Tooth decay puts a particularly heavy burden upon children of color, as do the pain and tooth loss that can result from untreated disease. With a growing recognition of the problem, professional, school and public health leaders in some communities are banding together to take action.
There are compelling stories to be reported about these efforts, as health reporter Laura Klivans found on her beat. In a recent State of Health story for KQED News, Klivans reported on a coalition that is bringing dental care to children in one San Francisco’s minority neighborhood. The story also gave her audience a better understanding of the specific factors that are contributing to the community’s high decay rate.
In this Q and A, Klivans describes how she first got interested in the topic and what she learned in her reporting. She also shares some wisdom on the sources she found most useful in getting the story.
You recently headed to San Francisco’s Chinatown neighborhood to report on concerns about high tooth decay rates among the children there. What got you started on this story?
I had a Human Rights Fellowship last summer from UC Berkeley School of Law. I was one of a small group of fellows, and each person was working on some human rights issue, either locally or abroad. One of my colleagues was working on treating children’s dental caries and told me that San Francisco’s Chinatown had high rates of tooth decay in kids — some of the highest. This was surprising to me, so I dug in.
What surprised you most about what you learned in your reporting?
I wouldn’t say this was surprising as much as it was inspiring. The group of people working together in Chinatown was an incredible example of a volunteer, community-wide effort to address a health disparity, and their efforts seem fruitful.
Racial disparities in oral health and disease are found in communities across the country. You interviewed a health worker who was trying to get a better understanding of the factors that might be playing a role in the higher decay rates in Chinatown. What are those?
A lot of the factors had to do with cultural differences, as there is a large population of immigrants in San Francisco’s Chinatown. According to a recent focus group health workers conducted, some reasons for less of a focus on visiting the dentist were:
- A lack of emphasis on oral health in the home country – China.
- The challenge of finding a dentist in someone’s insurance plan, or one that may speak their language.
- The price of going to the dentist.
- Concern that a visit to the dentist for a very young child would be too scary for them.
- A lack of comfort drinking tap water because many people were concerned their water was discolored – and therefore not good – due to old pipes. This can be an issue because tap water contains fluoride, which has been shown to help prevent cavities.
Poor oral health can have a wider impact on children’s lives. Was that an issue that people were willing to talk with you about? If so, what kinds of things did they tell you?
Yes, people certainly discussed this as an issue. Poor oral health has a negative impact on a child’s diet (since it’s less painful to eat soft foods, many of which are processed, and not hard foods like vegetables), the ability to concentrate in school, and self-esteem. Experts I spoke with echoed this, and the principal of the school mentioned in the article has had many experiences with kids who have improved academically after they got dental care addressing dental pain.
Oral health advocates sometimes discuss the shortage of minority dental providers and the need for more culturally appropriate care in minority neighborhoods. What did your sources say about that issue?
Some members of the focus group conducted in Chinatown cited a lack of dentists that speak their language as a barrier to access services.
What wisdom can you share with reporters who may want to look into dental disparities in their minority communities? What are some resources or sources to look for?
I found San Francisco’s Department of Public Health to be very helpful. They had produced reports and had statistics they shared with me. It was also helpful to talk to public health experts in Chinatown itself, to see if there was a story here.
Do you plan to follow up on this story, either by returning to Chinatown or visiting other communities with high burdens of untreated oral disease?
There’s always that opportunity! San Francisco’s Department of Public Health is hoping residents and health workers in other neighborhoods with high rates of dental caries develop task forces like the one in Chinatown. It will be interesting to see how easy or hard this is to do. I’d also like to revisit the data the SFDPH puts out a year from now to see if the rates of caries have decreased in Chinatown due to extra efforts being made there.