Oral Health in Early Head Start and Head Start Programs in Kentucky

INTRODUCTION: Although the Head Start (HS) program has been functioning for over forty years, its success in preventing oral diseases of enrolled children is not well understood. With the developing political stand-off over earmarks in appropriations bill, HS program is facing major cuts estimated at net $10.6 million in FY 2008. An assessment of Kentucky's (KY) HS/EHS programs has never been done. Therefore, it is difficult to assess the impact of potential budget cuts on KYs vulnerable populations.

OBJECTIVE: Develop GIS maps describing geographical distribution of HS/EHS programs in KY and assess the spatial-demographic adequacy in serving the population in need for HS/EHS services.

METHODS: After deriving the list of all HS/EHS programs in KY from the office of Head start; spatial and demographic data from KY government and US Census Bureau, we compared county-level socio-demographic and economic data with number of existing HS/EHS programs and developed GIS maps using Arc-View GIS software. We used Epi-info for basic data analyses.

RESULTS: 34 of KY's 122 counties (28%) have HS/EHS programs whereas 13 (11%) have integrated EHS programs. Although oral health coverage for HS/EHS children is provided through Medicaid and the SCHIP in some instances, unmet needs and barriers to accessing the delivery system are high. Substantial parts of the state with lower economic profile do not have easily accessible HS/EHS programs.

CONCLUSIONS: Proper understanding of the factors associated with access to care is necessary to develop adequate community capacity leading to enhanced preventive strategies and improved oral health outcomes.