Planning Oral Health Care for Vulnerable Communities

what is a health inequality

differnce in health status and distribution of health dterminant between different population groups

what is health inequity

presence of unfair avoidable or remeidiable differences between groups of people

what is dalhgren and whitehead model 1991

what is who global health status report 2022

what are commercial determinants and corprorate strategies in who

what is influencing the oral health determinants and what is being done to stop it

such as sugar tax, fruit and veg are more expensive than calorie high ready meals

what is social exclusion

is multidimensional and encompasses all aspects of poverty including social economic cultural and political factors that operate at macro and micro levels

is dynamic in that social exclusion can change over time and contexts

thise with social exclusion are seen to be in ectreme oral health crisis

what is extreme oral health

increased risk of oc caries pain missing teeth and reduced access to mainstream services

who is at risk of ectreme oral health

People isolateddue to older age

People who havelearningdisabilities

People whoendurehomelessness

People who arein custody orhave convictions

People who aremigrant workers

People who areasylum seekers or refugees

People who aresex workers

People who arevictims of slavery

People who havesubstance usedisorders

People who havemental healthcondition

what is intersectionality

helps to unpack the complexity and multidimensional and dynamic nature of social exclusion

.Intersectionality proposes that people who endure exclusion experience multiple forms of discrimination, stigma and disadvantage that are neither isolated nor independent, instead reflecting intersecting social identities

what action can we take

proprotionate universalims approach

what is proportionate universalism

the resourcing and delivering of universal services at a scale and intensity proportionate to the degree of need

eg mobile dental unit can help homeless and addicts to access dental care where they are unable to go to high street dentist

or smoking cessation advice

what are the principles of proportionate universalism

1. focus on improving health of most disadvantaged

2. focus on reducing the gap between best and worst off

3. focus on reducing entire social gradient

what are the marmot principles

6 policy objectives (in order of priority)

1: giving every child the best start in life

2. enabling all children, young people and adults to maximize their capabilities and have control overtheir lives

3. creating fair employment and good work for all

4. ensuring a healthy standard of living for all

5. creating and developing sustainable places and communities

6. strengthening the role and impact of ill-health prevention

what is inclusion in oral health

based on a theoretically engaged understanding of how social exclusion is produced and experienced, and how forms of exclusion and discrimination intersect to compound oral health outcomes

focuses on developing innovative inter‐sectoral solutions to tackle the inequities of people enduring extreme oral health

what is SIMD

scottish index of multiple deprivation

is a scale from 1-6976 1 is most deprived to least

broken down into 5 quintiles to measure

what are examples of inequalities in oral health

child dental health - dmft, mean dmft is average for the population

what are registration and participation rates in scotland

registered pt - any pt registered w an nhs dentist, excludes private dentists

participation- any registered pt who has contact w a dentist for exam or tx in the last 2 years

what are the participation and registration rates in tayside

almost all adults are registered in tayside in most deprived but only half are able to access the care

this is higher due to factors like transport childcare missing work/ income

what is need bradshaws taxonomy

normative need - defined by professionals baxsed on pro judgement from a suitable standard

felt need - defined by lay people

expressed need - felt need turns into action and expressed as a request to help