Nevada is striking in its contrasts. Famous for high rollers and low vices, mountain peaks and desert basins, the state’s oral health statistics depict similar extremes: 2.7 million residents. Fewer than 1,700 dentists. One dental school.
For underrepresented populations, those extremes are even more pronounced. U.S. Census figures show that 47 percent of Nevadans are Latino, Black, American Indian, Asian, Pacific Islander, or multiracial. Yet, a 2007 report, Dentist Workforce in Nevada, found that dentists who self-identify as White number more than 70 percent in every region. In the rural and frontier areas, the likelihood that a non-White patient will be treated by a White dentist is greater than 90 percent.
But a grant from the Robert Wood Johnson Foundation (RWJF)-funded Dental Pipeline National Learning Institute (NLI) program is helping to change those odds. NLI supports community-based dental education and recruitment of students from underserved communities through grants to dental school/community partnerships.
At the University of Nevada, Las Vegas (UNLV), a partnership between the School of Dental Medicine and the Center for Academic Enrichment and Outreach (CAEO) works to increase diversity in Nevada’s oral health care by introducing culturally diverse high school students to the health care professions.
Putting Dentistry on the Radar
The UNLV pipeline project launched in early 2013, partnering with CAEO’s federally funded Upward Bound program. “Our core objective was to recruit high-risk individuals who exhibit great promise but may not have role models in the health professions,” says Frank Jones, DDS, MBA, assistant professor and director of continuing education.
Through monthly events with health professionals, career days, simulation labs, and workshops, the project gives underrepresented students practical experience in the health sciences. “We want these students to see the enormously rewarding careers that exist for them, and to actualize their dreams,” Jones says.
“The students are from grades 9-12, generally from low-income families, and more than likely the first generation in their families to attend college,” explains community partner Jennie Johnson, CAEO’s Upward Bound director. “Before participating with us, very few of them knew anything about dentistry, let alone considered it as a career.”
The exposure to a new career path was eye-opening for students, she adds. “Even though dentistry wasn’t on their radar before, they saw that it can be both a great opportunity for them and a way to meet a community need.”
Economic Accessibility, Cultural Connections
“Community need” is acute in the Silver State, which has the highest unemployment rate in the country—and where, according to a report by UNLV’s Center for Democratic Culture, 58 percent of the combined Black, Latino, American Indian, and Native Hawaiian/Pacific Islander population lives in poverty.
Providing care to those communities is rife with challenges, explains Keith Rogers, CAEO’s deputy executive director. “Look at dentists and where they are located,” he says candidly. “They’re not taking new patients, not making care available to low-income patients. There’s no economic accessibility.”
With only about 10 percent of dental students at UNLV coming from underrepresented populations, Nevada has considerable work to do. But there’s hope on the horizon.
As Dentist Workforce in Nevada notes, 91 percent of dentists who went to high school in the state’s Urban South work in that region; the results are similar for the Urban North. Graduates of rural/frontier high schools also have a high return rate, at 62.5 percent.
“This strong relationship between high school region and workplace region suggests that efforts targeted at increasing the number of dental school students from underserved areas of Nevada, such as rural and frontier counties, may be particularly effective at increasing the number of dentists in those areas,” the report’s authors concluded.
The data supports what NLI and its grantees already know: dental pipeline projects are crucial to achieving that increase.
“We help students identify with all cultures, beginning with their own,” says Mildred A. McClain, PhD, associate professor of clinical sciences at UNLV and one of the project’s coordinators. “When they become culturally sensitive, they’re motivated to bring their newfound skills not only to their own communities but to communities across Nevada.”
Frank Jones adds, “Ultimately, we hope they’ll return to mentor the next generation of students who lack the resources to become the health care leaders of tomorrow.”
A Valuable Partnership
Reflecting on the 2013 project, CAEO’s Johnson is excited about the early outcomes. “We had an overwhelming response, and the summer program was huge,” she says.
Participants flooded the instructors with questions. What are the prerequisites? Am I going to be able to handle math and science? Who can help me with those subjects? How many hours do I need to study? Is there anyone who can help me find financial aid?
“These were college prep students, but some of them had no idea where to start,” Johnson says. “We talked about how they had prepared for college and what they saw as obstacles.”
In simulation labs, the high schoolers got to use the same instruments and equipment as first-year dental students. “They loved making the molds, using them, and having that hands-on experience. It gave them insight into what a day as a dental student is like,” Johnson explains. “That’s what was so exciting.”
To Keith Rogers, the project addresses a long-neglected need. “It’s vital that we expose students to the need for oral health care and foster greater awareness,” he says. “That’s why we’re always receptive to partnering with pipeline programs. We’ve crafted a valuable partnership here, and we need to continue expanding it.”