1. Oral Health Disparities: How do Latino Children Fare? Clemencia M. Vargas, DDS, PhD. University of Maryland Dental School March 19, 2011

2. Disparities Definition: “Health differences which are unnecessary and avoidable but, in addition, are also considered unfair and unjust”.

3. Disparities Social determinants of health: Social conditions people are born, live, and work Individual choices are important, but are influenced by social conditions. (David Satcher PHR 2010)

4. Disparities Health disparities put socially disadvantaged groups at further disadvantage regarding their health

5. Latinos in the US

6. Hispanics in the US by origin Source: American Community Survey collected Jan 2006-Dec 2008 from United States Life Tables by Hispanic Origin

7. Socioeconomic Status Indicators Source: “United States Life Tables by Hispanic Origin” from the CDC

8. Socioeconomic Status Indicators Source: “The Hispanic Population in the United States: 2008 Detailed Tables” from the U.S. Census Bureau

9. Oral health

10. Oral health: Sources of Disparities Structural issue – –Dental care “system” – –Financing dental care – –Inadequate federal and state programs – –Limited dental public health infrastructure Source: Vargas & Arevalo, Dental Clinics of North America 2009

11. Oral health: Sources of disparities Workforce – –Shortage (5,000 pediatric dentists v. 47,000 pediatricians) – –Maldistribution – –Limited scope of practice – –Racial/ethnic homogeneity – –Training deficiencies Source: Vargas & Arevalo, Dental Clinics of North America 2009

12. Oral health: Sources of disparities Population issues – » »dentists, patients and community – –Social determinants – –Oral health literacy !!!!! – –Plain literacy – –Cultural competency – –Behavioral Source: Vargas & Arevalo, Dental Clinics of North America 2009

13. Oral health literacy is … Degree of capacity to obtain, process, and understand basic health information services needed to make decisions Source: Healthy People 2010

14. Oral health literacy is … Affected by: – –Low English Proficiency (LEP) – –Low educational attainment – –Literacy and numeracy skills – –Context Still a new field … very limited information about Latinos with LEP

15. Oral Health Disparities

16. Monitoring Disparities: Data! As long as there are disparities, data are necessary to: – – Plan, develop, and monitor programs – – Track differences over time Also to identify new disparities

17. Oral Health Indicators Children Ages 2-11 19.527.633.1 61.456.644.6 Source: “Trends in Oral Health Status: United States, 1988-1994 and 1999-2004” by Dye BA, et al.

18. Oral Health Indicators Children Ages 12-19 16.225.728.6 41.945.635.5 43.925.727.2 Source: “Trends in Oral Health Status: United States, 1988-1994 and 1999-2004” by Dye BA, et al.

19. Oral Health Care Source: “Trends in Oral Health Status: United States, 1988-1994 and 1999-2004” by Dye BA, et al.

20. Conclusions Compared to other groups, Latino children have : – –Lower SES – –More oral health problems – –Less oral health care

21. Thank you!