Oral Health Data Profile Thurston County Local Impact

Oral Health Data Profile Thurston County Local Impact Network Mary Ann O’Garro, Epidemiologist Thurston County Public Health and Social Services Department September 2018

Purpose Population Health Indicators Describe current conditions Identify oral health disparities Inform anchor strategy planning Support network collaboration Thurston County Public Health & Social Services Department Population-Level: The whole community is accountable

is ranked 6 th Thurston County healthiest in Washington State Thurston County Public Health & Social Services Department

Dental Insurance Data Thurston County Public Health & Social Services Department

Dental Insurance: Thurston County Adults Dental Insurance All Adults Detail 24% Timeframe: 2016 Uninsured Estimate = 51, 000 adults Parameters: Covered or partially covered by dental insurance 76% Note: Any form of dental insurance Source: BRFSS Insured Uninsured Thurston County Public Health & Social Services Department

Dental Insurance: Thurston County Adults Insured Adults 100% 80% 66% 63% 72% 65% 76% 67% 40% 20% 0% 2012 Thurston 2014 2016 WA State Thurston County Public Health & Social Services Department Detail Timeframe: 2012 -2016 Insured Estimate • 2012 = 131, 500 adults • 2016 = 161, 700 adults Parameters: Covered or partially covered by dental insurance Note: Any form of dental insurance Source: BRFSS

Dental Insurance: Thurston County Adults Title Adults by Chart Income Detail 66% 86% Timeframe: 2016 Parameters: Covered or partially covered by dental insurance Low Income: Annual household income less than $35, 000 34% 14% Low Income Uninsured Not Low Income Insured Thurston County Public Health & Social Services Department Note: Any form of dental insurance Source: BRFSS

Dental Insurance: Thurston County Adults by Chart Age Title Detail 79% 66% Timeframe: 2016 Uninsured Estimate Age 18 to 64 = 35, 200 Age 65 and Up = 15, 200 34% 21% 18 to 64 Uninsured 65 and Up Insured Thurston County Public Health & Social Services Department Parameters: Covered or partially covered by dental insurance Note: Any form of insurance Source: BRFSS

Medicare & Dental Insurance: Thurston County Adults Dental. Adults Insurance All Medicare Detail Insurance: Medicare 33% Timeframe: 2016 67% Parameters: Covered or partially covered by dental insurance Note: Any form of dental insurance Source: BRFSS Dental Insurance No Dental Insurance Thurston County Public Health & Social Services Department

Health & Dental Insurance: Thurston County Adults Source of Health Insurance No Health Insurance 1% Detail Other 2% Timeframe: 2016 Parameters: 18 and up with any form of dental insurance 5% Purchased Own Plan 10% Medicare Military Source: BRFSS 11% 12% Medicaid 59% Employer/Union Plan 0% 50% 100% Among Adults with Dental Insurance Thurston County Public Health & Social Services Department

Medicaid Dental Utilization Data Thurston County Public Health & Social Services Department

All Ages o WA State: 39% o Thurston: 31% Thurston County Public Health & Social Services Department

Age Birth to 20 o WA State: 56% o Thurston: 47% Thurston County Public Health & Social Services Department

Age 21 and Up o WA State: 23% o Thurston: 19% Thurston County Public Health & Social Services Department

Dental Care Utilization: Thurston County Residents Age birth Chart to 20 Title 29, 885 31, 692 33, 054 34, 991 36, 430 Detail Insurance: Medicaid Timeframe: 2013 -2017 13, 052 13, 842 15, 039 16, 443 17, 043 Percent Change: § Eligibles = 22% increase § Users = 31% increase Note: FY = Fiscal Year FY 2013 FY 2014 FY 2015 Eligibles FY 2016 FY 2017 Users Thurston County Public Health & Social Services Department Source: Health Care Authority

Dental Care Utilization: Thurston County Residents Chart Age 21 and Up. Title 49, 261 49, 960 43, 719 Percent Change: § Eligibles = 166% increase 18, 762 FY 2013 Insurance: Medicaid Timeframe: 2013 -2017 32, 595 1, 954 Detail 7, 425 4, 616 FY 2014 FY 2015 Eligibles 8, 384 FY 2016 9, 618 § Users = 392% increase Note: FY = Fiscal Year FY 2017 Users Thurston County Public Health & Social Services Department Source: Health Care Authority

Age Birth to 5 o WA State: 53% o Thurston: 45% Thurston County Public Health & Social Services Department

Dental Care Utilization: Thurston County Children FY 2017 # Eligibles # Users % Users Age birth to 1 4, 769 1, 366 29% Age 2 to 5 7, 517 4, 152 55% 15, 263 8, 359 55% 4, 692 2, 152 46% Age 6 to 14 Age 15 to 17 Detail Insurance: Medicaid Timeframe: 2017 Note: FY = Fiscal Year Source: Health Care Authority Thurston County Public Health & Social Services Department

Licensed Provider Data Thurston County Public Health & Social Services Department

Ratio of Population to Dentists: Thurston County Detail Timeframe: 2016 Total Dentists = 203 Ratio Thurston = 1, 360 to 1 WA = 1, 250 to 1 Source: HRSA Thurston County Public Health & Social Services Department

Designations o North County o South County o Nisqually Tribe Thurston County Public Health & Social Services Department

Dental Visit Data Thurston County Public Health & Social Services Department

Last Dental Visit: Thurston County 8 th Graders Dental Visit All 8 th Graders Detail Timeframe: 2016 13% 3% Visit 1 or More Years Ago Estimate = 740 8 th graders 7% 77% Parameters: Visit for any reason Note: Provider can be based in any county In Past Year 2 or More Years 1 to 2 Years Never or Not Sure Thurston County Public Health & Social Services Department Source: HYS

Last Dental Visit: Thurston County 10 th Graders Dental Visit All 10 th Graders 5% Detail 6% Timeframe: 2016 9% Visit 1 or More Years Ago Estimate = 670 10 th graders 80% Parameters: Visit for any reason Note: Provider can be based in any county In Past Year 2 or More Years 1 to 2 Years Never or Not Sure Thurston County Public Health & Social Services Department Source: HYS

Last Dental Visit, Thurston County Youth In Past Year 100% 85% 84% 80% 69% 70% Detail Timeframe: 2016 Parameters: Visit for any reason 60% Low income: Eligible for free or reduced school meals 40% Note: Provider can be based in any county 20% 0% 8 th Graders Low Income 10 th Graders Not Low Income Thurston County Public Health & Social Services Department Source: HYS

Last Dental Visit: Thurston County Adults All Adults Dental Visit Detail 8% Timeframe: 2016 9% 13% Last Visit 70% In Past Year 1 to Under 2 Years 2 to Under 5 Years 5 or More Years • 1 Year or More Ago Estimate = 63, 800 adults • 5 or More Years Ago Estimate = 17, 000 adults Parameters: Visit for any reason, including specialists Note: Provider can be based in any county Source: BRFSS Thurston County Public Health & Social Services Department

Last Dental Visit: Thurston County Adults By Age Chart Title Detail 72% 78% Timeframe: 2016 Parameters: Visit for any reason, including specialists Note: Provider can be based in any county 28% 22% 18 to 64 65 and Up Not in Past Year Thurston County Public Health & Social Services Department Source: BRFSS

Last Dental Visit: Thurston County Adults Chart Title By Income Detail 57% 76% Timeframe: 2016 Parameters: Visit for any reason, including specialists Low Income: Annual household income less than $35, 000 43% 24% Low Income Not in Past Year Not Low Income In Past Year Thurston County Public Health & Social Services Department Note: Provider can be based in any county Source: BRFSS

Oral Health Data Thurston County Public Health & Social Services Department

Missed School Toothache: Thurston County 6 th Graders Tooth Pain 6 th Graders Detail 7% Timeframe: 2016 Missed School Due to Toothache Estimate = 220 6 th graders 93% Yes No Parameters: Missing school in past year (answer of yes or 1 or more days) Note: Does not include braces or injury Source: HYS Thurston County Public Health & Social Services Department

Missed School Toothache: Thurston County 8 th Graders Tooth Pain 8 th Graders Detail 4% Timeframe: 2016 Missed School Due to Toothache Estimate = 120 8 th graders 96% Yes No Parameters: Missing school in past year (answer of yes or 1 or more days) Note: Does not include braces or injury Source: HYS Thurston County Public Health & Social Services Department

Missed School Toothache, Thurston County Youth By Income Detail 20% 15% Timeframe: 2016 10% Parameters: Missing school in past year (answer of yes or 1 or more days) 6% 5% 6% 3% 3% Low income: Eligible for free or reduced school meals Note: Does not include braces or injury 0% 8 th Graders Low Income 10 th Graders Not Low Income Thurston County Public Health & Social Services Department Source: HYS

Mouth Pain in Past Year: Thurston County Adults All Adults Tooth Pain Detail 16% Timeframe: 2016 Experienced Mouth Pain Estimate = 34, 000 adults 84% Parameters: Yes (very often, occasionally), No (hardly ever, never) Source: BRFSS Yes No Thurston County Public Health & Social Services Department

Mouth Pain in Past Year: Thurston County Adults By Age Chart Title Detail 82% 91% Timeframe: 2016 Parameters: Yes (very often, occasionally), No (hardly ever, never) Source: BRFSS 18% 9% 18 to 64 65 and Up Yes No Thurston County Public Health & Social Services Department

Mouth Pain in Past Year: Thurston County Adults Chart Title By Income Detail 70% 88% Timeframe: 2016 Parameters: Yes (very often, occasionally), No (hardly ever, never) Low Income: Annual household income less than $35, 000 30% 12% Low Income Yes Not Low Income No Thurston County Public Health & Social Services Department Source: BRFSS

Permanent Teeth Removed: Thurston County Adults All Adults Tooth Pain Detail Timeframe: 2016 4% 63% 1 or More Teeth Removed Estimate = 78, 700 adults Parameters: Due to tooth decay or gum disease 33% Source: BRFSS 1 or More, Not All None Thurston County Public Health & Social Services Department

Permanent Teeth Removed: Thurston County Adults Chart Title By Age Detail 69% 42% Timeframe: 2016 Parameters: Due to tooth decay or gum disease Source: BRFSS 58% 31% 18 to 64 1 or More 65 and Up None Thurston County Public Health & Social Services Department

Permanent Teeth Removed: Thurston County Adults Chart Title By Income Detail 53% 69% Timeframe: 2016 Parameters: Due to tooth decay or gum disease 48% 31% Low Income 1 or More Not Low Income None Thurston County Public Health & Social Services Department Low Income: Annual household income less than $35, 000 Source: BRFSS

Diabetes: Thurston County Adults All Adults Diabetes 2% Detail 1% 10% Timeframe: 2016 Diabetes Estimate = 21, 200 adults Parameters: Ever told by health professional 87% Yes, Pregnancy Thurston County Public Health & Social Services Department Source: BRFSS

Smile Survey Data Thurston County Public Health & Social Services Department

Arcora Foundation Report for Thurston County http: //bit. ly/Thurston. Arcora. Oral. Health 2017

Emergency Department Data Thurston County Public Health & Social Services Department

Oral Health ED Visits: Thurston County Residents Location Chart Title Detail 60 Timeframe: July 1, 2017 - June 30, 2018 Total Visits = 72 12 Parameters: Visits for tooth, teeth, dental in chief complaint or discharge In-County: Providence St. Peter Hospital 2017 -2018 In-County Out-of-County Thurston County Public Health & Social Services Department Note: ED = Emergency Department Source: ESSENCE

Oral Health ED Visits: Thurston County Residents Age Detail 8% Timeframe: July 1, 2017 - June 30, 2018 15% Total Visits = 72 76% Parameters: Visits for tooth, teeth, dental in chief complaint or discharge Note: ED = Emergency Department Source: ESSENCE 19 and younger 20 to 49 50 and up Thurston County Public Health & Social Services Department

Oral Health ED Visits: Thurston County Residents Gender Detail 50% Timeframe: July 1, 2017 - June 30, 2018 Total Visits = 72 Parameters: Visits for tooth, teeth, dental in chief complaint or discharge 50% Note: ED = Emergency Department Source: ESSENCE Female Male Thurston County Public Health & Social Services Department

Overdose ED Visits, Thurston County Residents Opioids Detail 70 58 60 50 Timeframe: July 1, 2017 - June 30, 2018 50 45 Total Visits = 103 40 30 24 Average: 2 opioid overdoses ED visits every week (1 st half 2018) 21 20 8 10 0 7/2017 to 12/2017 Any Opioid 1/2018 to 6/2018 Non-Heroin Opioid Heroin Thurston County Public Health & Social Services Department Parameters: Includes unintentional, assault and undetermined Note: ED = Emergency Department Source: ESSENCE

Overdose Deaths, Thurston County Residents Opioids Detail 19 20 18 16 14 Timeframe: Calendar Year 2016 -2017 14 12 10 8 Average: 1 opioid overdose death every 3 weeks (2017) 10 8 5 6 4 2 2 Source: Opioid Quarterly Report 0 2016 Any Opioid Parameters: Includes unintentional, assault and undetermined 2017 Rx Opioid Heroin Thurston County Public Health & Social Services Department

Oral Health Disparities Definition • A difference in health outcomes due to systematic experiences or societal conditions that impact specific groups of people. • Thurston County • Age • Income Thurston County Public Health & Social Services Department

Population Change: Thurston County Residents Age 65 and Up 67, 252 70, 000 49, 971 60, 000 44, 964 50, 000 32, 764 40, 000 23, 629 30, 000 20, 000 10, 000 0 2000 2010 Thurston County Public Health & Social Services Department 2016 2020 2030

Income Change: Thurston County Residents All Ages Chart Title 71, 393 57, 467 22, 206 2007 61, 269 25, 417 2010 Low Income Detail Timeframe: 2007 -2016 29, 303 Parameters: Low income (less than 200% of poverty), Poverty (less than 100% of poverty) Source: American Community Survey 2016 Poverty Thurston County Public Health & Social Services Department

Contact Information Mary Ann O’Garro o 360 -867 -2525 o ogarrom@co. thurston. wa. us Presentation available online in PDF and Powerpoint o http: //bit. ly/PHSSHealth. Data Thurston County Public Health & Social Services Department