Influence of Social Networks on Community Oral Health

Eliminating oral health disparities requires more than an understanding of the biology and lifestyle of an individual, and needs to take into account the community and neighborhood where the individual lives, works, and plays, as well as the larger social, cultural, and political environment. The excess burden of oral diseases on older adults is well-documented. What is needed is a paradigm shift that views the social environment as a critical component of healthy aging. Toward this end, network analysis and simulation modeling can help expand the boundaries of the mental models in use, enhance the ability to generate and learn from evidence, and catalyze effective societal change. For instance, use of the system dynamics methodology has enabled the ElderSmile research team and project stakeholders to explicitly recognize, discuss, and modify feedback relationships relevant to treatment of oral health among older adults in northern Manhattan, New York City. A number of reinforcing dynamics that deteriorate oral health are induced with age, and yet inadequate insurance coverage, cultural beliefs, and daily routines often preclude preventive community care. Outreach programs such as evaluative preventive screenings generate useful opportunities to share critical information between participants and public health providers seeking to mitigate deterioration of oral health.