California dentists promote prevention for Children’s Dental Health Month / Public News Service

As part of National Children’s Dental Health Month, dentists are asking California parents to get actively involved while their children learn to brush their teeth.

By third grade, 22% of children in California have untreated tooth decay, according to the California Department of Health.

Dr. Erin Shah, a pediatric dentist who practices in the Bay Area and vice chair of the Government Affairs Council for the California Dental Association, recommends children use an electric toothbrush with a timer.

“We really encourage a child to work on developing the brushing skill, and the morning is a good time for them to work on that,” Shah advised. “And then have an adult physically help you brush and floss at night, so the child can go to bed with really, really clean teeth.”

A recent study shows an increased risk of COVID-related complications in people with gum disease, and experts at UnitedHealthcare noted that children who grind their teeth may benefit from a night watchman.

Shah recommended that babies have their first oral health checkup between 12 and 18 months, so parents can get advice on brushing technique and diet.

“Having this early visit gives us the chance to get ahead of the game, so we’re proactive and preventative rather than reactive,” Shah explained.

The California Dental Association welcomed Gov. Gavin Newsom’s January budget proposal because it would increase funding to train more people in dentistry, expand Medi-Cal and maintain a recent increase in fees paid to dental providers.

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Minnesota is often credited with having an overall healthy population, but disparities exist for certain racial groups. A prevention effort that is taking shape is giving patients the tools to monitor a crucial element of their health: blood pressure.

Through the American Heart Association (AHA), the Native American Community Clinic in Minneapolis recently obtained 220 self-monitoring blood pressure cuffs to donate to at-risk patients.

Moriah Johnson, community health manager for the clinic, said the rollout of the program, as well as the emphasis on telehealth, coincides with recent improvements in levels of hypertension management for patients, including those with are diabetic.

“Pairing the two together might be a factor in why we actually saw quite a marked improvement in hypertension control,” Johnson explained.

She noted that the challenges include the general lack of engagement with the public, as blood pressure is not seen as a visible health threat. Johnson added that tracking some patients, particularly if they lose track of their devices, can be a hurdle.

Minnesota is below the national average for adults with high blood pressure, but the state’s native populations are well above US levels.

Johnson hopes the emergence of another component of the program, which is a web-based Bluetooth platform, will boost the effectiveness of the effort. This allows the clinic to take a closer look at the levels taken from a patient outside of the facility.

“From a care perspective, it’s hard data, which is really good,” Johnson acknowledged. “We can connect so that patients who engage see where their readings are at home.”

The AHA hopes to accelerate the monitoring program, so it can reach other populations. He recently partnered with two other community sites, the Phyllis Wheatley Community Center and the Minneapolis Cultural Wellness Center, to help educate patients.

Nearly half of American adults suffer from hypertension. Medical experts have said that left untreated, it can lead to poor health outcomes and is a key risk factor for heart disease and stroke.

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Oregon’s residency requirement to access the state’s medical assistance in dying law is no longer, after a settlement in federal court.

Oregon’s Death with Dignity Act allows terminally ill sane adults with six months or less to live to access end-of-life treatment. The law had made residence in the state compulsory since it was passed by referendum in 1994.

Dr. Nick Gideonse, a plaintiff in the Oregon case, practices in Portland and has patients living in Washington state. He emphasized that no other aspect of care is limited by state residency.

“Although, you know, I certainly understand that it made sense when Oregon was the first state to allow physician-assisted dying, it just wasn’t of any use anymore and was an artificial barrier for people trying to get end-of-life care,” Gideonse said.

Gideonse noted that nearly a third of Americans live in states where medical assistance in dying is legal. It includes Washington State, although more than 60% of hospital beds in Clark County across the Columbia River from Portland are in health care facilities with religious prohibitions on assistive care to death.

Under the settlement, Oregon officials must issue directives ending the application of the residency provision and seek legislation to remove language of residency from the law.

Amitai Heller, lead attorney for Compassion & Choices, which represented Gideonse in the case, said the residency requirement is unconstitutional because it directly discriminates against people trying to access end-of-life care from other states.

“The United States Constitution requires equal treatment for people living in different states to be able to access services from neighboring states under the Privileges and Immunities Clause,” Heller explained. “And the commerce clause prevents undue restrictions on commercial transactions between states.”

Washington, DC, and eight other states, including California and Washington, also have residency requirements in their medical assistance in dying laws. Heller noted that the settlement could have repercussions in those states.

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March marks two years since COVID-19 first devastated people’s lives across the country. A new report aims to examine lessons learned in Connecticut and efforts to ensure health equity for people of color in the state going forward.

According to a fall 2021 survey, nearly one in three black residents said they had a close friend or family member who died of COVID-19, along with one in four Hispanic respondents.

Tiffany Donelson, president and CEO of the Connecticut Health Foundation, which published the report, said it was important to recognize the barriers to health care access for communities of color in the state that contribute to disparities.

“What we’ve seen is that people of color also have less financial security,” Donelson observed. “It made economic impacts more disruptive, and people of color were also more likely to have jobs that required them to be on the front lines.”

Donelson pointed out that research shows people of color are less likely to have a primary care provider. By February, 10,000 Connecticut residents had died of COVID-19.

The report also included recommendations for how state and local governments can achieve racial health equity.

Donelson noted that healthcare accessibility was a big issue during the pandemic. She added that people of color in the state have less access to transportation and that bringing health care directly to the community is essential.

“We use the example of a vaccination clinic in a Walmart parking lot,” Donelson noted. “Again, meeting people where they are and doing it on weekends, so you know people are going there, and it’s an accessible place, and it’s convenient for people to Getting There.”

Other report recommendations for state officials included building relationships with community organizations, which can act as trusted messengers on public health issues by sharing information, conducting outreach and by soliciting comments.

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