Oral Health in Central Virginia REGIONAL FOCUS FOR MAXIMUM IMPACT - PowerPoint PPT Presentation

Oral Health in Central Virginia REGIONAL FOCUS FOR MAXIMUM IMPACT

Oral Health and Overall Health Readiness to Learn Osteoporosis Employment Stroke Alzheimer’s Social Isolation Diabetes Menopause Premature Birth Failure to Thrive Heart Disease Renal Disease

Dental Coverage in Virginia – non Medicaid Medicare ▪ No dental benefits Almost 40% of adults ▪ Dually eligible (Medicare AND Medicaid) – in Virginia report some limited cleanings and extraction benefit having NO dental Traditional Dental Benefit ▪ Prevention services are free coverage ▪ Yearly cap Exchange Dental Benefit ▪ ▪ Pediatric Adult • No mandate • Subsidies • No subsidies • Deductible

Dental Coverage in Virginia - Medicaid Population FPL Family of 3 Dental Benefit Preg Women & Children Comprehensive 133% $25,390 Medicaid 200% $38,180 FAMIS Elderly & Disabled 80% $15,272 Extraction only Working Parents 30% $5,727 Extraction only Childless Adults NOT ELIGIBLE -- --

Why are we here today?

Who? ▪ Stakeholders from throughout the state, from a variety of orgs, agencies & P.O.V. What? ▪ Simple, easy to understand, data-based visual Why? that provides a snapshot of oral health in the How? state & a path to improvement So What? ▪ To provide a guide for progress, serve as a tool for advocacy, education & measurement ▪ LOTS of research, conversation & consensus ▪ Only helpful if it serves as a framework for state, regional & local efforts

1 2 3 4 Prevention Collaboration Health Coverage Status • Fluoride varnish • Medical Provider • Dental Benefits • Sealants participation - • Third grade referrals • Preventive decay dental visits • Tooth Loss Safety Net Measurement Categories Workforce Disparities

1 2 3 Population Geographic area Rarely measured groups constructs • Small area estimates (e.g., city/county, • Individuals with special • Influence of culture and census tract, health care needs language on health neighborhood) are behaviors and access • Older adults difficult to obtain to care Data Gaps

What Now? Region 4: Central Virginia Amelia County Henrico County Brunswick County Hopewell City Buckingham County Lunenburg County Charles City County Mecklenburg County Charlotte County New Kent County Chesterfield County Nottoway County Colonial Heights City Petersburg City Cumberland County Powhatan County Dinwiddie County Prince Edward County Emporia City Prince George County Goochland County Richmond City Greensville County Surrey County Halifax County Sussex County Hanover County

What does our region look like?

Racial & Cultural Demographics Other Multi Race 2% 3% Chesterfield, Henrico Asian & Richmond have the 4% largest populations of Hispanics and Latinos: • 5.6% of the region Black 30% identifies as White Hispanic or Latino 61%

Demographics – Race Native Native Hawaiian / White Black Asian American / Some Other Race Multiple Races Pacific Islander Alaska Native 42.03% 48.22% 0.27% 6.60% 0.11% 0.18% 2.58% Charles City 68.73% 22.71% 3.43% 0.26% 0.04% 2% 2.82% Chesterfield Colonial 79.66% 13.06% 3.50% 0.75% 0% 1.74% 1.30% Heights 64.48% 32.96% 0.45% 0.14% 0% 0.76% 1.21% Dinwiddie 78.79% 17.81% 1.33% 0.19% 0% 0.23% 1.66% Goochland 86.44% 9.30% 1.47% 0.16% 0.01% 0.70% 1.91% Hanover 58.59% 29.56% 7.37% 0.29% 0.07% 1.54% 2.58% Henrico 52.70% 38.09% 1.46% 0.14% 0% 4.24% 3.37% Hopewell 81.64% 12.25% 0.77% 0.75% 0% 0.55% 4.03% New Kent 18.15% 77.07% 1.32% 0.06% 0.02% 1.27% 2.10% Petersburg 85.04% 12.26% 0.54% 0.30% 0.06% 0.25% 1.54% Powhatan 44.03% 48.62% 2.21% 0.52% 0.02% 1.14% 3.46% Richmond 61.80% 29.86% 3.78% 0.35% 0.04% 1.47% 2.69% Report Area 68.98% 19.25% 5.97% 0.27% 0.06% 2.22% 3.25% Virginia 73.60% 12.61% 5.13% 0.81% 0.17% 4.70% 2.98% United States

Locality ty Health th Health th Outcomes comes Factor ors s County Health Rankings 2017 Rank Rank Goochland County 14 14 11 11 Powhatan County 15 15 17 17 Hanover County 19 19 7 Health Outcomes: how long people live and how healthy Chesterfield County 25 18 people feel while alive. New Kent County 26 22 Health Factors: Henrico County 34 23 health behaviors, clinical care, social and Colonial Heights City 64 46 economic, and physical environment factors . Dinwiddie County 85 90 Charles City County 96 104 Richmond City 109 123 Hopewell City 123 129 Petersburg City 132 133

Risk Factors & Outcomes Related to Oral Health Limited ed Premat ature e Income ome Drinki king ng Excessiv cessive e Diabe betes es Un Uninsured sured Access cess to Age- Locality ty Ad Adult t Smoki king ng Inequa uality ty Water Diabetes es Drinki king ng Moni nitor orin ing Populat ation ion Health thy y Ad Adjust usted ed Ratio io Violat atio ions ns Food Mortal ality ty Charles City 18% 14% 86% 18% 4.5 Yes 1% 330 14% 15% 16% 87% 11% 3.6 - 6% 280 9% Chesterfield Colonial Heights 15% 16% - 12% 4.0 - 6% 420 12% Dinwiddie 17% 16% 86% 13% 3.9 No 6% 400 11% Goochland 13% 18% 89% 7% 4.4 No 4% 360 12% Hanover 13% 17% 89% 9% 3.7 No 2% 300 9% Henrico 16% 16% 88% 12% 4.2 No 4% 300 10% Hopewell City 19% 15% 88% 15% 4.8 - 12% 600 14% 15% 18% 92% 12% 3.2 Yes 0% 320 10% New Kent 22% 18% 82% 15% 5.1 - 13% 680 16% Petersburg City Powhatan 14% 19% 88% 12% 3.8 No 2% 270 11% County Richmond City 20% 12% 83% 18% 4.4 - 8% 450 10%

Fluoridated Water Localities constantly face pressure from anti-fluoridation activists

What data do we have on oral health? ▪ Oral health data summaries in folders ▪ Regional comparisons on certain indicators ▪ Health department and other agency survey and administrative data: ▪ Claims and encounters ▪ Visual data ▪ Emergency department data – opioid use

Who’s here today? ▪ Attendee list in your folders ▪ Almost everyone lives and works in central Virginia ▪ A range of target populations & issues ▪ Many of you already working together across jurisdictions, populations, & issues

Which population groups are you most interested in addressing the oral health and overall health needs of? All Special Populations Adolescents Very Young Children Elementary Older Adults Working Age Adults High-risk adolescents Pregnant teens Homeless Low-income veterans Post-partum women

Access Ac ss Cost What (do you think) are the greatest barriers Minimal/no coverage to achieving good oral health among the Geographic isolation What are the greatest barriers to achieving good oral health Language/culture population groups you serve? among the populations group(s) you serve? Few care providers Transit 45 39 Aware renes ness 40 Don’t understand importance 35 32 Behavior vioral al 30 28 Not utilizing dental services 25 Poor nutrition Tobacco, alcohol, or drug use 20 Fear 15 12 Workf rkforce 10 8 Training 7 5 Supply/demand mismatch 5 Collabo laboratio ration 0 Access Awareness Behavioral All Barriers Workforce Collaboration Not sure Lack of collaboration/integrated practice Few or ineffective partnerships address systemic barriers

So What?

Oral Health…A Poster Child for Prevention Early Dental Visits Fluoride ▪ Water ▪ Varnish ▪ Toothpaste Sealants Diet, Oral Hygiene

Oral Health…A Poster Child for Prevention AND Innovation Systems Change ▪ Place ▪ Workforce ▪ Coverage ▪ Education ▪ Collaboration ▪ Payment

Questions?