The growing family of NIH institutes.
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Biomedical subjects
Publications and source records attributed to M Allukian.
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By the end of 1997, only 121 communities (59 percent) of the population in Massachusetts were receiving fluoridated water serving 3,523,615 people. Eleven communities, three of which are naturally fluoridated, are partially fluoridated communities. According to the 1992 Fluoridation Census. Massachusetts was ranked 35th in the nation by percentage of its population living in fluoridated communities. From 1968 to 1997, there were 135 fluoridation orders by 112 communities, of which 67 (49.6 percent) had binding referenda, with 30 (45 percent) winning and 37 (55 percent) losing the vote (one community had one order and two referenda due to a court decision). Eventually, 78 (58 percent) of the 135 orders resulted in fluoridation being implemented. The average length of time from the order of fluoridation to its implementation was seven years, with a range of less than one year to 29 years. From 1968 to 1977, there were 91 fluoridation orders as compared to only eight from 1988 to 1997. Fluoridation is still the most cost-effective preventive measure for dental disease and needs to be promoted once again in Massachusetts.
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During the 1980s, national policy promoted military expenditures and downsized domestic programs. These priorities, along with tax reform and deregulation, created a "domestic gulf crisis" with a new wave of vulnerable populations--poor children, the homeless, the elderly, and the uninsured. Our lack of a national health program compounds the problem. The 1990s will be a decade of change and challenge. To forge a healthier and stronger future for our nation, we must implement five public health imperatives: (1) We must have a national health program that is universal, comprehensive, and prevention-oriented, with built-in assurances for quality, efficiency, and a strong public health infrastructure. (2) We must have a comprehensive national health education and promotion program for all schoolchildren. (3) Women must have freedom of choice. (4) Prevention and public health must become one of our country's highest health priorities. (5) The federal government must increase its leadership, commitments, and resources to reach the goals set forth in Healthy Communities 2000 and Healthy People 2000.
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A meaningful national oral health policy is essential to have an impact on the oral health of women and children in our country. The federal government must exert strong leadership to promote oral health as an integral component of total health. The public and private sectors of the dental and health professions must work together in developing, promoting, and supporting this policy on the local, state, and national level to make an impact on the oral health of the people of our nation. This policy must include incentives, resources, evaluation, and community participation, to assure that the purpose of the policy is achieved. Mark Twain once said: "Even if you are on the right track, you will get run over if you just sit still." A national policy by itself is not enough. This policy must also include an implementation strategy with constituency support and advocacy so that the policy is implemented in an effective manner through organized community efforts to improve the oral health of women, children, and our nation.
This study determined whether or not income and other structural components of 15 Boston neighborhood health centers in 1979 and 1985 had a systematic influence on their dental productivity as measured by dental visits. Health center revenue sources, health center costs, dental program costs, dental and medical manpower, and type of facility license were analyzed in relation to dental visits using secondary data from multiple sources. Dental costs and dental manpower were substantial predictors of dental visits for both periods of time. Stepwise regression analyses suggest that in 1979, the type of license and the type of grants received also were associated with the number of dental visits. In 1985, however, none of the revenue variables showed an association with dental visits when controlling for dental manpower and dental costs.
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As fluoridation has become a legislative issue in Massachusetts, this study was done to determine what factors may influence the attitude of legislators. Ninety percent of the legislators had visited a dentist within the past year, thus providing an opportunity for the dentist to influence them on this issue.
Organized community efforts induced social change in 33 cities and towns in the greater Boston area to advance fluoridation in a state where fluoridation is a controversial and political issue. This regional approach was successful in obtaining fluoridation for the communities that shared a water supply.
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