healthy people 2020 objectives: michigan’s oral health status sept. 27, 2011; 12-1 pm est
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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.
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
Federal Interagency Workgroup (28 Federal Agencies)
HHS Secretary’s Advisory Committee
Federally Led, Stakeholder- Driven Process
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 PeopleTarget 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
Topic Area A-Z Listing
2020 Topics & Objectives 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 ProgressData 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
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
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.
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)
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)
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)
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.
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
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
Healthy People 2020 Objective Target U.S. Status Michigan Status (Yr) OH-1 Dental caries experience in primary teeth
Young children, ages 3-5 Children, ages 6-9 Adolescents, age 13-15
30% 49%
48.3%
33.3% 54.4% 53.7%
DNA 55.9% DNA
OH-2 Untreated dental decay
Healthy People 2020 Objective Target U.S. Status Michigan Status (Yr) OH-2 Untreated dental decay
Young children, ages 3-5 (primary teeth) Children, ages 6-9 (primary and permanent teeth) Adolescents, age 13-15 (permanent teeth)
21.4% 25.9% 15.3%
23.8% 28.8% 17%
DNA 27.1% DNA
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
Response Total Male (%, 95% CI)
Female (%,95%CI)
Yes 22.2% 21.7 (3.9) 22.6 (3.1) No 61.0% 61.1 (1.9) 60.9 (4.4) Don’t know/ Not sure 16.8% 17.2 (3.8) 16.5 (3.3)
• This question was also included in the 2011 Youth Tobacco Survey and will include middle school students.
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?
OH-6 Oral and pharyngeal cancers detected at earliest stage
Healthy People 2020 Objective Target U.S. Status Michigan Status (Yr) OH-6 Oral and pharyngeal cancers detected at earliest stage 35.8% 32.2% 33.2% (2007)
• 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
Healthy People 2020 Objective Target U.S. Status Michigan Status (Yr) OH-8 Low-income children and adolescents who received any preventive dental service during past year
29.4%
26.7%
32.5% (2008)
• 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
Healthy People 2020 Objective Target U.S. Status Michigan Status (Yr) OH-10 Local Health Departments (LHDs) and Federally Qualified Health Centers (FQHCs) that have an oral health component FQHCs with an oral health component LHDs with oral health prevention or care programs
83% 28.4%
75% 25.8%
82.8% (2011) 40% (2011)
• 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
Healthy People 2020 Objective Target U.S. Status Michigan Status (Yr) OH-11 Patients who receive oral health services at FQHCs each year 33.3%
17.5% 28.8% (2009)
OH-11 Dental Sealants
Healthy People 2020 Objective Target U.S. Status Michigan Status (Yr) OH-12 Dental sealants
Children, age 3-5 (primary molars) Children, ages 6-9 (permanent 1st molars) Adolescents, ages 13-15 (permanent molars)
1.5%
28.1% 21.9%
1.4%
25.5% 19.9%
DNA 26.4
DNA%
• Data was from the 2010 Count Your Smiles Basic Screening Survey
OH-13 Population served by optimally fluoridated water systems
Healthy People 2020 Objective Target U.S. Status Michigan Status (Yr) OH-13 Population served by optimally fluoridated water systems 79.6% 72.4% 91% (2011)
Population served by optimally fluoridated water systems, Michigan, 2000-2011
84
85
86
87
88
89
90
91
92
93
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Year
Pe
rce
nt
of
po
pu
lati
on
2
4
6 1
3
Gogebic36%
Ontonagon5%
Houghton0%
Keweenaw0%
Iron0%
Baraga42%
Marquette86%
Dickinson17%
Alger63%
Delta96%
Men
omine
e82
%
Schoolcraft93%
Luce0%
Mackinac 99%
Chippewa63%
Cheboygan80% Presque
Isle93%Charlevoix
90%
Antrim22%
Otsego0%
Leelanau
3%
Benzie0%
GrandTraverse
66%Kalkaska
0%
Crawford77%
Oscoda0%
Alcona0%
Manistee74%
Wexford0%
Ogemaw0%
Iosco97%
Mason85%
Lake0%
Osceola0% Clare
51%Gladwin
11%
Arenac23%
Newaygo43%
Mecosta88%
Isabella65%
Midland97% Bay
97%
Huron38%
Muskegon90%
Montcalm66% Gratiot
69%
Saginaw97%
Tuscola63% Sanilac
50%
St. Clair
92%
Lapeer93%
Shiaw
assee
68%
Clinton15%
Ionia64%
Kent97%
Ottawa97%
Allegan62%
Barry76%
Eaton85%
Ingham95%
Livingston57%
Oakland84%
Macomb99%
VanBuren45%
Kalamazoo81%
Calhoun88% Jackson
78%
Washtenaw93%
Wayne100%
Berrien57%
Cass78%
Hillsdale78%
Lenawee74%
Monroe72%
Missaukee60%
Alpena99%
Roscom
mon
Emmet16%
Genesee95%
Mon
tmoren
cy
Oceana0%
St. Joseph51%
Branch89%
Detroit
Percentage of Persons Served by MichiganCommunity Fluoridated Water Systems by County
Michigan Department of Community Health andWater Fluoridation Reporting System CDC 2009
0-24% Fluoridated
25-49% Fluoridated
50-74% Fluoridated
75-100% Fluoridated
0%
0%
**Does not account for those systems and wells with optimal natural fluoride levels
Fluoridation Surveillance, WFRS Report, 2009
OH-15 States with system for recording and referring infants with cleft lip and palate
(developmental)
Healthy People 2020 Objective Target U.S. Status Michigan Status (Yr) OH-16 Oral and craniofacial health surveillance system 100% 62.7% 100%
Healthy People 2020 Objective Target U.S. Status Michigan Status (Yr) OH-15 States with system for recording and referring infants with
cleft lip and palate (developmental) 100% Missing
data% 100%
OH-16 Oral and craniofacial health surveillance system
•Part of the Michigan Birth Defects Registry
•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?
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