Oral health disparities and the workforce: a framework to guide innovation.
BACKGROUND
Oral health disparities currently exist in the United States, and workforce innovations have been proposed as one strategy to address these disparities. A framework is needed to logically assess the possible role of workforce as a contributor to and to analyze workforce strategies addressing the issue of oral health disparities.


METHODS
Using an existing framework, A Strategic Framework for Improving Racial/Ethnic Minority Health and Eliminating Racial/Ethnic Health Disparities, workforce was sequentially applied across individual, environmental/community, and system levels to identify long-term problems, contributing factors, strategies/innovation, measurable outcomes/impacts, and long-term goals. Examples of current workforce innovations were applied to the framework.


RESULTS
Contributing factors to oral health disparities included lack of racial/ethnic diversity of the workforce, lack of appropriate training, provider distribution, and a nonuser-centered system. The framework was applied to selected workforce innovation models delineating the potential impact on contributing factors across the individual, environmental/community, and system levels. The framework helps to define expected outcomes from workforce models that would contribute to the goal of reducing oral health disparities and examine impacts across multiple levels. However, the contributing factors to oral health disparities cannot be addressed by workforce innovation alone.


CONCLUSIONS
The Strategic Framework is a logical approach to guide workforce innovation, solutions, and identification of other aspects of the oral healthcare delivery system that need innovation in order to reduce oral health disparities.
Hilton
Irene V
IV
San Francisco Department of Public Health, 1525 Silver Avenue, San Francisco, CA 94134, USA. irene.hilton@sfdph.org
Lester
Arlene M
AM
D003727:Dental Auxiliaries / Q000706:statistics & numerical data; D003729:Dental Care; D003815:Dentists / Q000600:supply & distribution; D006291:Health Policy; D054625:Healthcare Disparities; D006801:Humans; D008913:Minority Groups / Q000193:education*; D017146:Models, Organizational; D009936:Organizational Innovation; D011636:Public Health Dentistry; D014481:United States; D000078329:Workforce