Education

Combatting a Dental Health Epidemic

Published

10 years ago

May 21, 2015

In San Francisco, nearly 40 percent of children have experienced tooth decay by the time they reach kindergarten, and low-income kindergartners are eight times more likely to have untreated tooth decay, reports the San Francisco Children’s Oral Health Collaborative (SF COH).

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Oral health disparities are specific to local neighborhoods, with the highest rates in Chinatown, where more than 50 percent of all kindergarteners suffer from cavities.

To inform and elicit community feedback about the importance of children’s oral health – and continue to learn why some ethnicities are more at-risk – the SF COH, which includes UC San Francisco, the SF Department of Public Health and community health providers and advocates, hosted a community stakeholder meeting on April 30 in Chinatown.

Attendees at the two-hour meeting at the Chinatown YMCA included City and County of San Francisco Supervisors Julie Christensen and Scott Wiener, and Health Commissioner Ed Chow.

“Good oral health is critical to the well-being of our city, and we need to expand access to dental care as well as healthy and nutritious food, particularly in our low-income communities,” Wiener said.

Similar stakeholder meetings are planned for Latino and African American communities in San Francisco.

“Because of this meeting, we were able to raise the level of awareness of children’s dental caries that is disproportionately affecting the Chinatown neighborhood,” said Lisa Chung, DDS, MPH, associate professor in the UCSF School of Dentistry Department of Preventive and Restorative Dental Sciences and SF COH co-director.

“We were able to bring together local health and child care providers and organizations and engage in a spirited discussion about what could be causing these Chinatown disparities, existing barriers to addressing them, and how we can collaborate and move forward,” she said.

Tooth decay and periodontal disease are the two biggest threats to oral health and among the most common chronic diseases in the United States. In fact, former U.S. Surgeon General Regina Benjamin called oral diseases a “silent epidemic.”

Children with untreated cavities may experience pain, dysfunction, school absences, difficulty concentrating and low self-esteem, according to the SF COH.

“It is better to prevent tooth decay than to provide extensive dental treatment for a very young child,” said Dr. Steven Ambrose, director of Dental Services for the San Francisco Department of Public Health, a co-leading agency of the Children’s Oral Health Collaborative. “If we can help parents understand how to keep their babies’ teeth healthy, we can prevent unnecessary disease and pain, and promote and protect our children’s oral health in a far easier and cost-effective manner.”

Dental caries is largely preventable through dental sealants, fluoride varnish, healthy eating habits, daily oral care at home and routine dental visits. However, many parents, medical providers and even dental providers do not fully understand their critical roles in preventing this disease.

A cross-sector initiative designed to improve the health and wellness of all San Franciscans, the San Francisco Children’s Oral Health Collaborative coordinated the San Francisco Children’s Oral Health Strategic Plan 2014-2017 toward making the city cavity-free. The plan identifies the most effective, evidence-based actions each group can take to make the most impact. Target groups are children under 10, pregnant women, low-income communities of color, recent immigrants and other populations most at risk.

“Involving the community and collaborating with its members are essential in efforts to improve public health, and is at the core of SF HIP’s Children’s Oral Health Collaborative,” Chung said. “We prioritized this first meeting in Chinatown on public and private health professionals and Chinatown program planners, community leaders, and school administrators as they are working closest with the target population – young children and their caregivers.”

The San Francisco Children’s Oral Health Collaborative is supported by the Hellman Foundation. The Chinatown community stakeholder meeting was sponsored by the Chinatown YMCA, the Asian Pacific Islander Health Parity Coalition, APA Family Support Services, NICOS Chinese Health Coalition and API Council.

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Five Years After COVID-19 Began, a Struggling Child Care Workforce Faces New Threats

Five years ago, as COVID-19 lockdowns and school closures began, most early educators continued to work in person, risking their own health and that of their families. “Early educators were called essential, but they weren’t provided with the personal protective equipment they needed to stay safe,” said CSCCE Executive Director Lea Austin. “There were no special shopping hours or ways for them to access safety materials in those early and scary months of the pandemic, leaving them to compete with other shoppers. One state even advised them to wear trash bags if they couldn’t find PPE.”

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In the first eight months of the COVID-19 pandemic alone, 166,000 childcare jobs were lost across the nation. Significant recovery didn’t begin until the advent of American Rescue Plan Act (ARPA) Child Care Stabilization funds in April 2021.

Today, child care employment is back to slightly above pre-pandemic levels, but job growth has remained sluggish at 1.4% since ARPA funding allocations ended in October 2023, according to analysis by the Center for the Study of Child Care Employment (CSCCE) at UC Berkeley. In the last six months, childcare employment has hovered around 1.1 million.

Yet more than two million American parents report job changes due to problems accessing child care. Why does the childcare sector continue to face a workforce crisis that has predated the pandemic? Inadequate compensation drives high turnover rates and workforce shortages that predate the pandemic. Early childhood educators are skilled professionals; many have more than 15 years of experience and a college degree, but their compensation does not reflect their expertise. The national median hourly wage is $13.07, and only a small proportion of early educators receive benefits.

And now a new round of challenges is about to hit childcare. The low wages paid in early care and education result in 43% of early educator families depending on at least one public support program, such as Medicaid or food stamps, both of which are threatened by potential federal funding cuts. Job numbers will likely fall as many early childhood educators need to find jobs with healthcare benefits or better pay.

In addition, one in five child care workers are immigrants, and executive orders driving deportation and ICE raids will further devastate the entire early care and education system. These stresses are part of the historical lack of respect the workforce faces, despite all they contribute to children, families, and the economy.

The economic impact was equally dire. Even as many providers tried to remain open to ensure their financial security, the combination of higher costs to meet safety protocols and lower revenue from fewer children enrolled led to job losses, increased debt, and program closures.

Eventually, the federal government responded with historic short-term investments through ARPA, which stabilized childcare programs. These funds provided money to increase pay or provide financial relief to early educators to improve their income and well-being. The childcare sector began to slowly recover. Larger job gains were made in 2022 and 2023, and as of November 2023, national job numbers had slightly surpassed pre-pandemic levels, though state and metro areas continued to fluctuate.

Many states have continued to support the workforce after ARPA funding expired in late 2024. In Maine, a salary supplement initiative has provided monthly stipends of $240-$540 to educators working in licensed home- or center-based care, based on education and experience, making it one of the nation’s leaders in its support of early educators. Early educators say the program has enabled them to raise wages, which has improved staff retention. Yet now, Governor Janet Mills is considering cutting the stipend program in half.

“History shows that once an emergency is perceived to have passed, public funding that supports the early care and education workforce is pulled,” says Austin. “You can’t build a stable childcare workforce and system without consistent public investment and respect for all that early educators contribute.”

The Center for the Study of Childcare Employment is the source of this story.

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District Delegates to State Democratic Party Central Committee Meeting Celebrate Election Victory

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Front row: Megan Imperial, Genice Jacobs, Bobbi Lopez, Courtney Welch, Janani Ramachandran, Hercules Councilmember Dilli Bhattarai, Sarah Bell, Laura Babitt, Ashlee Jemmott, and Shawn Danino. Rear row: Ben Gould, Sam Davis, Victor Flores, Zac Bowling, Nate Hanson, Teddy Gray King, Cathy Adams, Neil Tsutsui, Sam Gould, Lauren Wilson, and Nick Pilch. Courtesy photo.

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Golden State Warriors Program Is Inspiring Next Generation of Female Engineers

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Front Row: UC Berkeley Steel Bridge Team Back Row: Girls, Inc. Participants. Photo courtesy of the Golden State Warriors.

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Organizers say the initiative is founded on the idea that science, technology, engineering, arts, and mathematics (STEAM) are crucial fields for innovation and progress, and empowering young girls to pursue careers in these areas is more important than ever. Studies consistently show that girls are underrepresented in STEAM fields, resulting in a gender disparity that limits potential and hinders diversity.

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