Healthy People 2020 Objectives: Michigan’s Oral Health Status Sept Healthy People 2020 Objectives: Michigan’s Oral Health Status Sept. 27, 2011; 12-1 pm EST

Presented by: Adrienne Nickles, MPH Christine Farrell, RDH, MPA Acknowledgements: -Beverly A Isman, RDH, MPH, ELS -Healthy People Website

Public Health Surveillance (CDC) Definition: The ongoing, systematic collection, analysis, and interpretation of outcome-specific data for use in the planning, implementation and evaluation of public health practice. It includes the timely dissemination of information derived from these data to persons who can undertake effective preventive and control activities.

Surveillance of Oral Diseases, Conditions and Behaviors Goals Establish and maintain the National Oral Health Surveillance System Include measures of oral health status in existing surveillance systems Identify and validate innovative ways to monitor oral health status Promote states to be self-sufficient in their data collection systems and integrate those data into NOHSS Monitor progress towards Healthy People and beyond

Healthy People Current News Two events in October: Review of the first decade “Healthy People 2010 Final Review” webinar. National Release of the Healthy People 2020 Leading Health Indicators Oral Health is proposed to be one of the leading health indicators Released during APHA conference in Washington, DC

Overview History and Purpose of Healthy People Objectives Development of HP 2020 Data Sources Available in Michigan Healthy People 2020 Oral Health Objectives in Michigan

Healthy People Background

What is Healthy People? A 10-year national agenda that communicates a vision for improving health and achieving health equity. A set of specific, measurable objectives with targets to be achieved over the decade. These objectives are organized within distinct Topic Areas.

Federally Led, Stakeholder- Driven Process HHS ODPHP Federal Interagency Workgroup (28 Federal Agencies) HHS Secretary’s Advisory Committee State and Local Governments (50 State Coordinators) Community-Based Organizations, Community Health Clinics, Social Service Organizations, etc. National-Level Stakeholders, Including Members of the Healthy People Consortium (2,200+ Volunteers) Individuals, Families, and Neighborhoods Across America 9

Key Features of Healthy People Creates a comprehensive, strategic framework that unites health promotion and disease prevention issues under a single umbrella. Requires tracking of data-driven outcomes to monitor progress and to motivate, guide, and focus action. Engages a network of multidisciplinary, multisectoral stakeholders at all levels. Guides national research, program planning, and policy efforts to promote health and prevent disease. Establishes accountability requiring all PHS grants to demonstrate support of Healthy People objectives.

Healthy People 2020 Website: healthypeople.gov Comprehensive one-stop-shop for HP information Tool developed to aid users to implement steps that would enable States, cities, communities, and individuals across the country to combine their efforts to achieve the national objectives

Evolution of Healthy People Target Year 1990 2000 2010 2020 Overarching Goals Decrease mortality: infants–adults Increase independence among older adults Increase span of healthy life Reduce health disparities Achieve access to preventive services for all Increase quality and years of healthy life Eliminate health disparities Attain high-quality, longer lives free of preventable disease Achieve health equity; eliminate disparities Create social and physical environments that promote good health Promote quality of life, healthy development, healthy behaviors across life stages # Topic Areas 15 22 28 39* # Objectives/ Measures 226/NA 312/NA 467/1,000 >580/1200 * With objectives 12

Topic Area A-Z Listing 13

2020 Topics & Objectives Each Healthy People 2020 objective has a: Healthy People 2020 is organized into 39 topic areas with objectives, and others are evolving Within each topic area, you will find 3 tabs Each Healthy People 2020 objective has a: -Reliable data source -Baseline measure -Target for specific improvements to be achieved by the year 2020

Objective Framework: Example

Assessing Oral Health Progress Data Sources National Health and Nutrition Examination Survey (NHANES) National Program of Cancer Registries (NPCR); Surveillance, Epidemiology and End Results (SEER) Program Medical Expenditure Panel Survey (MEPS) NASBHC School-based Health Care Census HRSA BPHC Uniform Data System ASTDD Annual State Synopses CDC Water Fluoridation Reporting System (WFRS) Indian Health Service Data System 19

Using HP 2020 in State and Local Oral Health Programs Mobilize programs and coalitions Needs assessment Strategic planning Priority setting Guide program implementation Framework for program evaluation Collaborative efforts with other programs Making the case for funding Commit to a national health movement Add links to HP 2020 on websites 20

How Health Care and Dental Care Providers Can Use Healthy People in their Practices Understand how dental care and oral health services fit into the context of population health. Offer patients relevant counseling, education, and other preventive services. Promote both population-based and individual preventive approaches Help to reduce barriers to receiving regular and comprehensive oral care. Benchmark and track the progress of a community of patients toward HP objectives.

Ways To Connect With Healthy People Spread the word about the 2020 objectives. Follow Healthy People on Twitter (@gohealthypeople). Connect with Healthy People on LinkedIn. Join the Healthy People listserv. Visit www.healthypeople.gov for up-to-date information and announcements. E-mail: healthypeople@nhic.org. 22

Healthy People Oral Health Objectives

HP 2020 Oral Health Objectives (HP 2010 Objective) Children and Adolescents OH–1 Dental caries experience (21.1) OH–2 Untreated dental decay in children and adolescents (21.2) Adults OH–3 Untreated dental decay in adults (21.2) OH–4 No permanent tooth loss (21.3/21.4) OH–5 Destructive periodontal disease (21.5) OH–6 Early detection of oral and pharyngeal cancers (21.6) 24

Oral Health Objectives Cont. Access to Preventive Services OH–7 Use of oral health care system (21.10) OH–8 Dental services for low-income children and adolescents (21.12) OH–9 School-based centers with an oral health component (21.13) OH–10 Health centers with oral health component (21.14) OH–11 Receipt of oral health services at health centers (NEW) 25

Oral Health Objectives Cont. Oral Health Interventions OH–12 Dental sealants (21.8) OH–13 Community water fluoridation (21.9) OH–14 Preventive dental screening and counseling (NEW) Monitoring, Surveillance Systems OH–15 Systems that record cleft lip or palate and referrals (21.15) OH–16 Oral and craniofacial State-based health surveillance system (21.16) Public Health Infrastructure OH–17 Health agencies with a dental professional directing their dental program (21.17) 26

Oral Health Objectives Cont. New/Developmental Objectives: currently do not have national baseline but have a confirmed nationally representative data source OH-11 Patients who receive oral health services at Federally Qualified Health Centers (FQHC) each year. OH-14: Increase the proportion of adults who receive preventive interventions in dental offices. reducing tobacco usage or smoking cessation oral and pharyngeal cancer screening from a dentist or dental hygienist (21.7) adults who are tested or referred for glycemic control from a dentist or dental hygienist. 27

Healthy People in Michigan

Data Sources Used in Michigan Basic Screening Surveys - Count Your Smiles (3rd Grade Students) - Older Adult Screening (65+ years of age) Behavioral Risk Factor Survey Water Fluoridation Surveillance System Youth Tobacco Survey Michigan Primary Care Association - Guide to Michigan Community Health Centers Michigan Cancer Registry CMS Reports

Michigan Oral Health Plan 30

OH-1 Dental caries experience in primary teeth Currently there are no data sources available to report dental caries status in young children or adolescents. The 2010 CYS survey found that 55.9% of 3rd grade students experienced dental caries in their primary teeth

OH-2 Untreated dental decay The 2010 CYS survey found that 27.1% of 3rd grade students experienced dental caries in their primary teeth Currently there are no data sources available to report untreated dental decay in young children or adolescents. However, the 2011 Youth Tobacco Survey will provide this data for adolescents. Although it is not required by the HP 2020 objective, this data is available for high school-aged students.

OH-2 Untreated dental decay Results from the 2007 Youth Tobacco Survey—Public High School Survey 2) Do you believe that you have dental cavities or holes in any of your teeth now? This question was also included in the 2011 Youth Tobacco Survey and will include middle school students.

OH-6 Oral and pharyngeal cancers detected at earliest stage Data source: Michigan Cancer Registry “Earliest stage” was defined as Stage 2. OH-8 Low-income children and adolescents who received any preventive dental service during past year Data was provided by the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Report (Form CMS-416)

OH-10 Local Health Departments (LHD) and Federally Qualified Health Centers (FQHC) that have an oral health component FQHC data was obtained from a report from the Michigan Primary Care Association LHD data was collected by contacting each site via phone. LHDs with oral health prevention or care programs within their building, not specific to any age group, income level, or insurance status were included in the numerator.

OH-11 Patients who receive oral health services at Federally Qualified health Centers (FQHCs) each year OH-11 Dental Sealants Data was from the 2010 Count Your Smiles Basic Screening Survey

OH-13 Population served by optimally fluoridated water systems

Fluoridation Surveillance, WFRS Report, 2009

OH-16 Oral and craniofacial health surveillance system OH-15 States with system for recording and referring infants with cleft lip and palate (developmental) Part of the Michigan Birth Defects Registry OH-16 Oral and craniofacial health surveillance system The Michigan Oral Health Surveillance System has enabled measurements of several health outcomes described in the Michigan OH Surveillance Logic Model, National Oral Health Surveillance system, and Healthy People OH objectives

Unavailable Baseline Data OH-3 Untreated dental decay OH-4 Permanent tooth extracted because of caries or periodontal disease OH-5 Moderate to severe periodontitis, adults ages 45-74 OH-7 Oral health care system use in the past year by children, adolescents and adults OH-9 School-based health centers (SBHC) with an oral health component (Currently collecting this data) OH-14 Adults who receive preventive interventions in dental offices (developmental) OH-17 State and local dental programs directed by public health professionals

Questions? 41