1. Katya Mauritson, DMD, MPH (c)
Oral Health Unit Director
Colorado Department of Public Health and Environment
May 16, 2012
2. Special focus on 3 Winnable Battles
Mental Health and Substance Abuse
Obesity
Oral Health
3. Oral Health
Why this matters
Periodontal disease is linked to cardiovascular disease,
diabetes and stroke
Colorado kids miss about 7.8 million school hours every
year because of mouth pain
An estimated 42 percent of working-age Coloradans and
approximately 67 percent of Colorado adults over 65 years
of age do not have dental benefits
4. Oral Health
The economic burden
•In FY09-10, 6,076 Colorado children received
hospital-based dental care costing Medicaid
$8,249,949
•Children’s Hospital has four operating rooms
dedicated to treating severe dental caries that are full
8 hours a day, 5 days a week – it is one of the top
three reasons for OR use at Children’s
•CDC: approximately$108 billion spent on dental
services annually (2010)
5. Percent of Colorado parents reporting that their child (age
1 through 5) first went to the dentist by 12 months of age,
2006-2010
5
Goal: 4.6% by 2016
4
3.4
2.9 2.8
Percent
3
2.1
2 1.6
1
0
2006 2007 2008 2009 2010
Source: Colorado Child Health Survey, Health Statistics Section, CDPHE
6. Percent of 3rd grade children in Colorado with sealants, Oral Health
Basic Screening Survey
50
Goal: 39% by 2016
40 37.1
35.2
Percent
29
30
20
10
0
2001-2002 2003-2004 2006-2007
Sealants = Percentage of 3rd Grade Students with dental sealants on at least one permanent molar tooth
Source: Oral Health Program, Colorado Department of Public Health and Environment
7.
8. Health Equity
NATIONAL INFLUENCES
GOVERNMENT POLICIES
U.S. CULTURE & CULTURAL NORMS
+ =
ACCESS ,
HEALTH
PREGNANCY ECONOMIC PHYSICAL SOCIAL MENTAL UTILIZATION
BEHAVIORS & HEALTH & QUALITY QUALITY OF LIFE
OPPORTUNITY ENVIRONMENT FACTORS
CONDITIONS
CARE
EARLY
• Nutrition • Mental health • Health
MORBIDITY
CHILDHOOD • Income Built • Participation
• Employment Environment • Social • Physical status insurance
• Education •Recreation support activity • Stress coverage MORTALITY
•Food • Tobacco use • Substance • Received
CHILDHOOD • Housing • Leadership
•Transportation • Skin Cancer abuse needed care
• Political LIFE EXPECTANCY
• Injury • Functional • Provider
influence
Environmental status availability
• Organization • Oral health
ADOLESCENCE quality • Preventive
al networks • Sexual health
•Housing care
• Violence
•Water
• Racism • Obesity
ADULTHOOD •Air
• Cholesterol
Safety • High Blood
Pressure
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 Workgroup
9. Oral Health
Effective strategies
•Water fluoridation and school sealant programs
•Ensure effective implementation of the Affordable Care Act:
•Recruit, train and enable general dentists that currently do not
accept children on Medicaid to begin accepting Medicaid patients
•Train dental providers to care for young children and pregnant
women following Cavity Free at Three protocols
• Recruit and train culturally competent dental providers
• Oral health promotion strategies
10. Oral Health
Oral health collaborative: CDPHE, DHS, HCPF,
external partners
• Dental benefits
• CHP+ eligibility
• Sealant work group
• Fluoridation work group
• Messaging summit
• Data summit
• Communications
MH: Nearly $75 million in direct and hospital costs, and more than $1.33 billion in lost productivityObesity: Health care for conditions related to obesity costs Coloradans more than $1.6 billion each year
Kaiser study on Diabetes: cost savings in 3 years if dental benefit
By 2016,75 percent or more of the population served by community water systems receives optimally fluoridated water;increase to 4.6 percent the percentage of Colorado infants who get a dental checkup by age 1 year;Increase to 39 percent the percentage of Colorado third-graders who have dental sealants on permanent molars.
Dr. Bill Moss from Pew’s CDHP, talk about this access being an equity issueOverlay with poverty map
PCO: SDOH, CWF, CF3CF3, ECC, Healthy Teeth Happy Babies, water treatment plants, schoolsKey Public and Private PartnersColorado Partnership for Children’s Oral Health Oral Health ColoradoDelta Dental of Colorado FoundationCaring for Colorado Foundation CDA, CCHN, CDHA, CDPHE, HCPFExpansions of CHP+ and Medicaid (dental benefits) Health Insurance Exchange include dental care for children Expand school-based dental sealant programs
Community Water FluoridationTrending downwardHP 2020 goal: 79.6%Sealants as preventionCo 38 of 50 C- receiving preventive dental visits30th for CWF and losing ground (down from 2002 we were 24th at above 75%)Oral Health Unit & CDPHE work:BSS: child, Headstart and older adulsBurden DocumentData SummitGrant, legislative, informational communications: mobilize when defluoridating