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HSPM doctoral student among speakers in D.C. to discuss improving oral, dental health for nation's children

March 1, 2012

When the Pew Charitable Trust held a meeting recently on Capitol Hill in Washington, D.C., to discuss ways to improve dental health and access to care, one of the guest speakers was Christine Veschusio, a doctoral student from the Department of Health Services Policy and Management at the Arnold School of Public Health.

The director of the Oral Health Division for the S.C. Department of Health and Environmental Control, Veschusio was invited by the Pew Charitable Trust to take part in the program, "The Power of Prevention: Spending Smarter to Improve Dental Health," that included representatives of the U.S. Congress' Oral Health Caucus.

Veschusio was in the nation's capital to discuss the success that the Palmetto State has had to improve dental health. The results of public-private partnerships, she said, have resulted in cost-effective measures that have yielded long-term savings.

Her talk, "Creating the Perfect Storm: How South Carolina Achieved Early and Sustained Wins for Children's Oral Health," showcased efforts that began in 1999 when the S.C. Department of Education received funding from the Centers for Disease Control and Prevention to develop a comprehensive system of oral health services and programs for school-aged children in the state.

"These efforts were bolstered with the creation of the Division of Oral Health at DHEC in 2000 and the development of critical partnerships with the state's dental associations, university dental provider training programs, child advocacy organizations and other key groups," she said.

As a result of South Carolina's oral health efforts, fewer children are experiencing tooth decay and the need for urgent dental care, and more children have dental sealants, which act as a barrier to the protect the teeth against decay-causing bacteria.

South Carolina has had "a true public health win," Veschusio said.

Among the successes:

• Untreated tooth decay in South Carolina children declined from 32 percent in 2002 to 22 percent in 2008.
• Dental sealant usage increased (from 20 percent to 24 percent).
• There was no disparity in the status of sealant use between black and white third-graders.
• Children enrolled in Medicaid experienced higher rates of tooth decay; however, they were most connected to dental care as demonstrated by greater sealant use and lower untreated tooth decay as compared to children not enrolled in the Medicaid program.
• Important laws have been passed and policies changed to enable more children to be screened for dental caries and to ensure access to dental care.

Veschusio began her professional career as a dental hygienist. Because of her work in a private clinical practice, she said, "I knew that there was a population that I was unable to reach. I wanted to do more."

She earned her bachelor's and master's degrees from Empire State College of the State University of New York and began working at DHEC in 2002. She began her doctoral program in 2009 at the Arnold School.

Through her work with the DHEC, Veschusio is working with the Oral Health 2014 Initiative of the DentaQuest Foundation that involves the S.C. Rural Health Research Center, the S.C. Oral Health Advisory Council and Coalition, the S.C. Dental Association, the S.C. Institute of Medicine and Public Health, and the Palmetto Project.

A $100,000 award from the DentaQuest Foundation will establish a statewide dental screening initiative and enhance the state's infrastructure to improve oral health for underserved children, said Dr. Amy Brock Martin, deputy director of the S.C. Rural Health Research Center at the Arnold School.

"South Carolina often lags the nation in positive health outcomes," Martin said. "However, we have made significant strides in improving dental health for more children, and Christine Veschusio and the S.C. Department of Health and Environmental Health have been vital to this effort."

Other speakers at the Washington, D.C., program included Shelly Gehshan of the Pew Children's Dental Campaign; Col. Gary C. Martin, U.S. Air Force Dental Corps, Consultant for Dental Public Health; Ed Choate, president and CEO of Delta Dental of Arkansas; U.S. Rep. Elijah E. Cummings, (D-MD), co-chair, Congressional Oral Health Caucus; Cathy Mudge, executive director, California Dental Association Foundation; and Dr. William Thompson of the Council on Access, Prevention and Interprofessional Relations, American Dental Association.

The briefing for Capitol Hill staffers and media was held in recognition of February as Children's Dental Health Month and the fifth anniversary of the death of 12-year-old Deamonte Driver of Maryland, whose fatal brain infection began with a tooth abscess. Driver's story received national attention because it exemplified the problems of access to healthcare for many of the nation's children and their parents.

      

Influence of Arnold School's HSPM department is far-reaching

The invitation for Christine Veschusio to appear before a U.S. Congressional committee is among a number of honors and accomplishments in recent months by those associated with the Arnold School's Department of Health Services Policy and Management.

Dr. Jan Probst, director of the S.C. Rural Health Research Center, spoke at a press briefing in Washington, D.C., in the fall on a study in the October issue of "Health Affairs," the leading journal of health policy thought and research. That month's journal, dedicated to "Disparities in Health and Health Care," included an article by Arnold School researchers on the factors associated with a higher risk of death among rural blacks and whites than those in urban areas.

 

 

Probst, who collaborated with Drs. Jessica Bellinger, Katrina Walsemann, James Hardin and Saundra Glover on the study, found that lower incomes, education and health coverage increase the risk for death among blacks and whites living in rural areas. The study examined middle-aged adults to determine whether race/ethnicity and residence -- two potential sources of disparity -- combine to adversely affect rural, minority populations.

They chose adults of pre-retirement age because prior research suggests that mortality disparities associated with race and ethnicity are particularly acute for people between the ages of 45 to 64. "Specifically, we estimated total and relative mortality among black and Hispanic adults, by residence, and investigated factors that contribute to mortality," Probst said.

The researchers found that rural whites and rural and urban blacks were at an increased rate of death before age 65 than urban whites.

Characteristics such as low education, poverty, and poor health, although higher among all minority populations than among whites, are particularly common among rural black and Hispanic adults. This disadvantage translates into higher mortality, Probst said.

"To improve the health of rural Americans, we need first to document and then to address these disparities," she said. "Routine public health monitoring should include rural minority populations. The disparities experienced by rural black populations, for example, are concealed when all black adults are examined as a group."

The study's findings also suggest that rural minorities need greater access to health insurance and noted that it remained unclear whether the Affordable Care Act would expand health coverage to rural minority adults.

"Many Americans do not realize the extent of health disparities. Targeted efforts that recognize unique local cultures and address specific educational and economic disadvantages are key to achieving change," the researchers found.

Among other recent achievements:

• Arnold School doctoral student Hanadi Hamadi received the 2011 Student Research Paper of the Year Award presented by the American Academy of Medical Administrators.

Hamadi's paper, "Exploring Health Care Organizations Through the use of Transaction Cost Theory," was recognized during the AAMA's annual conference in Scottsdale, Ariz. A native of Saudi Arabia, Hamadi grew up in the Washington, D.C., area. She said she chose to study at the Arnold School's Department of Health Services Policy and Management because of its "curricula, class work and interests in research."

Hamadi earned a bachelor's degree in biology in 2007 and a master's in health system management in 2010, both from George Mason University. "My plans are to pursue a career in research and consulting. I would like to focus on ambulatory care services and its effects on patients' quality of life," she said.

"Although Hanadi deserves the full credit for her award, we like to believe the strength of our program played some role here as well. I would like to congratulate Professor Jan Probst for advising Hanadi during the writing phase of the research paper. My best wishes go to Hanadi for her continued success in future endeavors," said Dr. M. Mahmud Khan, chair of HSPM.

"I am pleasantly surprised with the plethora of good news since my joining here at USC. Nothing is more satisfying than the recognition received by our students. Our mission is to produce high quality graduates through the generation and dissemination of knowledge in areas related to healthcare administration and management," Khan said.

The AAMA student research paper award is presented annually to a healthcare administration student who displays excellence and originality in healthcare administration research and writing. Based in Des Plaines, Ill., the AAMA was organized to advance excellence in healthcare leadership through individual relationships, multi-disciplinary interaction, practical business tools and active engagement.

• Dr. Chinelo Obguanu, a doctoral graduate of the Arnold School's Department of Health Services Policy and Management, received the 2011 Outstanding Manuscript Award – State Affiliation at the 17th annual meeting of the CDC Maternal and Child Health Epidemiology Conference in New Orleans.

The Manuscript Award Committee singled out Obguanau's paper, "The Effect of Maternity Leave Length and Time of Return to Work on Breastfeeding," saying that it "stood out above your peers." The award-winning article by Obguanu, who is working in the Georgia Department of Public Health, was one that she prepared as part of her dissertation research at the Arnold School.