Oral Health and Health Literacy

Since the early 1990’s, a number of major initiatives, conferences, and publications have focused attention on the importance of oral health and its relationship to general health. They have also served to bring attention to the issue of health literacy with regards to promoting oral health. Some of these pivotal activities include:

Oral Health in America: A Report of the Surgeon General20

On May 25, 2000, then Surgeon General David Satcher released the 51st Surgeon General’s report and first one dedicated to oral health. It reported that no less than a “silent epidemic of oral diseases is affecting our most vulnerable citizens–poor children, the elderly, and many members of racial and ethnic minority groups.” The report also cited a lack of awareness of the importance of oral health among the public. Based upon these findings, the Surgeon General called for action to promote access to oral health care for all Americans, especially the disadvantaged and minority children.

Healthy People: National Health Promotion and Disease Prevention Objectives21

The Healthy People initiative provides science-based, 10-year national objectives for improving the health of all Americans. They are grounded on the notion that setting national objectives and monitoring progress can motivate actions aimed at improving the health of all Americans. This program provides a framework for monitoring and measuring improvements in health status of the American population.

Healthy People 2000: National Health Promotion and Disease Prevention Objectives

In 1990 the U.S. Department of Health and Human Services (DHHS) issued its comprehensive set of national disease prevention and health promotion objectives for the ensuing decade titled: Healthy People 2000. It was the first time that oral health objectives were specifically addressed in the national objectives.

Healthy People 2010: National Health Promotion and Disease Prevention Objectives7

In 2000, the DHHS published their Healthy People 2010 objectives. Like the Healthy People 2000 document, the 2010 document provided a statistical description of the health of the US population, outlined current public health priorities, and outlined a strategic plan for improving the nation’s health. Twenty-two of the 467 objectives were related specifically to oral health. The document addressed the issue of health literacy saying: “Closing the gap in health literacy is an issue of fundamental fairness and equity and is essential to reduce health disparities.”

Healthy People 2020: National Health Promotion and Disease Prevention Objectives32

In December of 2010, the DHHS published their Healthy People 2020 objectives. For the first time in the history of Health People there is a special challenge to encourage developers to create easy-to-use applications in order to leverage information technology to make Healthy People come alive for all Americans in their communities and work places. According to Chief Technology Officer Todd Pare, “The myHealthyPeople” apps challenge will help spur innovative approaches to helping communities track their progress using Healthy People objectives and targets as well as develop an agenda for health improvement. You can find more information at HealthyPeople.gov: http://www.healthypeople.gov/2020/default.aspx. To view the specific Oral Health objectives in the 2020 objectives go to: http://www.healthypeople.gov/2020/default.aspx.

A National Call to Action to Promote Oral Health (2003)22

Then Surgeon General Richard Carmona released this report at the 2003 National Oral Health Conference in Milwaukee, Wisconsin. Dr. Carmona stated that:“One of the primary foci of this call to action is to promote activities to overcome the public’s perception that oral health is less important than and separate from general health, including enhancing oral health literacy.” In addition, he outlined the following oral health statistics:

  • Tooth decay is the single most common chronic childhood disease,
  • 1:600 children are born with a cleft lip and/or palate,
  • 22% of adults in the US had reported having had oral-facial pain within the previous 6 months, and that
  • 8,000 people die each year in the US from oral cancers.

Dr. Carmona described the “Call to Action” as a “map” or way of guiding efforts to improve oral health. Five specific action areas were identified:

  1. The public needs to realize that “oral” health is integrated with their “general” health.
  2. Strategies are needed to improve the effectiveness of Medicaid coverage.
  3. Biomedical and behavioral-science research is needed to increase knowledge related to the prevention, diagnosis, and treatment of oral diseases.
  4. Increased representation of women and minorities are needed in the oral health professions.
  5. Disease prevention and health promotion campaigns aimed at oral health are needed.

In September of 2003, Dr. Carmona attended the Pfizer Sixth National Health Literacy Conference. In his talk: “Health Literacy: Key to Improving American’s Health.” Dr. Carmona stated that, “Eliminating health care disparities is predicated on increasing health literacy.”23

NIDCR Work Group on Functional Health Literacy (2004)

The National Institute of Dental and Craniofacial Research is one of the 27 National Institutes of Health (NIH) and is within the U.S. DHHS. It is the federal government’s lead agency for scientific research on oral health and disease. It is also responsible for funding initiatives for studying and defining oral health literacy.

NIDCR convened a Working Group on Functional Oral Health Literacy in January 2004. The workgroup used existing health literacy knowledge from the medical field to begin building an understanding of oral health literacy. The workgroup was interested in the ways in which the issue of health literacy affected the adoption of effective disease prevention methods, patient adherence to treatment regimens, and ultimately, improved oral health status. In addition, the potential impact of oral health literacy on clinical research was also acknowledged.

Surgeon General’s Workshop on Health Literacy (2006)24

Acting Surgeon General Kenneth Moritsugu held a workshop in Sept of 2006 the goal of which was to present the state of science in the field of health literacy from a variety of perspectives. The conclusions that came out of this workshop were that:

  1. Health care providers must provide clear, understandable, science-based health information to their patients.
  2. The benefits of promising health information and new health technologies cannot be fully realized without also addressing health literacy.
  3. We need to look at the issue of health literacy within the context of large systems such as social systems, cultural systems, education systems, and public health systems.