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Health Equity Forum: Community Partner Article: Asian Americans Advancing Justice-Los Angeles – July 2017

Improving Oral Health through Community Collaborations

  

Fifty-six year-old Ms. Lin was taking over-the-counter pain killers to treat a persistent toothache. She turned to Asian Americans Advancing Justice - Los Angeles (Advancing Justice-LA) for help. The staff helped her enroll in a dental plan under Medi-Cal. But problems persisted. The treatments she needed were not covered — and the cost for care was unaffordable at $600. So she just received fillings for some of her teeth. She went home and continued to use pain killers. Ms. Lin’s story is far too common.

An extensive two year community needs assessment, outreach and education project conducted by  Advancing Justice-LA in collaboration with ten Health Access Project (HAP) partners across the state, sheds light on California’s oral health disparities among Asian American, Native Hawaiian, and Pacific Islander (AANHPI) communities.

They heard countless stories from community members about challenges they face finding qualified dentists, confusion about dental coverage, long delays before accessing care even while in unbearable pain, and having to choose between paying for oral health care and other basic needs.

Access to dental care is one of our country’s most glaring inequities, with people from communities of color and low income areas suffering because of a lack of providers and services, especially in their own language. Doreena Wong, Director of the Health Access Project (HAP) at Advancing Justice-LA explains, “If the dentist does not speak a patient’s language, talking about their dental problems, medical history, treatments options, or even filling out insurance forms are almost impossible.”

The lack of access to oral health care can have serious negative and wide-ranging effects on a person’s life. Periodontal disease can exacerbate chronic conditions, like diabetes and heart disease, which disproportionately affect certain AANHPI communities. It can also cause people to lose their teeth, which can make it difficult for a person to eat nutritious food or even find a job.

The staff at Advancing Justice-LA is working on a multi-year oral health initiative to highlight these inequities in California’s AANHPI communities. In the first year, they developed, translated, and analyzed over 1200 needs assessment surveys in eight languages—Bangla, Chinese, Hmong, Khmer, Korean, Mien, Urdu, and Vietnamese. “Those surveys identified critical needs, including community members wanting increased access to affordable dental care, desiring more educational materials in their own language, and needing more practitioners who understand their culture and/or speak their language,” explains Eddie Hu, Program Coordinator with HAP.

In the second year, they expanded their network, designed and implemented eleven culturally and linguistically appropriate AANHPI focus groups. The focus groups were in English, Bangla, Cantonese, Hmong, Khmer, Korean, Mandarin, Tagalog, and Vietnamese. They developed and translated oral health educational materials into AANHPI languages to accompany ongoing outreach, education, enrollment and advocacy efforts expanding coverage to the state’s health programs.

Their findings to date paint a bleak picture of oral health in AANHPI communities, especially access to dental care. It is often less expensive and not uncommon for people to buy round trip plane tickets back to their home countries in South Korea, China, or India for dental care, rather than brave the expensive and confusing system in California.

The goals for the future of the oral health work include developing more effective messages about the value of oral health to one’s overall health, reducing the challenge of accessing dental coverage and receiving services, and making preventive oral health care a priority for our communities. Marianna Yamamoto, Program Coordinator at HAP notes, “There is still much work to be done to increase AANHPI communities’ knowledge on the importance of oral health, and we will continue to work towards that goal.”