Oral Health Regional Assessment

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Oral Health Regional Assessment Planning
Project(RAPP)
Greater Cincinnati, Northern Kentucky
Southeastern Indiana

• 2002-2005

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October 10, 2000
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Cincinnati Enquirer 9/8/00
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(No Transcript)
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(No Transcript)
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What was the RAPP?

• Rising interest in dental issues
• Small funds available
• United Way looking for initiatives
• Planning process needed

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RAPP Process Created

• United Way and Health Foundation funding
• Oral Health Council project management
• Advisory Council leadership
• Broad community participation by stakeholders

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How the Process Worked
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What We Found
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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
Private sector
Educational
practices
system practices
Neighborhood
System
characteristics
relationships
Family
Personal
characteristics
choices
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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

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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

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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.

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Recommendations

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

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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 to Treatment
• Expand and build, lower fees, Urgent Care
  Center, dental vans

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Regionalized Efforts

• Public Policy
• Provider Education
• Head Start School Support
• MRDD Program
• Nursing Home Program
• Strategies for cultural competence/relevance

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Public Policy Recommendations

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

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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.

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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

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Cost

• One tenth of 1 of the regions total health care
  expenditures
• 13 million
• of 13 billion health expenditures per year in
  the region

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Funding Possibilities

• Shifts in priorities
• User taxes
• (sugar-based drinks, candy)
• Share of levies
• New levy
• Dental insurance underwriters assessment
• Sales Tax on dental fees

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