CENTERS FOR DISEASE CONTROL AND PREVENTION
Volume 15 • Number 2 • Spring/Summer 2002

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Eliminating Disparities in Oral Health: The National ‘Call to Action’

Vulnerable populations, including children, the elderly, the poor, and some racial/ethnic groups, continue to experience profound disparities in both their oral health status and access, according to the Surgeon General’s landmark report, Oral Health in America. One response to the report was the creation of the Partnership Network Group to begin development of a National Oral Health “Call to Action.” The group comprises national health, advocacy, and trade organizations; foundations; and federal agencies with oral health programs, including CDC. 

“The Call to Action process is intended to stimulate initiatives and expand efforts to improve oral health,” said Caswell A. Evans, Jr., DDS, MPH, Director of the Oral Health Initiative in the Office of the Surgeon General, Department of Health and Human Services, who is responsible for coordinating the initiative. “The goal of this process is to foster collaboration and develop shared strategies to promote oral health, prevent oral disease, and provide appropriate care and access to needed services.”

This initiative is consistent with recommendations made in the Surgeon General’s report, which include development of a National Oral Health Plan with a goal of improving quality of life and eliminating health disparities though effective collaboration at all levels of society among individuals, health care providers, communities, and policy makers. 

The following health disparities are highlighted in the report: 

• Poor children experience more tooth decay than other children and are twice as likely to have untreated tooth decay. Seventy percent of poor Mexican American children aged 2 to 9 years, 67% of poor African American children, and 57% of poor white children have untreated tooth decay. 
• African American men are less likely to be diagnosed with oral cancer at an early stage; the 5-year survival rate for black men is only 34%, compared with a 56% survival rate for white men. African American adults (aged 30 and older) are twice as likely as white Americans to have severe periodontal disease. 
• Elderly Americans who have low income or less than a high school education are more likely to have lost all their teeth. 

Development of the National Oral Health Plan builds upon action elements identified by the Partnership Network Group and the Surgeon General’s report, which include the following: 

• Change perceptions of oral health and disease so that oral health becomes an accepted component of general health. 
• Accelerate the building of the science and evidence base, strengthen and expand oral health research and education capacity, and apply science effectively to improve oral health. 
• Build an effective health infrastructure that meets the oral health needs of all Americans and integrates oral health effectively into overall health, and ensure the development of a responsive, competent, diverse, and “elastic” workforce. 
• Remove known barriers between people and oral health services. 
• Use public-private partnerships to improve the oral health of those who suffer disproportionately from oral diseases. 

Beginning in March 2002, five regional listening sessions were held in San Diego, Denver, Atlanta, Chicago, and Cambridge (Mass.) to gather information on priorities and strategies for improving oral health. The sessions included “open mike” public testimony. 

As a result of the testimony and written information submitted by more than 150 individuals, organizations, and interest groups, a National Oral Health Plan was drafted during summer 2002. As envisioned, this document will be directed toward a broad audience, including the public, health professionals, directors of community public health programs, and policy makers. It will contain specific actions organizations can take to improve oral health surveillance, epidemiology, and research; policy development and implementation; health professions education; delivery of programs and service systems, particularly those that improve access to care; and communications, health promotion, and health literacy.

“We hope this process will create a broadly shared vision and provide a common direction for improving the oral health of the nation,” noted Dr. Evans.

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