Horizontal approaches to improving oral health in rural communities
Addressing health concerns in the arctic.
Recently, I was afforded the opportunity to attend the Water Innovations for Healthy Arctic Homes (WIHAH) in Anchorage, Alaska.1
WIHAH was the first conference of its kind, and I was one of two dentists to attend. My mentor, Dr. Brittany Seymour, Assistant Professor of Oral Health Policy and Epidemiology at Harvard, and I were invited to take part in this interdisciplinary opportunity. This conference brought together the Department of Environmental Conservation of Alaska,
Environmental Protection Agency (EPA), One Artic, the Center for Disease Control (CDC), Artic Research Commission, United States Department of Agriculture by rural development and of course, two dentists under one roof to brainstorm innovative ways to address the impact of climate change on arctic human health.
Our attendance at the conference not only sparked interest in the impact of dental caries in Alaskan native children, but it elicited stories about the magnitude of the burden of oral disease. With a profession full of technology, we sometimes forget one of the first technologies that provided improved health outcomes was clean running water. In Anchorage, we were able to participate in conversations around water fluoridation, water borne and washed diseases, and the impact of water insecurity on overall health.
You might ask, what is water insecurity? Simply put, water insecurity is the human experience of not knowing where your water is going to come from. Can you imagine not knowing when you were going to get your next glass of water? Or how you were going to wash your clothes? And not knowing when your next opportunity would be to take a shower, or even brush your teeth? For me, the idea of water insecurity was mind-boggling.
According to the World Health Organization (WHO), there are five factors that influence water insecurity: amount, distance, time, quality and affordability.
In some areas of Alaska, they have less than 13.2 gallons per person per day, and when they are able to receive water they have to haul water for more than 100 meters which can take 30 minutes to a few hours.2 But the difficulty doesn’t stop there—many times their water is full of minerals, making it unpalatable and expensive. By definition, not only do areas of rural Alaska suffer from water insecurity, but they also have increased health disparities as a result.
Health disparities can be a product of poor water quality or minimal water quantity. Poor water quality is due to contamination from bacteria or viruses consequently producing water borne disease. Water insecurity leads to lower quantities of water, producing water-washed diseases.
Water-washed diseases are an outcome from an inability to maintain proper hygiene, which results in bacterial skin infections, respiratory infections and diseases such as dental caries.
Astoundingly, 40 percent of rural Alaskan children under the age of five have been hospitalized for full mouth rehabilitation under sedation due to dental infections.
Up next: What are some solutions to this problem?