Culture of Health Blog

Monique Trice, 24, is a University of Louisville School of Dentistry student who will complete her studies in 2015. Trice completed the Summer Medical and Dental Education Program (SMDEP) in 2008 at the University of Louisville site. Started in 1988, SMDEP (formerly known as the Minority Medical Education Program and Summer Medical and Education Program), is a Robert Wood Johnson Foundation–sponsored program with more than 21,000 alumni. Today, SMDEP sponsors 12 sites, with each accepting up to 80 students per summer session. 

Diversity is more than ethnicity. It also includes geography, perspective, and more. I was raised in Enterprise, Ala., which is in Coffee County. The community’s demographic and geographic makeup set the stage for an oral health care crisis. Here’s how:

• Enterprise is a community of 27,000 and just 15 licensed general dentists, three Medicaid dental providers, and zero licensed pediatric dentists to service Coffee County, a population of 51,000. In 2011, Alabama’s Office of Primary Care and Rural Health reported that 65 of the state’s 67 counties were designated as dental health shortage areas for low-income populations.
• According to this data, more than 260 additional dentists would be needed to bridge gaps and fully meet the need. For some residents, time, resources, and distance figure into the equation, putting dental care out of reach. In some rural communities, an hour’s drive is required to access dental services.
• Lack of affordable public transportation creates often-insurmountable barriers to accessing dental care.

Growing up in a single-parent household, my siblings and I experienced gaps in dental care. Fortunately, we never suffered from an untreated cavity from poor oral health care, but many low-income, underserved children and adults are not so lucky.

Voters across the country were presented Tuesday with more than 170 ballot initiatives, many on health-related issues. Among them, according to the Initiative & Referendum Institute at the University of Southern California:

- Assisted Suicide: Voters in Massachusetts narrowly defeated a “Death with Dignity” bill.

- Health Exchanges: Missouri voters passed a measure that prohibits the state from establishing a health care exchange without legislative or voter approval.

- Home Health Care: Michigan voters struck down a proposal that would have required additional training for home health care workers and created a registry of those providers.

- Individual Mandate: Floridians defeated a measure to reject the health reform law’s requirement that individuals obtain health insurance. Voters in Alabama, Montana and Wyoming passed similar measures, which are symbolic because states cannot override federal law.

- Medical Marijuana: Measures to allow for medical use of marijuana were passed in Massachusetts and upheld in Montana, which will make them the 18th and 19th states to adopt such laws. A similar measure was rejected by voters in Arkansas.

- Medicaid Trust Fund: Voters in Louisiana approved an initiative that ensures the state Medicaid trust fund will not be used to make up for budget shortfalls.

- Reproductive Health: Florida voters defeated two ballot measures on abortion and contraceptive services: one that would have restricted the use of public funds for abortions; and one that could have been interpreted to deny women contraceptive care paid for or provided by religious individuals and organizations. Montanans approved an initiative that requires abortion providers to notify parents if a minor under age 16 seeks an abortion, with notification to take place 48 hours before the procedure.

- Tobacco: North Dakota voters approved a smoking ban in public and work places. Missouri voters rejected a tobacco tax increase that would have directed some of the revenue to health education.

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.

On April 27, 2011, Robert Wood Johnson Foundation Ladder to Leadership: Developing the Next Generation of Community Health Leaders program graduate (2009-10) Beth Albright Johns, M.P.H., assistant vice president for Early Childhood Initiatives and Education and the Success by 6 program at the United Way of Central Alabama, watched as much of her hometown was destroyed by tornadoes. While helping her friends, neighbors and colleagues in any way that she could, Johns also focused on her primary role, finding ways to protect the emotional health of the children affected by the tornado.

On April 27, 2011, the largest outbreak of tornadoes in the history of our country hit the southeastern United States and my home state of Alabama. Living in my part of Alabama, I am used to severe weather, but the 27th felt different. The day started with a sense of foreboding, but given our weather history, worrying about it was out of character. In our community, a warning of severe weather generally means watching experienced meteorologist, James Spann, roll up his sleeves and get down to business to help us prepare. So that April day, we tuned in only to watch Spann struggle to maintain his composure as the tornado destroyed Tuscaloosa. I became more and more alarmed as I watched it devastate the communities of friends, colleagues and other neighborhoods where I work and tear through my hometown of Birmingham. Numbing disbelief set in as Spann said, “Oh my God, take cover…it’s out of control.”

First Responders

The next day, April 28th, the community sprung into action. Our boardroom became the statewide 2-1-1 help line headquarters. Calls poured in from people asking for assistance or asking: “What can I do to help out?” Over 13,000 citizens registered through Hands On Birmingham and 2-1-1 to assist with the clean up and recovery. Pallets of clothes, water, generators and people from all over the country arrived to help. While trying to help others, my co-workers were also searching for loved ones and focusing on our job—protecting the mental health of children affected by the storms.

We immediately went to work with local agencies to advocate for mental health assessments for post-traumatic stress disorder among the kids.