Tag Archives: disparities

Campaign strives to improve access to care; critics say ADA misses mark

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health, curating related material at healthjournalism.org. She welcomes questions and suggestions on oral health resources at mary@healthjournalism.org.

Give Kids a Smile event

Photo by um.dentistry via Flickr

Advocates for the poor and uninsured have worked long and hard to bring attention to the shortage of dental care for millions of Americans.  On Wednesday, the American Dental Association weighed in on the problem too, announcing a nationwide campaign designed to respond to address what leaders called the nation’s “dental crisis.”

“We’ve made great progress with each generation enjoying better dental health than the one before,” ADA President Robert Faiella, D.M.D., noted. “But there is still a dangerous divide in America between those with good dental health and those without. Our mission is to close that divide. Good oral health isn’t a luxury – it’s essential.”

Yet many go without that care.

While a vast majority of middle- and upper-income Americans reported good access to dental services, nearly half of lower-income adults said they had not seen a dentist in a year or more, according to a Harris poll released by the ADA as part of the campaign’s launch. The poll also found that poor Americans are more than two times as likely to be toothless than their wealthier counterparts and that low-income adults were far more likely to seek last-resort care in emergency rooms than their better-off counterparts. Continue reading

States yank dental benefits, leaving low-income adults in hole

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health, curating related material at healthjournalism.org. She welcomes questions and suggestions on oral health resources at mary@healthjournalism.org.

The photo of the man sitting in a dental chair, cradling his hurting face, drew me right into the San Francisco Chronicle story.

Reported by staff writer Drew Joseph, the Jan. 31 article took a thoughtful – and painful – look at the shortage of dental care for California adults.

“Jabari Kelly showed up at San Francisco General Hospital’s dental clinic last Friday looking like he was hiding a golf ball in his left cheek. He had been in pain for three weeks.

“The 36-year-old San Francisco man had an infected wisdom tooth, and swelling had spread into his jaw and cheek. A few more days, he was told, and the infection could have advanced below his chin, possibly restricting his breathing,” Joseph wrote.

“You’ve got 32 teeth – each one can kill you,” Newton Gordon, D.D.S., of the UCSF School of Dentistry, told Joseph. Continue reading

Hispanic children bear brunt of poor access to dental care

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health, curating related material at healthjournalism.org. She welcomes questions and suggestions on oral health resources at mary@healthjournalism.org.

The lack of dental care is a big problem for children living below the poverty level and untreated tooth decay hits Hispanic children particularly hard.

Data from one large national survey found a full 26 percent of Hispanic 6- to 9-year olds suffered from untreated tooth decay, compared with 14 percent of non-Hispanic white children of the same age.

February is National Children’s Dental Health Month and oral health advocates from the Maryland Dental Action Coalition just launched a new campaign, Dientes Sanos, Ninos Sanos, (Healthy Teeth, Healthy Children) tailored to reach more of the state’s at-risk kids.

“This started because Hispanic children have more tooth decay than other populations, said Harry Goodman, D.M.D., M.P.H., director of the Office of Oral Health at the Department of Health and Mental Hygiene. He stopped by the Prince George’s County Health Department dental clinic on Feb. 1 to help kick off the effort. It expands on a statewide English-language oral health literacy initiative and includes Spanish language posters for bus and train shelters, brochures, a series of radio spots and a website, DientesSanosNinosSanos.org aimed at raising oral health literacy and helping Spanish-speaking parents find dental care for their children. Continue reading

Causes, consequences of Nashville’s diabetes hot zone

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

In The Tennessean (and USA Today), Tom Wilemon has assembled a series of reports on what he calls “the diabetes hot zone,” “a cluster of predominantly African-American, inner-city neighborhoods where diabetes rates soar to more than double the Davidson County average.”

After establishing the outlines and perils of the hot zone in his first piece, Wilemon follows up by looking into the scarcity of transplants and pervasiveness of dialysis in the area.

Although organ transplants can occur between races, matches are more difficult to achieve for blacks. Transplant recipients must have similar genes in their immune systems to those of the donor. Otherwise, the body will reject the organ.

Whites account for 68 percent of all organ donors, while African-Americans account for only 14 percent, according to the U.S. Organ Procurement and Transplantation Network. Although the number of blacks and whites waiting for a kidney in 2011 was about the same, whites received just over half of kidney transplants that year, while blacks received less than a third.

Finally, he examines the causes of the diabetes epidemic and, in the process, wading deep into the “soul food” versus “fast food” debate.

Wilemon is a 2012-13 AHCJ Regional Health Journalism Fellow and wrote this story with support from USC’s Annenberg School of Journalism.

Moms’ health, education can affect kids’ teeth

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health, curating related material at healthjournalism.org. She welcomes questions and suggestions on oral health resources at mary@healthjournalism.org.

Poor children suffer from more dental decay than their wealthier peers. In many cases, they live in communities where oral health services are hard to find. They lack access to the basic preventive care that children from more affluent families take for granted.

Mary OttoMary Otto, AHCJ’s topic leader on oral health is writing blog posts, editing tip sheets and articles and gathering resources to help our members cover oral health care.

If you have questions or suggestions for future resources on the topic, please send them to mary@healthjournalism.org.

Health officials and advocates stress the importance of addressing those disparities, expanding the nation’s public health infrastructure, opening more clinics in poor places.

Researchers into public health challenges have pointed out that whether you are fighting obesity or dental decay, it is harder to grow up healthy in a stressed, dysfunctional neighborhood than in one with amenities that promote well-being.

Better oral health services can help address the oral health problems of the community. But the community is just one ring in a kind of concentric system of factors some experts see as coming to bear upon wellness and disease.

The family is another ring in that system, they say. And new research suggests that the emotional health and educational level of mothers can have a lasting impact upon children’s oral health.

Starting with the oral health of teens and working backwards to age 3, researchers at Case Western Reserve Dental School explored what factors in the children’s past might have influenced their oral health outcomes.

Continue reading

Reporter looks at Spokane’s efforts to address disparities

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

Reporting for The Spokesman-Review in Spokane, Wash., Shawn Vestal started by observing massive life-span disparities in the city and surrounding area (mapped by neighborhood), then started looking for causes.

Vestal begins with a fairly predictable correlation.

The difference between the longest-lived neighborhood in the county (Southgate) and the shortest-lived one (downtown) is about 18 years: an entire American childhood. But it is not simply a matter of extremes; neighborhood by neighborhood, there is a gradual rise in years of expected life that tracks the rise in neighborhood wealth.

But the story expands quickly, encompassing a variety of indicators and causes, some standard, some quite unique. Vestal even finds a project in which high school students compared beer and tobacco advertising and other visual signals between two nearby neighborhoods – a pair which just happen to have a decade’s difference in life expectancy between them.

Vestal describes what they found.

One startling comparison involved a pair of Conoco stations. The Comstock station has bushes and treed landscaping and a vintage Coke sign; the East Central station has not a single bit of greenery – not counting a stubborn weed or two – and an enormous red sign: “CHEAPEST BEER & CIGARETTES.”

Other unique Spokane efforts – many of which are geared toward improving entire neighborhoods, not just individual families – include a regular community open house to discuss health issues, city park cleanups, and streetlight repair.

Research delves into disparities in children’s oral health

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health, curating related material at healthjournalism.org. She welcomes questions and suggestions on oral health resources at mary@healthjournalism.org.

Poor children suffer from more dental decay than their wealthier peers. In many cases, they may lack private insurance or live in communities where routine care or preventive dental treatments such as sealants can be hard to find. They may live in areas without fluoridated water or in places where tap water is mistrusted. Public health officials and advocates place great emphasis upon addressing such community needs.

Mary OttoMary Otto, AHCJ’s topic leader on oral health is writing blog posts, editing tip sheets and articles and gathering resources to help our members cover oral health care.

If you have questions or suggestions for future resources on the topic, please send them to mary@healthjournalism.org.

In fact, at a recent Capitol Hill forum on oral health Lynn Douglas Mouden, D.D.S., the chief dental officer for the Centers for Medicare and Medicaid Services went so far as to say, “The combination of dental sealants and community water fluoridation can prevent virtually all decay in children.”

Yet even when community issues are addressed, family dynamics may play a deciding role in oral health disparities.

Newly published research suggests that even young children who have had the benefits of dental insurance, fluoride treatments and sealants can suffer dental decay by the time they are teens.

For a study just published in the Journal of Dental Research, researchers at Case Western Reserve University’s School of Dental Medicine explored what factors in the children’s past might have influenced their oral health outcomes.

They concluded that the emotional health, educational level and coping skills of their mothers could have made the difference. Continue reading

Potential stories about changes in health care delivery are abundant

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

Many of you probably saw the recent Sunday New York Times Magazine story about home- and community-based health care, called “What Can Mississippi Learn From Iran.” Basically, it describes a still rudimentary and not fully funded vision of creating “health homes” using community health workers to reach the medically underserved in the Mississippi Delta, particularly those with chronic diseases. The idea is based on a similar program in Iran.

Core Topics
Health Reform
Aging
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There’s a lot I liked in this article by Suzy Hansen. The author is an American living in Turkey and she’s not a health care writer. She came to the subject – and to the Mississippi Delta – with fresh perspective. I liked her focus on chronic disease, disparities (black/white, rich/poor, rural/urban), prevention and wellness, the need for more and better primary care, the lack of care coordination and the rationale for more integrated delivery systems with primary care at its core. She did that well. Hansen also did include some context (I would have preferred a bit more) about some of the other delivery system changes unfolding through the Affordable Care Act, changes in the delivery of health care that my posts here often urge you to report on.

So the points I raise below aren’t because I think the article was bad – as I said, I liked it. Rather it’s because I wanted to draw out a few points that will help you as health journalists read it a little more critically and then think a little harder about what’s going on in your own states or communities.

Hansen said in an interview that she first got intrigued about the Mississippi initiative after seeing an earlier report on it in 2010 AARP Bulletin. When I went back and read the 2010 article, and then re-read the Times piece several times I wasn’t really clear on how much the “health homes” had achieved in the two intervening years. I emailed her and she said, “It’s all moving slowly. They have implemented the HealthConnect program, they have trained community health workers, they have designed the health worker certificate program at Jackson State, and opened clinics in some of the schools. They are trying to demonstrate various aspects of the model in order to convince people to fund them.” But the to-do list is still long.

Given all the attention right now on changing health care to achieve precisely the goals that the Mississippi group is trying to achieve (wellness not sickness, better care coordination, fewer hospitalizations, reducing disparities, etc). I was left wondering what’s stuck here – why isn’t this program accomplishing more. (It might have to do with Mississippi and local politics and personalities – not purely “health.”) Continue reading

Campaign pushes children to brush teeth

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health, curating related material at healthjournalism.org. She welcomes questions and suggestions on oral health resources at mary@healthjournalism.org.

What do gerbils on a train have to do with oral health?

Take a look at this video to find out.

The ad is part of a new Kids’ Healthy Mouths public service campaign launched this week by a formidable partnership: the nonprofit Ad Council, which harnesses the powers of Madison Avenue for worthy causes (think Smokey Bear and “Friends Don’t Let Friends Drive Drunk”) and the Partnership for Healthy Mouths, Healthy Lives, a coalition of 35 dental organizations.

The public service announcements, distributed to media outlets nationwide on Aug 14, look silly.

But they are designed to help address a serious problem: widespread dental decay that particularly burdens poor and minority children (PDF). Continue reading

Survey: Cost keeps Americans from visiting dentists

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health, curating related material at healthjournalism.org. She welcomes questions and suggestions on oral health resources at mary@healthjournalism.org.

Three-quarters of American adults say they have good or very good oral health.

The news is not so good for the other 25 percent, according to newly released statistics from the Centers for Disease Control and Prevention.

Mary OttoMary Otto, AHCJ’s topic leader on oral health, is writing blog posts, editing tip sheets and articles and gathering resources to help our members cover oral health care. If you have questions or suggestions for future resources on the topic, please send them to mary@healthjournalism.org.

Seventeen percent report their oral health is only fair and 7 percent say they have poor oral health. The findings, contained in a new report, were gathered as part of the 2008 annual National Health Interview Survey, based upon face-to-face interviews with more than 17,000 men and women aged 18 to 64.

According to the survey findings, adults with Medicaid (21 percent) were almost twice as likely as adults overall (12 percent) to have not had a dental visit in more than five years.

The main reason for forgoing a dental visit for an oral health problem in the past six months was cost, respondents said. A full 42 percent told interviewers they could not afford treatment or did not have insurance.

Adults with Medicaid were almost five times as likely as adults with private health insurance to report poor oral health. And this was in 2008. As the effects of the recession wore on, Medicaid enrollment swelled. To contain costs, many states began cutting even the often meager adult dental benefits they carried, the Kaiser Commission on Medicaid and the Uninsured found. Continue reading