent. You can see from this slide that the Healthy People 2020 target is 49 percent or greater, so that’s where we’re aiming for the future. The next several slides show the same data broken down by various dimensions that highlight the very critical theme of disparities. This one shows dental visits in the past year for those aged 2 years and over by education and income according to year 2007 in green and 2009 in blue. On the left you see the trends by educational status. For persons aged 25 years and over, those who attended at least some college had the highest percentage of dental visits. That’s about 58 percent, but, of course, with less educational attainment, that percentage is much, much less. And then on the right hand side you see the same trends by family income, and again, those with higher income over 400 percent of poverty have a much higher percentage of dental visits in the last year compared to those with much lower family income. The next slide shows the same trends by race and ethnicity. White non-Hispanic populations have the highest percentage of dental visits in the past year, about 49 percent, but much lower rates for those of various racial ethnic backgrounds. And you can see the lowest rate for Hispanic-Americans which is about 28 percent. And then the last slide before I turn it over shows a new outcome here that we are reporting to you, untreated dental delay for kids and teens for children age three to five years in blue, children age six to nine years in green and adolescents 13 to 15 in red. For each of those you see startling rates of untreated dental decay for these three categories, ranging from 14 to … rather from 11 to 17 percent and then great disparities according to race ethnicity or according to income for each of these three conditions. So these trends you see over and over again for this very important public health topic and the question is how do we address this and build better systems to promote oral health and oral care and that’s why we asked the State of Maryland and Dr. Goodman to come onto this webinar and discuss how Maryland has improved access to dental care by leveraging partnerships. So I’d like to turn the webinar now over to him.