[Re: https://www.hifa.org/dgroups-rss/launch-who-global-report-%E2%80%9Cstate... ]
Dear Christine, and colleagues,
Thank you for raising the omission of oral health — I would like to underline it from the perspective of a clinic that sees its consequences every week. Somos Amigos runs a free dental clinic alongside primary care in a rural, mountainous part of the Dominican Republic, and for our patients oral disease is not a footnote to noncommunicable disease; it is part of the same picture. It shares the same risk factors — sugar, tobacco, poverty — travels alongside conditions such as diabetes in both directions, and, left untreated, brings pain, infection, lost work and school, and real social cost. WHO itself now counts oral diseases among the noncommunicable diseases, which makes their absence from a report on NCD inequality all the more striking.
It is also an inequality story in its own right. Dental disease falls hardest on exactly the populations such a report should illuminate — the rural and the poor, for whom a dentist may be hours and a wage away. In our experience it suffers the same "continuity gap" raised in the recent patient-safety discussion: care is episodic, follow-up is difficult, and problems are met late. A report that leaves oral health out risks understating the very inequality it sets out to measure.
So I would gently echo Christine's hope that future editions find room for oral health (and, as she notes, mental health). Including them would give a truer account of how unequally the burden of chronic disease is really borne.
With best wishes,
Frank Brightwell
Founder and Executive Director
Somos Amigos Medical Missions
El Naranjito, San José de las Matas, Dominican Republic
HIFA profile: Frank Brightwell is Executive Director at Somos Amigos Medical Missions, in the United States. Email: frank@somosamigos.org