by Schuyler Center | Aug 6, 2024 | Data, News, Oral Health
View the full report.
Oral health plays a critical role in a person’s overall health and wellbeing, yet many New Yorkers face limited access to the oral health services they need. Identifying where these needs are most acute can help guide resource allocation to fill service gaps.
A new report, released by the Center for Health Workforce Studies (CHWS) at the University at Albany’s School of Public Health, indicates that improving access to oral health services in New York State requires a broader understanding of oral health needs and the challenges that underserved populations face. The study, conducted by CHWS and funded by the Schuyler Center for Analysis and Advocacy (SCAA), identified geographic areas throughout the state with the highest oral health needs.
“This research study quantifies factors that contribute to unmet need for oral health services,” said Jean Moore, CHWS Director. “These findings can strengthen policy discussions, identifying strategies that can effectively meet the state’s unmet oral health needs. Policies that prioritize education, socioeconomic support and workforce expansion can help improve access to oral health services, particularly for the underserved.”
The research team identified 31 high-need areas with significant oral health needs, primarily located in rural regions such as the Mohawk Valley, North Country and Southern Tier, where more than two-thirds of the population live in high-need areas. Similarly, over one-third of the population of the Central New York region resides in high-need areas. The Long Island, Hudson Valley and Finger Lakes regions show the lowest percentages of high-need areas and the smallest proportion of the population living in these areas.
To determine the areas of greatest need, researchers analyzed 15 sociodemographic and oral health indicators that influence the level of need for oral health services. They found that factors such as disabilities/special needs, level of education, pregnancy and the relative number of dentists and dental hygienists per capita were the most important indicators connected with need. Other factors in the analysis included water fluorination, obtaining preventive oral health services, age, smoking and drinking habits, cancer diagnosis, minority status and English proficiency.
“This new data confirms the tremendous unmet need for preventive and routine oral health services in New York populations, especially New Yorkers with low income,” said Kate Breslin, president and CEO of the Schuyler Center for Analysis and Advocacy. “Poor oral health and dental pain impacts a person’s ability to live a full life, and a lack of access to oral health care is a matter of health equity. In the coming month, Schuyler Center will be researching and analyzing the data around policy solutions that promote oral health equity statewide, especially in the high-need regions identified in this report. Central to those solutions is bolstering the oral health workforce.”
About the Future Oral Health Workforce Project
Schuyler Center has been awarded a grant from CareQuest Institute for Oral Health to develop recommendations addressing the tremendous unmet need for preventive and routine oral health services in New York populations, especially New Yorkers with low income. The project is focused on increasing the availability of care by identifying comprehensive changes to policies that address the state’s significant oral health workforce shortage.
As part of this project, the 2024 oral health needs assessment aims to improve access to oral health services in New York by identifying areas with the highest oral health needs and addressing access barriers, particularly for underserved and vulnerable populations. This study adopts a community-centric approach, analyzing oral health and social indicators at the local level to provide a comprehensive understanding of need.
The findings advocate for policy changes to expand the oral health workforce, in order to benefit low-income populations, children, individuals with disabilities, and the elderly. The assessment underscores the importance of social and oral health factors and provides critical insights for policymakers to develop strategies aimed at reducing oral health disparities and promoting equitable oral health outcomes across New York.
Funding for this report was provided to the Center for Health Workforce Studies by the Schuyler Center for Analysis and Advocacy through a grant from the CareQuest Institute for Oral Health.
View the full report.
Learn more about The Future Oral Health Workforce Project: Oral Health Equity Through Workforce Design.
by Schuyler Center | May 15, 2024 | Child Care, Child Poverty, Child Welfare, Legislative, Oral Health
Download the PDF of Schuyler Center’s End of Session Policy Priorities.
In the remaining weeks of the current New York State Legislative Session, Schuyler Center will be advocating for the following policy priorities, most of which have active bills in both the Senate and Assembly. We are working with partner organizations and our legislative partners to move these important bills through both houses and to the Governor’s desk before New York’s Senators and Assemblymembers head home to their districts for the summer. These bills would benefit New York’s children and families, especially those impacted by poverty and inequity.
Child Care
Create a permanent child care fund to increase child care worker compensation. One-time “bonuses” or “retention grants” do not create a landscape where professionals can feel confident in the stability of this line of work.
A.8878 (Hevesi)/S.8152 (Brisport) — End New York’s rule of tying child care assistance to parents’ exact hours of work —This rule makes it difficult for many working parents with fluctuating schedules, including parents working in the gig economy or in retail, to access child care. This “decoupling” law was passed overwhelmingly by the Legislature in 2023, then vetoed by the Governor with a note that it would be “more appropriately considered in the context of the budget process.” The Legislature included this proposal in both of their one-house budgets; it was excluded from the final budget.
A.4099 (Clark)/S.4667 (Brouk) — Statewide presumptive eligibility — Allow families quick access to child care assistance while waiting for paperwork processing to be completed so parents do not lose job opportunities, and children experience more continuity of care. A recently-enacted federal rule (Improving Child Care Access, Affordability, and the Child Care and Development Fund), clarifies that federal funds can be used to cover the presumptive eligibility period, and encourages states to implement this and other policies that will ease enrollment burdens on families.
Child Welfare and Youth Justice
A.2479 (Hevesi)/S.902 (Brisport) —Anti-Harassment in Reporting — Requires reporters to the State Central Register to provide their name and contact information to prevent reports being used as a form of harassment. Reporters’ names could only be accessed by the Office of Children and Family Services and counties. Black children are nearly twice as likely as white children to be reported to the SCR. False anonymous reports are often used as a form of harassment.
A.9321 (Hevesi)/S.8724 (Hoylman-Sigal) —Safe Landings Act — Aims to protect and ensure support for young persons exiting foster care by authorizing the Family Court to enforce orders on behalf of children after they are discharged from, or age out of, foster care. For example, a young person (up to age 22, or older in certain cases) can return to the court and be appointed a lawyer if they are still in need of stable housing or other necessary services for their transition to adulthood.
A.4027 (Kim)/S.7054 (Hoylman-Sigal) —End automatic child support referrals upon foster care entry — Directs counties away from automatically referring parents of children who enter foster care to child support collections. For every $100 child welfare-involved parents pay toward foster care costs, their child’s duration in care lengthens for 6.6 months. States consistently spend more money trying to collect child support than they collect, typically at a 3:1 ratio. Some New York counties collect approximately $2.3 million a year on “foster care child support” cases, likely spending $6 million in child support administrative costs and delaying reunification.
A.8923-A (Hevesi)/S.1099-A (Bailey) — Right2RemainSilent — Prohibits police from engaging in custodial interrogation of a child under the age of 18 until the child has consulted with an attorney. It is well-understood by psychologists, sociologists, and neurologists that children lack the capacity to fully appreciate the meaning and significance of the right to remain silent, and to appreciate the repercussions of waiving that right. Data show that children falsely confess at three times the rate of adults.
Health
A.7402 (Peoples-Stokes) — Topical Fluoride Varnish — Amends the Education Law to permit dental assistants and licensed practical nurses to perform the application of topical fluoride varnish. Applying fluoride varnish to the teeth of young children is proven to reduce dental disease, but too few children in New York receive treatments. Allowing additional types of health providers to perform this service, as well as parents under the supervision of providers, would create more opportunities for children to receive this preventive service. This is an approach followed successfully in many other states.
A.8983 (Paulin)/S.7667-A (Cleare) — Adult Dental Benefits — This bill would codify dental implants, replacement dental prosthetic appliances, crowns and root canals as medically necessary and eligible for coverage under the Medicaid program.
Child Poverty
Urge the Legislature to monitor the State’s progress toward its child poverty reduction goals. In 2022, the State enacted the Child Poverty Reduction Act, thereby committing to reduce child poverty by 50% over the next decade. The Legislature should work with the Child Poverty Reduction Advisory Council to pursue a more ambitious timeline to reach this goal.
Additional Schuyler Center Priorities
A.1980 (Walker)/S.901 (Brisport) —Family Miranda Rights — Requires Child Protective Services (CPS) caseworkers to advise parents and caregivers of their rights at first contact.
A.109-B (Rosenthal)/S.320-B (Salazar) —Informed Consent for Drug Testing Parents and Babies — Requires medical care providers to seek the informed consent of pregnant people and new mothers before they or their babies are drug tested.
A.4238 (O’Donnell)/S.3426 (Myrie) — Youth Justice & Opportunities Act (YJ&O) — Expands alternatives to incarceration, diversion, and immediate record sealing for young people who are arrested in New York.
A.1885 (Clark)/S.3355 (Kennedy) — Implement a “cost estimation” method of setting child care assistance reimbursement rates — A cost estimation model is designed to better reflect the true cost of providing high-quality child care, including paying the child care workforce a thriving wage.
by Schuyler Center | Nov 8, 2023 | Oral Health, Past Events
By Bridget Walsh, Senior Policy Analyst for Health and Public Health
This October, Schuyler Center partnered with the NYS Oral Health Coalition and the NYS Early Childhood Advisory Council on a conference that highlighted progress that has been made since the 2022 Early Childhood Oral Summit. Over 120 people attended the two-day event that saw a variety of speakers, breakout sessions and roundtables discussions. The conference highlighted programs and policies that can continue to reduce oral disease in young children.
For the last century, and particularly in the last few decades, the oral health of very young New Yorkers has improved substantially. The decline in dental disease is a testament to the efforts of health professionals and individuals, public health investments, government policies, educational institutions and health care organizations. However, the improvements are not uniform and certain populations continue to experience a high degree of oral health problems.
Dental disease in children has been called a “hidden epidemic.” Hidden because dental disease is not always apparent until the pain becomes unendurable or until it manifests in an inability to eat, sleep, or concentrate in school. It is also hidden by poverty. Most children will not experience severe dental disease. Instead, the effects are felt primarily by low-income children because it relates to many of the same social and economic factors that drive other health disparities. Nearly one in four children ages 2-5 has had a cavity, and the prevalence of decay for kids ages 2-8 is distinctly higher for children of color. Lack of access to providers for preventive as well as treatment services is a primary reason for these disparities.
The NYS Early Childhood Advisory Council has endorsed a set of recommendations from the 2022 Summit and is advancing some of those with the Governor’s office. The Schuyler Center has worked to introduce legislation to increase access to fluoride varnish, an important preventive measure. Planning is also underway to develop convenient ways that early childhood programs can access quality information on oral health resources and trainings. The full Summit report is on the Schuyler Center website. Expanding the oral health workforce remains an important priority for those attending both last year’s and this year’s events.
The good news is that tooth decay is largely preventable, but there must be investments in access to care, integration of dental care into primary care, public health programs such as community water fluoridation, and providing education to families and communities about the importance of good oral health. By implementing the recommendations from the 2022 Childhood Oral Health Summit, New York State will be on the path to healthy smiles for all children.
by Schuyler Center | Feb 27, 2023 | Health, Oral Health
This column appeared in The Buffalo News on February 27, 2023.
Stephen Turkovich, MD
President, John R. Oishei Children’s Hospital
Sarah Ventre, MD, MPH
Pediatrician, Niagara Street Pediatrics
Clinical Assistant Professor of Pediatrics, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo
Bridget Walsh
Senior Health Policy Analyst
Schuyler Center for Analysis and Advocacy
February is recognized as Children’s Dental Health Month, but this year’s observance takes on special meaning in New York State after the recent, surprise news that drinking water in Buffalo has not been fluoridated since 2015. This disturbing discovery reminds us of the need to raise awareness of how fluoride prevents tooth decay.
Tooth decay is the most common chronic disease of children. Pediatricians see first-hand how the impact of poor dental health goes far beyond the mouth. Research shows that children with dental pain are three times more likely to be absent from school and four times more likely to earn lower grades.
Fluoride is a mineral found naturally in lakes, rivers, and other water supplies. Some communities have enough natural fluoride to reach the level proven to reduce the rate of tooth decay by 25 percent for children and adults. Most communities must add a little more fluoride to their water to reach this level.
Until recently, dental professionals and public health officials in Buffalo had assumed the city’s water system was properly fluoridated. The disclosure that this isn’t the case shocked local health officials, pediatricians, dentists, and parents — and for good reason.
The news from Buffalo might have prompted some New Yorkers to wonder: “Is fluoridated water needed if you brush with a fluoride toothpaste?” It turns out that both of those forms of fluoride are needed to prevent tooth decay.
The Centers for Disease Control and Prevention (CDC) reports that fluoride toothpaste and fluoridated water “provide important and complementary benefits.” So what happens when a city stops adding fluoride? Spoiler alert: It’s bad news for teeth, especially the developing teeth of children.
A recent study looked at what happened to children’s teeth after a city stopped adding fluoride to its tap water. After fluoridation ended in Juneau — Alaska’s capital city — the average costs for treating children’s cavities jumped by 47 percent in nine years. By contrast, the treatment costs for children in continuously fluoridated Anchorage rose only 5 percent in the same period. In Juneau, the impact was the worst for preschool-age kids.
There is no reason to believe that Juneau children stopped brushing their teeth after water fluoridation ended. In fact, one might have expected parents to make brushing more of a priority afterward. Nonetheless, children there needed a lot more fillings and other types of treatment. Clearly, fluoride toothpaste was not enough.
Pediatricians want patients to be as healthy as possible, from teeth to toes. Fluoride is an important part of protecting those growing teeth from decay. Now that the city’s water does not contain fluoride, Buffalo parents should speak with their children’s pediatrician or dentist about the best way to continue that protection.
Together, we can make sure Buffalo’s kids have healthy smiles.
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by Schuyler Center | Sep 21, 2022 | Health, News, Oral Health
By Bridget Walsh, Schuyler Center Senior Policy Analyst
As children around New York State settle into a new school year, it’s important to remember that giving children the best opportunity to learn and grow begins with ensuring they are healthy. Often overlooked in back-to-school checkups is oral health, but good oral health helps a child perform well in school and lead a healthy life.
Parents might find this surprising, but tooth decay is the most common chronic childhood illness. It is five times more prevalent than asthma, and potentially every bit as disruptive to a child’s ability to learn. Children who suffer from dental pain have, on average, lower grades than students with healthier teeth. Poor oral health can also impact a child’s speech development, self-image and concentration. Despite the fact that it is largely preventable, oral health challenges remain prevalent in many communities across New York State.
A healthy mouth is part of overall health, and is influenced by many factors. The path to good oral health goes through several “doors.” These doors include:
- Insurance coverage that makes care affordable
- The availability of oral health care providers within a community
- Access to preventative measures like dental sealants or fluoridated water.
Because these “doors” are locked in some areas and to some communities, there are stark racial and ethnic inequities in oral health outcomes. In fact, people of color, Latino people, and Mexican Americans experience nearly twice the amount of untreated tooth decay as their white, non-Latino counterparts. To advance justice in health, policies must provide the keys to good oral health to all.
Strong policies and programs that equitably support children’s oral health require continued advocacy. As children learn the routines of a new school year, Schuyler Center is advocating for public policies that provide the keys to good oral health for all communities, so all children are healthy and ready to learn.
We are proud to co-sponsor the upcoming Early Childhood Oral Health Summit with the Early Childhood Advisory Council, with the NYS Early Childhood Advisory Council, NYS Department of Health, NYS Council on Children and Families and NYS Head Start Collaboration Office. The free, one-day event will be held in Albany on Monday, November 14. The Summit will showcase best practices on preventing and treating oral disease in children and develop a shared policy agenda that will allow us to work across sectors to improve children’s oral health. Please register to join us.
For additional resources on public policy and research to support childhood oral health, visit our Oral Health page.
by Schuyler Center | May 30, 2019 | Oral Health
Bridget Walsh, Senior Policy Analyst at Schuyler Center, is recognized as a national leader in oral health. Bridget, at Schuyler Center for 20 years, is responsible for much of our health and public health success. On June 8th in Buffalo, Bridget and Schuyler Center are being recognized by the NYS Dental Foundation with their Foundations of Excellence in Community Service award, in recognition of our “leadership in fostering improved oral health for individuals, particularly underserved and at-risk populations, through advocacy efforts that emphasize education and prevention and foster ongoing partnerships among a wide spectrum of stakeholders.”
Schuyler Center also was recognized, in April, by the national Association of State and Territorial Dental Directors (ASTDD) with their 2019 Fluoridation Merit Award, for Schuyler’s work in NYS, for “outstanding contributions toward the promotion of science and progress of fluoridation.” The award was made jointly with ASTDD, the Centers for Disease Control and Prevention and the American Dental Association for our work in promoting fluoridation, particularly our “advocacy resulting in a state law that effectively stops Community Water Fluoridation rollback attempts and in obtaining $10 million in Medicaid funding for fluoridation; their work can be used in other states to model changes.”
Bridget Walsh accepts the NYS Dental Foundation Award. Standing with her is Laura Clark, Executive Director of the NYSDF and Ron Uba, Schuyler Center Board member.
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