Download Cavity Free Colorado

Katya Mauritson, DMD, MPH (c)
Oral Health Unit Director
Colorado Department of Public
Health and Environment
[email protected]
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Oral Health Unit
 Mission: To improve the oral health of all Coloradans,
especially vulnerable populations.
 6 members of the OHU team:
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Dental Director
OH Workforce Manager
Sealant Coordinator, health educator
Water Fluoridation Expert
OAP Dental Program
Program Assistant
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Oral Health Unit
What is the OHU doing to move the needle?
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1. Assessment
Monitor Health Status
- Surveys
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CHS, BRFSS, PRAMS, YRBSS
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Phone Interview
LPHA surveys
ASTDD survey
- Screenings
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BSS (Basic Screening Survey)
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Kindergarten & 3rd graders
Head Start
Older Adults
Communication of Data
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Chew on This: Burden Document
COHID
http://www.chd.dphe.state.co.us/cohid/Default.aspx
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2. Policy Development
 Educate: public, providers, partners, decision
makers
 Support policies and plans for individual and
community health efforts
 Research solutions to health problems
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Medicaid/CHP+ Reimbursement
Promote Healthy Environment
Promote oral health equity
School sealant programs
CWF
Links to obesity prevention, chronic disease
mgmt
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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
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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
Comparing CDC and Colorado
CDCs Winnable Battles
Colorado’s Winnable Battles:
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 Safe food
Food safety
HIV
Motor vehicle injuries
Nutrition, physical activity,
obesity
 Teen pregnancy
 Tobacco
 Healthcare-associated infections
 Infectious disease prevention
 Injury prevention
 Obesity
 Unintended pregnancy
 Tobacco
 Oral health
 Mental health and substance abuse
 Clean water
 Clean air
 http://www.cdphe.state.co.us/hs/winnable.html
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
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Colorado’s Winnable Battles
 Data driven
 Health equity
 New Governor’s Cabinet desire for common metrics
and framework
 State agency leadership
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Prioritizing oral health:
How chosen:
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Understanding the consequences
Cross-cutting causes
Leadership wanted to focus on three
Convincing data
Key Decision Makers:
 Bipartisan legislators
 Data experts
 Public health officials
The Cost of Doing Nothing….
In FY09-10, 6,076 Colorado
children received hospitalbased dental care costing
Medicaid
More Oral Health Opportunities
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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
Measuring our successes:
• Increase age one dental visits.
• Increase sealants on permanent teeth.
• Increase rates of community water
fluoridation.
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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
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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/
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Toolkit for Promoting Maternal and Child Oral
Health in Colorado Communities
http://www.
oralhealthcolorado.org/
new-toolkit-for-promoting-oralhealth-in-colorado-communities
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Budget
 CDC Cooperative Agreement
 CDC Preventive Health & Health Services
 HRSA Oral Health Workforce
 HRSA NHSC
 State
 Foundation
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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
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Monitoring monthly reports
Enter data and update CDC database
Inspections
Trainings
Technical assistance
Health Equity
An Explanatory Model for Conceptualizing the Social Determinants of Health
NATIONAL INFLUENCES
GOVERNMENT POLICIES
U.S. CULTURE & CULTURAL NORMS
LIFE COURSE
PREGNANCY
EARLY
CHILDHOOD
CHILDHOOD
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SOCIAL DETERMINANTS OF
HEALTH
ECONOMIC
OPPORTUNITY
PHYSICAL
ENVIRONMENT
• Income
• Employment
• Education
• Housing
Built
Environment
ADOLESCENCE
ADULTHOOD
•Recreation
•Food
•Transportation
HEALTH
BEHAVIORS &
CONDITIONS
SOCIAL
FACTORS
• Nutrition
• Physical
activity
• Tobacco use
• Skin Cancer
• Injury
• Oral health
• Sexual health
• Participation
• Social
support
• Leadership
• Political
influence
Environmental
quality
• Organization
al networks
•Housing
•Water
•Air
• Violence
• Racism
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HEALTH
FACTORS
MENTAL
HEALTH
• Mental health
status
• Stress
• Substance
abuse
• Functional
status
ACCESS ,
UTILIZATION
& QUALITY
CARE
• Health
insurance
coverage
• Received
needed care
• Provider
availability
• Preventive
care
POPULATION
OUTCOMES
QUALITY OF LIFE
MORBIDITY
MORTALITY
LIFE EXPECTANCY
• Obesity
• Cholesterol
• High Blood
Pressure
Safety
OLDER ADULTS
Public Health’s Role in Addressing the Social Determinants of Health
•Advocating for and defining public policy to achieve health equity
•Data collection, monitoring and surveillance
•Coordinated interagency efforts
•Population based interventions to address health factors
•Creating organizational environments that enable change
•Community engagement and capacity building
Colorado Department of Public Health - Social Determinants of Health
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Metal Mouth
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Results of dental screening among children in kindergarten.
Colorado Children’s Oral Health Screening, 2003–2004, 2006–2007, and 2011–
2012
Colorado Department of Public Health and Environment
100
90
80
Percent
70
60
50
46
45
40
40
27
30
23
14
20
6
10
5
2
0
Caries experience
2003-2004
Untreated decay
2006-2007
Urgent need for care
2011-2012
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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
100
90
73
80
64
70
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Percent
60
43
50
42
35
40
30
53
50
43
48
43
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24
23
20
23
17
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15
16
20
19
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10
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<25% FRL
25-49.9%
FRL
50-74.9%+
FRL
75%+ FRL
<25% FRL
Caries experience
2003-2004
25-49.9%
FRL
50-74.9%+
FRL
75%+ FRL
Untreated decay
2006-2007
2011-2012
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Why Oral Health Matters
•Preventable diseases
•Inequitable burden
•Sustainable change
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