Advancing Equity in Oral Health Policy
Research shows that dental disease can affect physical and mental health and economic wellbeing and, as we see throughout all facets of our society, long-standing policies based on structural racism mean Black and brown communities experience poorer oral health as a result. For instance, Black and Hispanic adults have more untreated tooth decay than white adults and children of color and those in lower income families have more cavities, too. Moreover, Black, indigenous and people of color as well as immigrants and low-income populations face the greatest barriers related to living in areas without enough providers. While policy solutions exist that can increase access to care and improve oral health outcomes, it can sometimes be difficult to figure out which policies center equity, how to prioritize them and how to foster conversations around the importance of equity and community engagement in oral health advocacy – or health advocacy in general.
Few existing policy analysis tools examine how a policy addresses inequities or explores the role of community engagement in setting a policy agenda. Due to particular power dynamics that often arise in oral health, it’s critical to foster conversations about equity and racial justice and to center authentic relationship building in oral health advocacy spaces. To help support the field in this critical work, the Dental Access Project worked with oral health advocates and organizers across the country to better understand how they think about and incorporate principles of oral health equity and community engagement into their policy advocacy. One result of this relational work was our Oral Health Policy Equity Tool.
The Policy Tool is an interactive resource to help key stakeholders center equity and community engagement in oral health policy agenda-setting and includes:
Six sections of guided questions, discussion prompts and additional resources to inform policy agenda setting.
Targeted questions focused on how various populations and marginalized groups will be affected by a policy, how inequities might be addressed and how advocacy efforts are (or can be) following the lead of directly-impacted communities.
Links to additional policy analysis tools and suggestions of where to consider integrating them with the equity analysis this tool offers.
A follow-up survey, where users can share experiences, feedback and suggestions for future updates to the tool.
The tool is designed to be flexible and user friendly with opportunities to analyze a specific piece of legislation or a comprehensive policy agenda. You can use the tool in full or to choose specific sections, based on need. It can also be used to work on specific policies or to foster conversations. Some specific examples of how the tool could be used include:
A statewide health advocacy organization is engaged in a process to set its policy agenda for the year ahead and wants to assess whether items from their prior year’s agenda are in line with a newly-identified commitment to advocate for policies that address inequities. The organization uses section 3 of the tool to analyze each policy on their agenda to help them prioritize.
A coalition focused on improving access to oral health care that includes advocacy and community-based organizations has been asked to sign onto a letter supporting dental therapy legislation in their state. They run the legislation through the full tool to assess how well it centers equity and community engagement before deciding whether to sign on.
A community-based organization is hosting a community forum to understand the oral health issues people in their community face and what solutions people want to see. The organization uses questions from sections 4, 5 and 6 to inform how they structure the forum and what information they are trying to elicit in these conversations.
While this tool was created with specific attention to the particular power dynamics that often arise in oral health spaces, it can easily be applied in other content areas, too. We hope it will support your efforts to deepen community engagement and center health equity in your advocacy.