Oral Health Equity: San Joaquin Valley
The Central Valley Health Policy Institute (CVHPI) and the DentaQuest Foundation Grassroots Initiative are working together, along with stakeholders in the San Joaquin Valley, to identify the barriers community members encounter in accessing oral health care and living healthy lives.
As many dental providers and their staff prepare to re-open their practices, it is
essential to understand their perspective on how the COVID-19 pandemic may have a
long term impact on their practices and dentistry in general. Patients will certainly
be affected by this impact. There is a need to understand the policies that dental
providers would support that aim to ensure patients would be able to receive safe
and affordable dental care after the COVID-19 pandemic. This report presents findings
of a survey that the Central Valley Health Policy Institute sent to dental providers
nationwide. As a timely response to the pandemic, this work aims to understand the
dental providers’ perspective on how dentistry is and will be impacted by the COVID-19
pandemic and to know their suggested policy recommendations to support the dental
Why Oral Health?
Oral health is an essential part of an individual’s overall health and well-being. Oral diseases harm the physical, psychological, and social health, and often results in pain, reduced quality of life, and diminished function. Besides, many studies have shown an association between chronic oral infections and many other health problems, including diabetes, heart disease, strokes, and adverse pregnancy outcomes.
Currently, significant disparities exist in the U.S. regarding oral health because of multiple causes that include; environmental, social, diverse cultural, and political processes. All of which lead to decreased access to quality and timely dental health care for some of us.
To learn more about how communities in the SJV are experiencing barriers to accessing oral health care, CVHPI surveyed 650 underserved community members. The survey aimed to help us understand how community members perceive and experience oral health services in the Valley. CVHPI also aimed to understand how residents value and perceive oral health in general.
The findings revealed some of the barriers that residents have experienced in regards
to accessing oral health care which included, but not limited to; high cost, lack
of access to quality and timely dental care and lack of access to oral health information that
is appropriately addressing the cultural and linguistic needs of our communities.
The identified barriers were concluded under two main overarching gaps; Access to Care and Oral Health Literacy. Those barriers laid the foundation for CVHPI's current and future oral health work.
Oral Health Literacy
The American Dental Association (ADA) defines oral health literacy as the degree to
have the capacity to obtain, process, and understand basic health information and services needed to make appropriate oral health decisions. To address low oral health literacy level, CVHPI prepared an oral health training suitable for Community Health Workers (CHWs) and Promotores. The training was delivered to 50 Community Health Workers (CHWs) who work with underserved communities. The training aimed to empower the CHWs with the knowledge needed about oral health and its related connection to general health across the life span. The main goal was to improve their oral health literacy and subsequently the communities they serve. A training evaluation was concluded in a detailed report.
Access to Oral Health Care
Access to regular dental visits is essential to improve the population's oral health outcomes, however, many residents in Fresno County have challenges accessing dental services for prevention or treatment. Regular visits to the dentists are an opportunity for receiving preventive and treatment dental care, oral health education, and counseling. Besides, those visits are opportunities for screening, early diagnosis, and treatment of various oral diseases and conditions.
To better understand how to address the challenging access to oral health care in the County, we interviewed dental providers that serve in the region to ask them about their challenges to providing care for the underserved population and possible solutions to address them.
Social Determinants of oral health can greatly impact how population access dental care. In addition, health communication efforts need to consider those determinants when communicating oral health messages. CVHPI surveyed 600 Medi-Cal Dental beneficiaries to identify effective messages that would motivate them to utilize their covered dental services and to identify their perceived barriers to accessing those services.
To further examine the barriers to accessing oral health care for the SJV residents, CVHPI explored the impact of the midlevel dental providers in the valley to improve the access to oral health care. We conducted a series of focus groups with residents to understand the public perception of the authorized midlevel oral health providers in CA, the Registered Dental Hygienist in Alternative Practice (RDHAP) who serve as dental practitioners to meet the needs of under-served populations in California. Ultimately, we aimed to gauge the level of awareness about this model among participants and their acceptance to receive care from these providers.
Fresno County Oral Health Programhttps://www.co.fresno.ca.us/departments/public-health/office-of-health-policy-and-wellness/programs/local-oral-health-program
American Dental Association: https://www.mouthhealthy.org/en
Oral Health Progress and Equity Network: http://www.oralhealth.network/
California OPEN: https://ca-open.org/
Center for Disease Prevention and Control: https://www.cdc.gov/oralhealth/index.html
UCSF Resource Center: https://oralhealthsupport.ucsf.edu/resource-center
California Dental Association: https://www.cda.org/