Background on Environment & Policy
What are environment and policy strategies?
- Environment and policy interventions help create healthy places and practices to support healthy community members.
- Environmental interventions are designed to modify structures and physical surroundings in ways that improve individuals’ access to resources and overall capacity to prevent oral diseases and illnesses (e.g., cavities, gum disease, oral cancer) in order to impact their own health or the health of those around them.
- Policy interventions are laws or regulations that are put in place to achieve a goal, including organizational policies or public policies at the local, state or national levels. Policies are an important way to focus on the social, economic, and environmental factors that serve to create and/or enable individual oral care habits (e.g., brushing, flossing, using fluoride, visiting an oral health professional regularly, or getting oral cancer screening).
- Environment and policy interventions are intended to improve behaviors and environments in order to address the positive health effects of good oral care behaviors. Environment and policy interventions can also support:
- Policies supporting improved oral health-related behaviors (e.g., avoiding tobacco, minimizing use of sugar and alcohol, and using protective head and mouth gear during athletic events);
- Environmental changes that provide ways to change individuals’ lifestyle patterns by increasing access to resources (e.g., toothbrushes, toothpaste, floss, fluoride, protective gear, dental services, screening, sugar-free food and drinks) and minimizing access to other resources (e.g., tobacco, foods and drinks with high sugar content, alcoholic beverages); and
- Policies that support ways to change individuals’ lifestyle patterns by reducing barriers to prevention of oral diseases and illnesses (e.g., water fluoridation, access to dental sealants, reduced costs of services or resources, transportation to dentists’ offices).
Why are environment and policy strategies useful?
- Environment and policy interventions are attractive because they have the potential to reach all community members and create community changes that last much longer than most other types of interventions. It is believed that changes in environments and policies are critical to creating broad-based changes in oral diseases and illnesses as well as adoption of proper oral care habits.
How can I use environments and policy strategies in my oral health intervention?
- Oral health environment and policy interventions affect the availability of and access to oral services and products as well as incentives to adopt proper oral care habits. These may include interventions to enhance access to oral screenings or to minimize barriers to proper oral care habits (e.g., providing tooth brush and floss, sugar-free drinks and snacks), policy changes to increase insurance coverage for oral health services (e.g., oral cancer screening, treatment of gum disease, dental sealants among children), and urban planning and transportation interventions to increase the availability of or access to dental services or fluoridated water in your community.
- Interventions to increase access to oral screening and treatment act to change availability to services in a wide variety of settings including early childhood education centers, schools, businesses and community settings. This may entail using a mobile van at schools, senior centers or businesses; locating a full- or part-time dental clinic at these sites; utilizing local dentists and/or dental hygienists to conduct annual oral screenings in area schools; or providing transportation to and from the nearest dental clinic. Policy change interventions may also be used to increase access, for example, by improving the claims process for Medicaid covered oral health visits and case management or by providing funds to subsidize costs of oral health care.
- Interventions to increase access to fluoride have included providing fluoride tablets to community members; offering fluoride varnish treatments to children in early childhood education centers, Head Starts, or schools; or increasing access to fluoridated water throughout the community.
- Interventions to increase access to dental care products may include providing toothpaste, toothbrushes, and/or dental floss.
- Interventions to provide oral health-friendly food and snacks have been developed to provide sugar-free meals and drinks in primary schools as well as to eliminate refined carbohydrates in snacks and lunches at schools, senior centers and businesses.
With whom should I work to develop and implement environment and policy strategies in my oral health intervention?
- In order to create policies and environments that support oral care habits in your organization, you may need to work with management and decision-makers to decide what makes sense for the organization (e.g., changes to vending machines, changes to tobacco use policies).
- In the community, you may want to meet with local organizations (e.g., businesses, educational institutions, community organizations) to decide what can be implemented as well as policy- and decision-makers to develop, enforce, and evaluate these policies and changes to the environment.
- It is also critical to work with local businesses that can help to implement these interventions (e.g., pharmacies, restaurant and grocery store owners and managers, food manufacturers and producers).
- You might consider working with experts in public policy, law, advocacy, law enforcement, community organizing, insurance or other partners to decide what changes can be made to improve the community as well as how these changes can be promoted.
How can I enhance environment and policy strategies in my oral health intervention?
- Intervention strategies such as group education and campaigns and promotions are often used in conjunction with environment and policy interventions. These strategies can be used to provide information to vendors, restaurants, schools, worksites, or other places on the benefits of proper oral care habits, guidance to encourage and enforce the desired policies, and communication to let others know about the environmental changes and or polices (e.g., newspaper, radio and television ads).