1. Chapter 4 Social Responsibility and Justice

2. Objectives Describe the role of the dental hygienist in meeting the oral health care needs of the public Relate the importance of the Surgeon General’s Report on Oral Health to the profession of dental hygiene. Describe the issue of access to care and social responsibility Identify several strategies that a dental hygienist can implement in striving for social justice

3. Disparities in Oral Health Care Surgeon General’s Report on Oral Health First report was published in 2000. “Mouth is a mirror” of the body Addressed disparities and inequalities that affect the most vulnerable populations: poor, children, elderly, disabled and racial and ethnic minorities Pg 57

4. Disparities in Oral Health Care Report includes conditions and diseases such as oral cancers, lesions of the head and neck, birth defects, and facial pain. Report established that oral health is integral to general health and that the two should not be looked at separately. Oral health is a critical component of overall health.

5. Disparities in Oral Health Care

6. National Institute of Dental and Craniofacial Research published A Plan to Eliminate Craniofacial, Oral and Health Disparities in 2002. Report listed many factors besides finances that must be identified when determining why certain populations become patients and others do not. Social, political, economic, and cultural factors clearly underlie the complex social problem of inequality. In 2006, 2 children died due to dental abscesses, making headlines and triggering legislative actions to prevent this from happening again.

7. Health Disparities & Professionalism 47 million in the US are uninsured or have no health insurance; even more have no dental insurance Historic definition of a profession—finding solutions to oral health disparities. Dental hygienists are focused on prevention, a focus that fits well with the goals of health promotion established by the US dept. of Public Health. What it means to be a professional—pg 58

8. Standards of professional responsibility, community, and society. Increased access to care Promoting public health Supporting justice Recognizing an obligation to provide pro bono service

9. Ethical Goals in Oral Health Care Values of importance to achieving ethical goals in healthcare (goals that focus on society) Caring Stewardship Justice Different from ethical principles that focus on the individual like autonomy and self-determination. Justice in dental care is a complex topic……..

10. Ethical Goals in Oral Health Care What is fair or just? What does the just distribution of dental health care resources look like? What kind of care are individuals entitled to when resources are limited? What really is considered basic or adequate dental care?

11. Ethical Goals in Oral Health Care Even the definition of access can be misleading- Access: freedom or ability to obtain Accessibility: the ease with which health care can be reached in the face of barriers such as finance or culture According to Garetto and Yoder, we also have the responsibility to those who are unaware of need, do not seek it, cannot get to it, or are afraid of it. Ethically the goal of improving the health of the population is a societal greater good benefitting society at large

12. Social Justice Social responsibility as part of professionalism ADEA: American Dental Education Association ADEA defined its role and responsibility with its member institutions in improving the oral health status of all Americans in a report in 2003. Findings stressed the importance of increasing the diversity of the oral health workforce Teaching and exhibiting values that prepare future dental professionals to commit to oral health care to all populations, including the underserved.

13. Social Justice ADEA Recommendations for Improving Oral Health of Americans………..How to do this? Monitor future workforce needs Improve effectiveness of health care delivery system Prepare students to provide services to diverse pop. Increase the diversity of the workforce Improve effectiveness of allied dental professionals in reaching the underserved (pg. 60)

14. Role of the DH in addressing social disparities Suggested activities pg. 61 Safety net clinic Local water fluoridation School based sealant and fluoride programs Mobile dental vans Dental and general health fairs

15. Dental Community Clinics

20. The dental hygienist, along with other health care providers, must recognize the collective and individual responsibilities held as health professionals to address the oral health needs of the entire public.

21. The test of our progress is not whether we add more to the abundance of those who have much; it is whether we provide enough for those who have too little.” Franklin D. Roosevelt