Tuesday, May 31, 2016

Engaging Grassroots with Grassmiddles to Facilitate Changes in Oral Health Equity


Why should grassroots and grassmiddles engage for oral health care? “If you want to go fast, go alone. If you want to go far, go together.” – African proverb

It’s been a busy spring for our team as we just wrapped up six meetings in six states (in just three weeks!). During the months of April and May, DentaQuest Foundation convened partners in the six states of our Grassroots Engagement Initiative, which launched last year in Arizona, California, Florida, Michigan, Pennsylvania, and Virginia.

The grassroots strategy aims to amplify the voice of those most impacted by oral health disparities –people who are living with tooth and mouth pain, limited access to dental services or affordable coverage, and other barriers to obtaining good oral health.

These meetings brought together those working at the state level (like oral health coalitions) – also known as the “grassmiddles” – with local-level community advocacy organizations – the “grassroots” groups.

DentaQuest Foundation’s grassmiddle partners have been working in oral health for many years and have a deep understanding of the policy environment in their states, often in addition to clinical knowledge or experience. Grassroots organizations, meanwhile, understand the needs of their communities and are experts at organizing and mobilizing community members to create change around issues like the environment, racial justice, jobs and more.

Why the Grassroots Engagement Initiative? Within it, these stakeholders learn from each other’s respective expertise. Together, they can take aligned action to improve oral health while also respecting and including the voices of those most impacted by oral health disparities.

These kinds of partnerships only serve to strengthen the effort of a larger national movement by getting everyone to agree on the priorities and join together where action is needed to improve oral health.


Illustrating the power of partnership

One of the Grassroots Engagement Initiative grantees in California is SCOPE (Strategic Concepts in Organizing and Policy Education) helped bring grassroots and grassmiddle partners to agreement on oral health change efforts.

SCOPE is a group that first emerged in the early ‘90s in the midst of the Los Angeles uprising following the Rodney King verdict. Staff from SCOPE facilitated what’s called “power mapping” at each of the six state meetings.

 “Power mapping” asks:
  •  what are the major issues in a state (for example, in Arizona: lack of adult dental coverage in Medicaid, lack of access to quality oral health care in Native American and other poor communities, and a weak social safety net);
  • who are the decision makers that could potentially influence those issues (for example, Governor Ducey and the Arizona legislature); and finally,
  • who else might be potential allies or challengers.


Participants then map out where all of these factors and people stand on the issue. Finally, they strategize on what’s needed to shift these dynamics in a way that positively impacts oral health in the state. Ultimately, the resulting power map should be used to track progress by revisiting it periodically to see how opinions have shifted.

At each state meeting, SCOPE helped participants reach consensus on a draft power map to begin using and measuring against. The agreement resulted from peer-to-peer learning, as well as collaboration across grassmiddles and grassroots experience.


Why does this matter? How will oral health equity improve?

Power mapping can be an excellent complement to the state’s oral health plan, which is goal-oriented and shows where the state wants to go. In fact, the power map and community level actors can help inform how to get there – an element that is improved with grassroots and grassmiddles on the same page.


Ultimately, it’s crucial that efforts to create change are in line with one another when facing a problem as significant as poor oral health. These state meetings seek to encourage all of us to see ways in which we can work together, and bring our respective strengths to the table, as we work for a healthier America.