Title: Using CBPR Methods to Address Oral Health among Korean Older Adults
1. Significance:
The proposed research, which uses Community Based Participatory Research (CBPR) methods, builds on Dr. Ahluwalia’s existing work with homebound older adults, which seeks to inform oral health policy for New York City home delivered meal recipients in New York City (NYC). The proposed research will focus on working with the Korean community in NYC to understand oral health needs among Korean older adults, and to use the data collected to inform the development of oral health-related interventions for this population.
A recent review of the oral health literature indicates that there are few studies that document oral health needs among Koreans in
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Therefore, the goal of this project is to use CBPR methods to collaborate with partners in the Korean community to address oral health among a particularly vulnerable subset of the Korean community – older adults who may have significant medical, cognitive and functional co-morbidities, and who may find it difficult to navigate the oral and health care systems due to challenges associated with language, transportation and culture. By working with KCS, we hope to improve the visibility of oral health in the Korean community, and to leverage the potential of the collaboration to address oral health in other Korean groups e.g. children and family. CBPR methods are an effective way to achieve this goal because they require working closely with KCS, the community partner, and seek to enhance the capacity of the community, thus enhancing the potential sustainability of future intervention programs. The proposed research can potentially impact approximately 5000 Korean seniors through KCS.
The proposed research builds on Dr. Kavita Ahluwalia’s continuing CBPR project titled 'Oral health and nutrition in NYC HDM recipients '. I have been working with Dr.Ahluwalia on this project for the past year. I want to extend and apply what I have
Oral health has a direct impact on the general health, hence, it is important that all Canadians have adequate access to dental care services. Over the years successive Governments have reduced financial support to programs delivering dental care to most vulnerable populations. As a result, many low income families and other vulnerable groups have been unable to access dental care. There is further escalation in the disparities in oral health care among Canadians, as the number of Canadians losing dental care benefits continues to increase. Also, higher oral health care costs can be expected in the near future due to shortage of health care professionals.
As a nurse in a skilled nursing facility, oral hygiene care is very important, but the importance significantly increases when our patients are functionally dependent or cognitively impaired. These patients are unable to perform this task and depend on nurses to provide daily care. Nurses need to pay close attention for potential problems. They will need to perform assessments, develop oral care plans, and identify preventions and strategies to eliminate any potential problems. Poor oral health has been linked to serious systemic illnesses including diabetes mellitus, stroke, hypertension, myocardial infarction and aspiration pneumonia (Dyck et al., 2012). Patients who suffer from a lack of oral care can have a dramatic impact to their
Good oral health is important for a person's sense of well being and quality of life (Fiske, 2001). Inadequate oral hygiene can lead to pain, tooth loss, oral disease,
The accessibility of dental care in relation to race, ethnicity, income level, and overall socioeconomic status is evaluated. Across the board, a huge lack of dental care is seen in individuals of low-income levels and minority groups. In addition, the most susceptible groups to dental disease are identified as children, low-income adults, and the elderly. Ways to improve the oral health status of these groups are recognized. The various needs of underserved communities with respect to the access of dental care are assessed, despite a lack of sufficient dental insurance coverage of individuals who are members of these communities. This includes the improvement of both preventative and restorative care via public health programs, such as
As society continues to age, one fourth of the world will be 65 years or older, thanks to the influx of baby boomers. Due to this rapid growth in longevity, this will multiply the problem of access to care. Attention towards systemic conditions such as Alzheimer’s disease, cardiovascular disease, diabetes, and strokes are being discussed by government agencies and health care professionals. (Overview of oral health, 2017). There is evidence linking oral health to systemic health, therefore, a need for a more collaborative approach towards prevention is critical to achieve overall health for the public (Jin, 2016).
The first health disparity I would like to discuss is Oral health interventions among Hispanics, especially among Hispanic children. An article, “Community-based oral health self-care intervention for Hispanic families”, By Hull and other authors, focuses on monitories who are at high risk for poor oral health have dental caries, oral disease and not having much access to dental care based on their socioeconomic status Hull, 2013).
To begin, dentistry plays an integral role in the daily lives of countless individuals. Dentistry as defined by the International Council of Nurses is, "The profession of practice of providing care for the sick and inform in regards to oral hygiene." Populations around the world, and in particular Japan, are aging quite rapidly. Baby Boomers, individuals born between 1946 and 1964 are reaching retirement age as they too become older. As this demographic age becomes older, they will typically become more prone to sickness or other forms of detrimental illnesses. As such, the importance of dentistry in the coming years will be even more profound. As such, interviewing an individual within the health care industry provided valuable insights as to the overall profession, and the implications it has on society.
Research studies have indicated that the elderly Hispanic-American population residing along the Texas-Mexico border has minimal access to healthcare as well as inadequate use of preventive and screening services. The elderly population in El Paso, Texas is speculated to increase by 21.8% between 2014 to 2019 for the age group between 70 to 74 and 11.7% for the age group between 75 to 79. Unfortunately, many oral healthcare professionals are avoiding geriatric certification as a result of the low fees associated with Medicare and Medicaid and the bothersome paperwork that is often affiliated with the elderly, low-income, and minority patient. Based upon the Healthy People 2020 objectives for issues that are applicable to older adults; the objective to be addressed within this review report is the objective of increasing the proportion of dentists with geriatric certification. The specific research question to be addressed is “What are various factors that might be inhibiting dentists from attaining their geriatric certification and what are some strategies to overcome these obstacles and further facilitate this objective?” While the main priority should be to advocate for further health promotion of oral care in the elderly population and increasing the numbers of elderly adults that are able to understand the health benefits of oral care; various factors among the dentistry profession and elderly population must also be addressed. These factors might include ethnic
In the course of my time volunteering at the UCSD Student-Run Free Dental Clinics, I came to understand how poverty, language barriers, and a lack of knowledge about the importance of dental care can lead to readily preventable and treatable dental problems. These dental problems can lead to a cascade of issues, preventing an individual’s progress. As a clinic volunteer inside the school’s dental clinic, I noticed young students, with poor dental care, have constant pain that affected their studies and attitude. I recall a Hispanic young boy telling me he was sharing a toothbrush with his family. I hand over multiple toothbrushes and, using Spanish cards, educate him on oral hygiene. With each treatment visit, he was eager to tell the dentist
A health system defined as ‘all the activities whose primary purpose is to promote, restore and/or maintain health’ (WHO 2013). A good health system is indicated by its capability to delivers quality services, when and where the people need them (Australian Institute of Health and Welfare 2014). Australia’s health-care system is a combination of public welfare and private market provision (Willis, Reynolds & Keleher 2009). There are multiple layers of responsibility and funding provided by governments, individuals, health providers and private health insurers (Biggs 2013).
This proves that the lack of dental insurance within these low-income households plays a key role in whether or not these children will receive dental care. When these children do not visit the dentist, they increase their chances of developing dental caries significantly. The British Dental Journal disclosed that, “Sugars consumption varies by social class. National food surveys reveal a higher consumption of sugar and sugar-containing foods and drinks amongst low income groups”(Watt 8). Healthy food is expensive; therefore lower class families resort to unhealthy food because it is significantly cheaper. This extensive consumption of sugar-ridden foods is extremely detrimental to the enamel. The British Dental Journal also declared that “oral inequalities will only be reduced through the implementation of effective and appropriate oral health promotion policy”(Watt 6). The dental program will make the inequalities in dental care known and work to reduce those inequalities. Dental health is often times overseen because it is typically expensive and people are unaware of how the condition of their teeth affects the condition of the rest of their body. The all-inclusive dental health program will give people the treatment they need, regardless of their socioeconomic status.
While the private sector provides excellent quality of oral health care for its patients, many vulnerable groups have difficulty with access.2 It is also these vulnerable groups who demonstrate extremely high levels of oral health disease. According to a 2014 report issued by the Canadian Academy of Health Services (CAHS), the following represent Canada’s most vulnerable groups: individuals with low incomes; younger age children living in low-income families; individuals working without dental insurance; elderly populations with low incomes and/or living in institutions; aboriginal people, immigrants/refugees; people with disabilities; and, populations living in rural/remote communities.2 The CAHS authors report that increasingly and in light of challenging economic times, families from lower-middle income strata are also demonstrating difficulty with accessing oral health care (this is partially attributable to an increasing tendency toward part-time employment rather than full-time employment with benefits).
Underserved and Low-income populations face high rates of untreated dental diseases due to low access to dental treatment. One of the main causes of this problem is lack of participating dentists or poor distribution of dentists due to transportation problems. Untreated oral diseases are often seen in low-income communities and underserved populations The most common oral diseases that manifest in underserved populations are periodontal diseases and dental caries
Lastly, low income countries have 62% of the world population and there world health expenditure is 2%. By looking at this information “Evidence based intervention for all major oral diseases exist. But they are not available or implemented in majority of countries” (Beaglehole Pg 91). Please refer to appendix 5 and 6
Although many Americans have good oral hygiene due to fluoride and making everyday good decisions, others do not have any access at all to oral health care. Over the years, dentists have been trying to demonstrate the importance of oral care. (“Access to Dental Care”) From commercials to campaigns, dentists will continue to demonstrate to their patients as well as to the people who don't have insurance the importance of oral health care. They will teach them preventative care and some techniques on how to prevent from getting any diseases.