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An Invisible Barrier_ Literacy and Oral Health - Maryland

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An Invisible Barrier_ Literacy and Oral Health - Maryland Powered By Docstoc
					     Oral Health Literacy:
 A Pathway to Reducing Oral
Health Disparities in Maryland

     2011 Maryland Oral Health Summit:
   Pathways to Common Ground and Action

                October 20, 2011
             Alice M. Horowitz, PhD
        Dushanka V. Kleinman, DDS, MScD
  SCHOOL OF
  PUBLIC HEALTH
              Remember

• Efforts to improve quality, reduce costs
  and reduce oral health disparities cannot
  succeed without simultaneous
  improvements:
• In oral health literacy of the public, health
  care providers and policy makers; and
• Ensuring the user friendliness of our dental
  facilities.
         Health Literacy is:


the interaction between skills of individuals
  and demands of the healthcare system(s)

                            IOM Report 2004
Oral Health Literacy - Defined

  “The degree to which individuals have the
  capacity to obtain, process and understand basic
  oral health information and services needed to
  make appropriate health decisions.”
                               Healthy People 2010
Importance of Literacy Skills

Literacy influences one’s ability to access
information and to navigate the highly
literate environments of today’s society.




              influences
         Oral Health Literacy
         is Associated With:
• Knowledge and understanding of
  preventive measures
• Frequency of dental visits
• Severity of dental caries
• Oral health and quality of life
      What’s the Problem?

• Health literacy varies by race, ethnicity,
  level of education, and poverty level.
• The lower the health literacy the more
  likely the individual will have poor health,
  use fewer preventive procedures and use
  costly ER services.
• Less likely to manage chronic health
  conditions.
                  National Assessment of Adult Literacy 2003
   Maryland’s Approaches to
     Meet This Challenge
• Establish state needs

• Determine what the public knows and does regarding
  caries prevention & early detection

• Determine the public’s perceptions of providers
  communication skills

• Determine what health providers know and practice
  regarding caries prevention & early detection

• Determine communication techniques of healthcare
  providers
Health Literacy Fits in the Oral
          Health Plan
• A major topic in Maryland’s oral health
  plan is oral health literacy & education
What We Have Done to Date:

• Phone survey of MD adults 18 years of age
  and older. KOP’s about caries prevention &
  their perception of dental staff
  communication skills.
• Focus groups of MD adults 18 years & older
 • [4 in English; 2 in Spanish]
• Surveyed physicians, dentists, dental
  hygienists and nurse practitioners. KOP’s
  about caries prevention & use of
  communication techniques.
What We Have Done (Con’t)

• Focus groups/interviews of all four
  provider groups
MD Adults’ Understanding of
    Caries Prevention
• 97.9% said they had heard of fluoride
• Only 58% knew the purpose of fluoride
• 64.9 % had heard of dental sealants
• Of those, only 46% knew their purpose
• Only 23% could identify an early sign of
  tooth decay
Perceptions of Communication
   Skills of Dentist & Staff
• AA were significantly more likely to express
  lower satisfaction with the amount of time
  DDS spent with them than Caucasians, and
• AA were more than twice as likely to report
  they were treated unfairly due to race,
  ethnicity, or education
• Those with private dental insurance were
  significantly more likely than those with
  Medicaid to report favorably about providers
  listening practices.
         Use of Tap Water

• Adults with high school education or
  less were significantly less likely to:
 • Know if their tap water was fluoridated
 • Drink tap water
 • Give it to their child

• Medicaid recipients were less likely
  to drink tap water than non-Medicaid.
              Demands of Our
             Healthcare System
• Health literacy is dependent on the demands of the
  healthcare and public health systems. Individuals need to:
  • Know how to locate and navigate a health facility
  • Read, understand, and complete many kinds of forms to receive
    treatment and payment reimbursement
  • Articulate their signs and symptoms
  • Know about various types of health professionals and what
    services they provide and how to access those services
  • Trust us
  • Know how and when to ask questions or ask for clarification
    when they do not understand
What We Are Working On…..

• Determining user friendliness of dental
  clinics in community health settings
• Surveying Head Start & WIC personnel
  regarding their KOP’s about caries
  prevention
• Conducting focus groups of Head Start and
  WIC personnel
              Remember

• Efforts to improve quality, reduce costs
  and reduce oral health disparities cannot
  succeed without simultaneous
  improvements:
• In oral health literacy of the public, health
  care providers and policy makers; and
• Ensuring the user friendliness of our dental
  facilities.
Improving Oral Health Literacy

• Of the public, health providers and policy
  makers is one essential pathway to
  eliminating disparities among Marylanders.
       Maryland Oral Health Literacy Model: Moving Science into Action


                           Sta
Healthy People 2020            te
                           Pro , Coun
                                fess     t
                                     ion y & L
                                        al O oca                                        Increased
Health Literacy Call to                     rga     l
                                                niz Agen                                Health
 Action                                            atio    c
                           Research                     ns ies and
                                        and Dev
                                                  elopmen                               Increased
Plain Language Act                                         t
                                                                                        Disease
                                                                                        Prevention
Oral Health Literacy       State Oral Health Plan and State Oral                        Programs &
 Workshop                   Health Policies                                             Services

                                                                                        Increased
                                                      ice
2011 IOM Reports
                                               P  ract                                  Healthcare
                                           and                          ent             Delivery
                                  ati   on                          nem
                             E duc                            Ref i
Surgeon General Reports                                    nd
                                                   n   a
                                               tio
                                          al ua
                                        Ev
Evidence-based Protocols          ram
                            P rog




      Drivers            Assessment                 Policy Development  Assurance
THANK YOU!

				
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