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Executive Summary
Executive Summary
Needs Assessments are a valuable instrument and means for individuals and groups to methodically learn from populations about their experiences, to identify needs, and develop solutions. Oral Health has been historically separated from United States healthcare financing, education, delivery, and research. This Oral Health Assessment is one institution’s (Cambridge Health Alliance – CHA) experience in utilizing available resources from the state’s Medicaid sponsored technical assistance marketplace (MassHealth Delivery System Reform Incentive Payment Program) to partner with a leading non-profit organization with significant experience in conducting needs assessments (Health Resources in Action – HRiA) to learn from local populations (Malden and Everett) at risk of oral health access barriers and investigate their likely needs.
This Oral Health Assessment was designed using available literature on community oral health needs assessments and associated oral health quality of life instruments implemented in the United States, United Kingdom, and elsewhere globally. Populations of interest were identified using recent utilization claims of non-traumatic dental conditions data from the locally serving hospital emergency department (CHA Everett Hospital). Relationships with CHA Needs Assessment workers, community-based organization, and subject matter experts were consulted with study team members to design and implement the following Oral Health Assessment:
● Key Informant Interviews ● Focus Groups (Malden Senior Living Center, Everett Haitian Community Center, CHA
Group Based Opioid Treatment, Malden parents of children) ● Online Oral Health Survey (266 Malden or Everett responses transcribed into English,
Spanish, Portuguese-Brazilian, Haitian Creole, Mandarin) ● Expert Advisory Group (Eight Representatives affiliated with state government, non-profit, grant-awarding, oral health advocacy, healthcare, and academic organizations)
Key findings from this report
▪ Pervasive disparities in access to oral health services by self-identifying people in the black, indigenous, and people of color communities of Malden and Everett. ▪ Barriers associated with accessing oral health services are strongly associated to financing, provider availability, and trust in the oral health system. ▪ Respondents report their oral health status affects their quality of life as it relates to their ability to function as well as their physical, psychological, and social wellbeing.
Opportunities for further work highlighted from this project
o The role that social support services, like community health workers or care coordination may have in enhancing access to oral health services. o The role that education, communication, and access to preventive oral health services plays in empowering communities to support their oral health where they work, learn, and live. o The value in integrating oral health and training allied health workers to address oral health needs in community with a culturally humble approach.
o The value in measuring oral health status in a community-focused approach compared with traditional healthcare system and provider centric methods.
This report may be used to help direct resources for oral health and community building in the communities of Malden and Everett. Healthcare agencies, healthcare payers, community assessment organizations and individuals interested in addressing oral health needs in their community may also use the process and findings from this report as they see fit.
To the communities of Everett and Malden, this project represents a hopeful beginning to fruitful collaborations aimed at empowering individuals and groups to reach healthy and meaningful lives.
-Alec S. Eidelman, DMD, MPH Community Dentist, Cambridge Health Alliance
Acknowledgements
This report is aware that individuals and groups are entitled to their own identities and that the act of being characterized into distilled categories for the purposes of reports can be harmful and hurtful. Concerted efforts were made to bring this awareness to our project activities, our language, and the intent of this report. While conducting the actions of this project, we also recognize the impact the COVID-19 pandemic and community-based research plays in our communities and thank those that participated for their time, patience, and efforts to let their voice be heard.
A special note of gratitude to the following individuals and organizations who helped support the work of this project:
Cambridge Health Alliance:
● Population Health Management ● Department of Community Health, Health Improvement Team ● Department of Dental Medicine and Oral Health
