Introduction
This newspaper article is focused on the issue of dental care in Ontario. As the majority of population has OHIP coverage for their general healthcare, the dental care is only covered by private insurances that only a certain category of people has. In some cases, for example if an individual is on a social assistance plan, he does have some dental coverage, but this includes solely basic coverage, excluding any major dental interventions (root canals, etc…). In the case of this article’s central figure, he belongs to the lower middle class category, but still has his own business. The fact of his employment reflects on his situation in the worst possible way, as he has not much income, and at the same time is not entitled to government social assistance provided only to the unemployed. Being able to afford only minor dental manipulations, he did have occasional cleanings, fillings, and even once had a root canal. But unfortunately he did not realize the potential problem of an inflamed nerve, and that the infection from the dying tooth could eventually creep up through the blood vessels to the nerves of the orbital cavity, and eventually make him go blind. Having not been able to pay the amount of $ 1 300 requested by the dentist for the root canal and the crown, he decided to just courageously bear the suffering. Now, that he started having major health problems, the OHIP will have to spend hundreds of thousands of dollars for his treatment.
People affected by this community health issue
This major health issue for the most part affects the lower class, especially those involved in some sort of low-income employment and not receiving social assistance. The province is willing to pay for critically needed procedures, such as tooth extractions, but it does not go with simply preventing tooth decay. The lower middle class is affected to, as they might be able to afford low-cost procedures, but major interventions are still out of their price range. The same problem concerns those on social assistance. Not every procedure they might require is covered by the social support plan. Thinking broadly, even those people that do have dental insurance plans do not always have it covering the whole bill. For example, Standard Life dental insurance plan covers all minor procedures, but to a limit of $ 1 200 per year. Concerning major restorative work, it covers only 50%. In many cases such dental plans provide significant assistance, but sometimes the price for much needed dental care exceeds the abilities of a dental insurance. And again, not all families can cope with that.
Affected pre-requisites to health and/or primary health related concepts
The main health-related requirement affected is the ability of all people, disregarding their financial status being able to receive efficient dental care. The “social justice and equity” pre-requisite is afflicted. According to the Ottawa Charter Health Promotion, the action of health promotion intends to provide the same opportunities and resources to give all people a possibility of “achieving their fullest health potential” (Ottawa Charter for Health Promotion, 1986, p. 2). Right now in Ontario there are only private dental clinics that are unable to provide dental care services to all layers of population. Public dental clinics are the most favorable option to help resolve this problem. Although some people believe that an open-ended system of insurance would provide open-ended entitlement, it is possible to control the insurance amount, and arrange a certain individual fixed amount for a yearly budget. Community center based dental clinics will provide the essential tooth care for the poorer category of people.
Dental care offices are much needed in the GTA area health care centers. It was estimated that in order to provide hospitals with such, the government would spend approximately 2 million dollars per year, with the annual healthcare budget being 35.4 billion. The second affected pre-requisite is the “income”. The Ottawa Charter Health Promotion clearly states that equity policies for different people categories must be implemented. “It is coordinated action that leads to health, income and social policies that foster greater equity” (Ottawa Charter for Health Promotion, 1986, p. 2).
Realistic strategies to address these issues
First of all, the task of a community health nurse in partnership with community is to create a healthy public policy. All levels of healthcare, especially dental care should be placed on the agendas of all policy makers. The community should focus on guiding the policy makers, but keeping them aware of their decision’s consequences, realizing their health responsibilities. “Health promotion policy combines diverse but complementary approaches including legislation, fiscal measures, taxation and organizational change” (Ottawa Charter for Health Promotion, 1986, p. 2). According to the Ottawa Charter, the policy of health promotion calls for obstacles to be identified in non-health sectors, and be adopted and solved by the healthy public policy. A proper health promotion should aspire to making the healthy choices, also the easier ones for the policy makers. The second aspect that might help addressing these issues is reorienting health services in a way that community groups, medical professionals, institutions, and government work together towards a rational healthcare system. “Health services need to embrace an expanded mandate which is sensitive and respects cultural needs. This mandate should support the needs of individuals and communities for a healthier life, and open channels between the health sector and broader social, political, economic and physical environmental components” (Ottawa Charter for Health Promotion, 1986, p.3).
Roles enacted by the community health nurse while working on these issues
While working with the community on the issue of dental care in Ontario, the role of community healthcare nurse would consist of enclosing partnership with the community and define its legible health requirements during assessment, as well as setting their own priorities among the health goals. “During assessment and throughout the community health nursing process, community health nurses identify the health values of the individual/community, including what health means to that particular individual or community” (Canadian Community Health Nursing Standards of Practice, 2003, p. 6). “A community’s salient health needs may or may not initially be expressed explicitly” (Rafael and Falk, 2000). Another important role would include empowerment – a process where groups of people and communities engage towards an increase of community control, as well as political efficiency, social justice in order to improve the quality of community life.
References
Community Health Nurses Association of Canada, (2003). Canadian Community Health Nursing Standards of Practice.
Ottawa Charter for Health Promotion. First International Conference on Health Promotion Ottawa, 1986.
Rafael, Adeline R. Falk. “Watson’s philosophy, science, and theory of human caring as a conceptual framework for guiding community health nursing practice.” Advances in Nursing Science. 23.2 (2000): 34(12).
Welsh, M. (2007). Plunged into darkness. Toronto Star, pp. 18-19.