Research Paper on "Community Organizing for Health"

Research Paper 7 pages (2033 words) Sources: 5

[EXCERPT] . . . .

Oral Health: A Community Health Problem

Oral remains a serious public health issue in the U.S., since it has significant effect on the overall health and well-being of people (Kaylor, Polivka, Chaudry, Salsberry, & Wee, 2011). Oral health has been a public health and government concern since the 1970s, with efforts geared towards the increment of the proportion of persons who use oral health systems. The U.S. Department of Health and Human Services in (2000) strove to reduce the proportion of American families experiencing difficulties and delays in receiving health care and those that do not receive healthcare. This paper explores the challenges and problems of oral health in the U.S. community health sector. This is supported by evidence from a review of literature on oral health as a public health issue, the effect of Obamacare on oral health care and insurance, and solutions to the challenges and problems of oral health.

Challenges and Problems Associated with Oral Health

Oral health has been a major public health concern in the U.S. since the 1960s following the identification of disparities in the use of dental healthcare in population groups by studies like that of Okada and Wan (1979). This disparity is indicated in terms of differences in race and income groups creating serious healthcare delivery problems. In the history of dental healthcare, there was a gap in the utilization of this community health sector between whites and blacks, and between poor and non-poor people. These inequalities were attributed to the lack of access to quality or affordable dental care. However, over the decades, the oral health status in the U.S. population has immensely improved, especially in the last 30 years. This is despite the fact that there is a profound and growing disparity among certain populations, especially among people of color, working class, and those with disabilities and chronic illnesses (Zabos et al., 2008). These disparities have created a need for new efforts in community health in eliminating the poor oral health status and oral diseases in the population.

According to Kaylor et al. (2011), poor oral health contributes to health conditions like cardiovascular disease, poor blood sugar control in diabetes, and cerebral ischemia. Poor oral health also reduces the quality of life of an individual by reducing their self-esteem, it affects speech, and makes it difficult for an individual to chew. This is because poor oral health creates pain, which disrupts speech and chewing ability, while the foul smell prevents individuals from speaking in public. Poor oral health is a major health problem in women, especially pregnant women. This is because the health problem negatively affects the fetal development, which leads to poor birth outcomes (Kaylor et al., 2011). This is because poor oral health is associated with periodontitis, which are linked with preeclampsia, low birth weight, and preterm birth (Kaylor et al., 2011, p.214). Another population group affected by poor oral health is people of color and those with chronic sicknesses and disabilities. For example, the research by Zabos et al. (2008) finds that adults, especially colored adults in Harlem suffer the highest mortality and morbidity rates due to the impact of oral disease in New York's population. Oral health disparities in this manner are associated differences in the use of oral health services and access to primary healthcare by different population groups.

Oral health is also considered a major public health concern, since it is prevalent in every part of the U.S. According to Kris berg (2004), oral health is a concern since certain populations experience worse rates of untreated and severe oral health diseases, which are often left untreated creating lifelong problems. This is common among rural America, where there is poor or no access to critical oral healthcare. The studies use data from the National Rural Health Association that finds that 11% of rural Americans have never visited a dentist (Krisberg, 2004). This is especially common among rural adults who are more likely to have untreated tooth decay than their non-rural counterparts (Krisberg, 2004, p.11) are. In addition, the situation is also prevalent among the rural young between the age of 18-24, who are twice more likely than their adult non-rural counterparts to have lost all their teeth. Krisberg (2004) indicates that oral is a major public health concern since most conditions are indicated by dental caries, which are common chronic tooth disease for American children, but are more likely to occur in children in the rural areas.

Oral health is an important community health problem since primary health givers like nurses and registered nurses who are also available in local and rural communities to educate the public on the importance of basic oral hygiene. According to Krisberg (2004), oral health becomes a public health issue from its prevalence in America, caused by a shortage of dentists, with 30 dentists available for 100,000 people in rural areas and 60 dentists for 100,000 people in urban areas. The other challenge of providing oral health in rural and poor communities like Harlem in New York, is that many dentists do not provide oral health without Medicaid or any state assistance.

Review of Community Health Literature

Dental healthcare was not a community healthcare concern like reproductive health or mental health. However, dental healthcare has received support from the federal government with its inclusion in the Obamacare or the Affordable Healthcare Act. This is a step towards provision of accessible and affordable healthcare to people at the community level. The inclusion of dental health in the Obamacare is an improvement since traditionally government and commercial insurance focused primary on medical and major medical care. Dental healthcare is included in the healthcare law as one of the 10 major benefits in insurance plan covers by 2014. Therefore, this recognizes dental health as an essential health benefit crucial for keeping Americans healthy. In essence, Obamacare places dental health in the same category as pediatric, maternity, hospitalization, and vision care.

Dental healthcare should be a major community healthcare issue. A review of literature finds evidence for the need of the inclusion of dental health as a major community health issue and an essential part of the healthcare act. The goal for including dental health as a community health concern is to reduce the disparities that exist in America, where certain populations receive little or no dental healthcare. A study carried out by Zabos et al. (2008) of a population-based survey of adults in Central Harlem between 1992 and 1994 revealed that there was prevalence of oral health complaints among residents of Harlem. The study finds that the prevalence was associated with social factors like social class and access to oral healthcare. The results indicate that 0% complained of teeth and gum problems, with 36% being those with an annual household income of less than $9,000 being more likely to report oral health issues. Of the surveyed 34% were unemployed, 34% did not have health insurance, and those with 87% of those with private insurance being twice as likely to visit or have a dentist for oral health problems than the 48% of the uninsured (Zabos et al., 2008). The results of this study confirm previous studies of the existence of disparities in the provision of oral health in American. The study found the need for urgent oral health services, and recommended to integration of oral health with comprehensive and primary care.

Studies like that of Kaylor et al. (2011) investigating dental health and insurance among American women of the childbearing age found a need for dental healthcare in the community and primary care setups. The study carried out a secondary analysis of 1,071 women in America, and found that 40% did not have dental health insurance. Kaylor et al. (2011) also identified that women with less education, with dental need, and low incomes are less likely to have dental insurance. Moreover, dental health insurance was low among racial and ethnic groups indicating the disparities mentioned by previous studies.

Critical Analysis of Challenges

The review of literature indicates that oral health is a major public health concern created by inherent disparities in the American society. The disparities exist in terms of racial and ethnic group, income level, and community, the lack of education or low literacy levels, a high rural population without dental care. These challenges make it difficult for the U.S. To achieve a high level of public health since factors like racial and ethnic disparities can be eliminated in social behavior. Therefore, this creates a challenge to the provision of oral health given the lack of adequate insurance cover for dental health for many decades.

Recommended and Implementation of Solutions

Kaylor et al. (2011) in their study identified that one of the best solutions of the oral health problem in America is the inclusion of dental health community programs. The study identifies that the best intervention at the community level is the use of nursing interventions to improve the oral health of at-risk women (Kaylor et al., 2011, p.213). This recommendation is… READ MORE

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