1. 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

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

3. 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.

4. 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

5. 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

6. 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

7. Healthy People Background

8. 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.

9. 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

10. 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.

11. 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

12. 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

13. Topic Area A-Z Listing 13

14. 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

16. Objective Framework: Example

19. 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

20. 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

21. 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.

22. Ways To Connect With Healthy People
Spread the word about the 2020 objectives.
Follow Healthy People on Twitter
Connect with Healthy People on LinkedIn.
Join the Healthy People listserv.
Visit for up-to-date information and announcements. 22

23. Healthy People Oral Health Objectives

24. 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

25. 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

26. 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

27. 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

28. Healthy People in Michigan

29. 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

30. Michigan Oral Health Plan30

31. 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

32. 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.

33. 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.

34. 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)

35. 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.

36. 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

37. OH-13 Population served by optimally fluoridated water systems

38. Fluoridation Surveillance, WFRS Report, 2009

39. 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

40. 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

41. Questions? 41