Opinion | Michigan can address race disparities by expanding dental benefits

Myechia Minter-Jordan

Dr. Myechia Minter-Jordan is President and CEO of the DentaQuest Partnership for Oral Health Advancement, a Boston-based nonprofit organization focused on reforming the broken health system and enabling better oral health for all. She is the former CEO of the Dimock Center.

As a country, we are waking up daily to the avoidable loss of Black life. We know some of their names, like George Floyd and Breonna Taylor. But many more we sadly know only as numbers and statistics, reported as part of the daily coronavirus public health updates. 

What they have in common is their cause of death: systemic racism.

 The COVID-19 crisis has laid bare the inequities in health care in Michigan and across the country that existed well before the pandemic. We know this not only from the powerful experiences of Black and Brown people, we know it because we can see it in the data. 

According to Michigan’s Coronavirus Task Force on racial disparities, while African Americans account for 14 percent of the state’s population, they make up 40 percent of COVID-19 related deaths.

40 percent.

No wonder cities across Michigan, from Port Huron to Lansing, from Jackson to Flint all have declared racism a public health crisis.

Lack of economic opportunity, lack of affordable housing and healthy food options, lack of access to health insurance, lack of quality affordable care, lack of representation in the medical field, implicit bias and stereotyping, all contribute to a system that does not adequately value Black lives. 

These inequities have created a disparity so great that the average life expectancy of a Black man in Michigan is 10 years less than that of a white neighbor.

We need fundamental reforms in our health care system to fix these deep inequities. Yet there is one aspect of health care that is overlooked as a key component of that work — oral health. 

Poor oral health has a direct link to higher risks of chronic illnesses, including cardiovascular disease, diabetes, hypertension, asthma, and more. It leads to greater instances of depression and other mental health diseases. 

So yes, increasing access to preventive oral health care must be part of any solution to the racial disparities in this country. We have a long way to go.

Recent research from DentaQuest showed that more than 74 million Americans lack access to dental coverage — four times the number of people who are medically uninsured. More than 45 million Americans live in areas without an inadequate number of dentists. It shouldn’t surprise anyone that this gap in access disproportionately harms poor, Black, and Brown Americans. 

  • Americans in poverty are 2.5 times more likely to have an unmet dental need due to lack of insurance. 
  • Black adults are 68 percent more likely to have an unmet dental need than white adults.
  • Latino adults are 52 percent more likely than white adults to report having difficulty performing at work due to poor oral health.
  • Nearly 4 in 10 Black and Latino adults reside in the 14 states where Medicaid’s adult dental benefits cover no services or emergency-only care.

This has significant economic impacts as well. Due to a lack of access to preventive care and a reliance on emergency care, low-income adults spend 10 times more of their annual family income on dental services than high-income families. 

Fortunately, there is one thing Michigan can do now to address these racial disparities – protect and expand adult dental benefits in its Medicaid program. 

Michigan covers only limited dental benefits for low-income adults enrolled in the Medicaid program– and today, those benefits are at risk due to budget pressures. More than 1 million Michiganders — a disproportionate number of whom are Black and Brown — risk losing access to the same preventive oral health care as those who have private dental insurance. Michigan’s 2020 State Oral Health Plan calls for expanding access to oral health services for low-income, not reducing it.  Protecting oral health coverage is a no-brainer. Further limiting access to oral health services will exacerbate existing disparities.

There are other things we can do as well. We need a revolution in patient care – integrating medical, dental, and behavioral health. We must better leverage technology, like telemedicine, as not just a crisis tool but a long-term solution to increase access and reduce costs. And we also must empower patients, continuing to educate people about the direct link between good oral health and good physical health. 

Dr. Martin Luther King Jr. once said, “Of all the forms of inequity, injustice in health care is the most inhumane.”

He was right. We must be outraged and motivated to end the racial disparities in our health care system. As we emerge from this pandemic, we have an opportunity – and a moral imperative – to do just that.

Black lives depend on it.

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Comments

John S.
Thu, 08/06/2020 - 8:00pm

It appears the major problem as the author points out is lack of funding. My dentist told me that for years he delivered services to patients on Medicaid. He stopped. He told me that the paperwork and lesser reimbursement rates from Medicaid compared to patients with private insurance weren't worth it. He told me, "I've done my share."

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CRB
Sat, 08/08/2020 - 10:51pm

How about allowing food stamps to cover basic preventative health care items: soap, toothpaste, toothbrush, cleaning supplies, ...? If an item is on the list for FSA or HSA we should allow that flexibility of low income Michigan residents to purchase it with assistance money they are already receiving from state/federal sources. Help people stay healthy, so they don't need to use services that could have been prevented and allow them and their families to be healthier; even if they don't trust the medical service care available or today possibly scared to use the services.

zooman
Mon, 08/10/2020 - 2:11pm

This is an important and timely article. The question that lingers is why all medical insurance, private,m employer funder, Medicaid, and Medicare do not cover dental (and eyecare), which seems to be pretty much the norm in the rest of the developed world. What history underlies this omission?

Dr Raymond Gist
Mon, 08/10/2020 - 10:03pm

I am in total agreement with Dr Minter-Jordan. I have been advocating on behalf of organized dentistry, on behalf of my private practice, and in conjunction with Dental HealthPlan of Michigan, for fair remuneration for our services for all of the reasons cited by Dr Minter-Jordan. I am also an advocate for community fluoridation and was a keynote speaker for the 75th year anniversary celebration by the American Dental Association.
This is a mission and a passion of mine, and of organized dentistry, and we will lobby until we are successful in creating a pathway for treatment of these patients that desperately need our care. I am pleased to read her message.
Dr Raymond Gist, former president, American Dental Association

Zilphia Daniels...
Tue, 08/11/2020 - 3:22am

Your Guest Commentary, Dr. Myechia Minter-Jordon, brings light to a dark situation and provides stats to support the need for fundamental reforms in the Health Care System. Dr. Jordon indicates good oral health is a link to good physical and mental health. Increase access, reduce cost and educate the public will improve life expectancy in the Black and Brown community. She agrees with Dr. Martin Luther King Jr., "Of all the forms of inequity injustice in Health Care is the most inhumane."

livingwages
Wed, 08/12/2020 - 1:04pm

Yes, oral health and preventive care ... I had Medicaid as a single parent in the '80s. I quickly learned that it wasn't funded, doctors/dentists refused to take Medicaid patients because they weren't adequately reimbursed, etc. Now it is the same old story, the states begging the feds for funding and a Trump administration in chaos. This vicious cycle continues with BCBSM big business and CEO/UAW profiteering while the uninsured and underinsured clamor for preventive healthcare and die because nothing has changed. I knew universal healthcare/Medicare for All was necessary 35 years ago, and here we are. The supposedly richest nation not providing the basics like healthcare, housing, food is a moral catastrophe, and Covid -19 should be our wake-up admittance that the healthcare and corporate CEOs are sacrificing our families on their altars of greed.

Zane R Nobbs
Fri, 09/04/2020 - 11:35pm

This is clearly an abuse of power. Either masks work, in which case businesses, churches, and other public facilities can be open, or the masks don't work, so it doesn't matter if everything is open or not. Notice that when the Antifarts of Black Lies Matter Thug Cop-Killers want to "peacefully" protest (loot, burn, rob, rape, murder, etc.) COVID-19 is magically not mentioned, however, just suggest going to church, and a political ruckus gets started. Then there's the executive order for nursing homes to accept COVID-19 patients resulting in needless and untimely deaths of our most vulnerable population, the elderly. On this issue Governors Whitmer, Cuomo, Newsom, and others need to be charged with murder at the federal level, put on trial and be sentenced. Unfortunately, being elected governor hasn't cured any of these people from remaining blithering idiots.