Improving oral health care accessibility for homeless and vulnerably housed pet-owning populations

• Published in: Canadian Journal of Dental Hygiene Vol. 56; no. 2; pp. 98 - 103
• Main Authors: Jennings, Brianna M, Lem, Michelle, Kilborn, Susan, Donnelly, Blanaid, Acker, Amanda
• Format: Journal Article Trade Publication Article
• Language: English
• Published: Ottawa The Canadian Dental Hygienists Association 01-06-2022; Canadian Dental Hygienists Association; CJDH
• Subjects: Anxiety; Auditory discrimination; Clinics; Collaboration; Communication; Environmental health; Health care; Health care access; Health care reform; Health services; Homeless people; Homelessness; Medical personnel; Mental disorders; Mental health; Oral health; Oral hygiene; Pets; Professionals; Public health; Short Communication; Socioeconomic factors; Substance use; Canada; Ontario
• ISSN: 1712-171X; 1712-1728

Keywords: attitudes; community health centres; dental hygienists; dentists; health care delivery; health services accessibility; homeless persons; oral health CDHA Research Agenda category: access to care and unmet needs; capacity building of the profession INTRODUCTION Oral health is necessary for overall health, yet it is influenced by socioeconomic factors and health inequities.1,2 For example, the privatization of the oral health care system renders oral health care inaccessible to individuals with low incomes.2,3 One in five Canadians cannot access sufficient oral health services because of cost.4 Systemic barriers combined with access limitations result in poor oral health for people experiencing homelessness.1,58 PRACTICAL IMPLICATIONS OF THIS RESEARCH * Individuals experiencing homelessness face barriers to professional oral care, such as cost, discrimination, competing priorities, and past negative encounters. * Offering compassionate oral health care services in alternative, community-based settings may reduce these barriers and help to build trusting relationships between clients and clinicians. * Compassionate care training for oral health professionals and students is recommended. CVO is a Canadian registered charity that innovated a One Health approach to care, providing pro bono preventive veterinary health services alongside human health care to pet-owners experiencing homelessness.9 The Canadian definition of homelessness includes individuals who are, or are at risk of being unsheltered, emergency sheltered or provisionally accommodated and therefore vulnerably housed.10 One Health is a concept that human, animal, and environmental health are connected.9,11 Optimum human health can only be obtained when animal and environmental health are equally prioritized through a collaboration between sectors and disciplines9,11 CVO utilises a One Health approach to promote human health service uptake with pet-owners experiencing homelessness and to increase trust between clients and clinic volunteers. "15p7This statement echoes current literature, which highlights a concerning trend of people experiencing homelessness facing discrimination when accessing oral health care services. 18~23 Individual circumstances People experiencing homelessness may be unable to prioritize oral health care due to competing concerns, such as finding food.19,20,22,23 One participant mentioned the inability to prioritize oral care because of mental health issues: "It's not that I don't care, but when I'm depressed, you know things fall apart...my biggest concern isn't brushing my goddamned teeth...it's getting through the day. "14p4 Oral health care clinics rarely offer walk-in services or flexible appointment times, which are better suited to this population.20,22 The research projects and supporting literature suggest that mental health conditions, such as general anxiety, depression or substance use disorders, may make it difficult for individuals to attend oral health care appointments. 12-U-1S-20-23 Participants also reported anxiety specific to oral health care due to past negative experiences, which prevented them from accessing further care.1214 CVO clients are pet owners and therefore may experience additional barriers to care relative