Integrated oral and vision health delivery model: Improving access to comprehensive care for an underserved urban preschool population

The importance of early detection and treatment of vision and oral problems in children is widely published, yet vision and dental care are among the highest unmet needs in childhood. Not surprisingly, negative outcomes are most significant among lower income families (often ethnic minorities) and the uninsured are three times as likely to have unmet needs. 

Cherry Health (Michigan's largest community health center) and the Head Start Program of Kent County (Michigan) created an integrated model of oral and vision care delivery for preschool children. This no-cost, mobile, comprehensive care model for preschoolers, with integrated oral and vision care in a single visit, is unprecedented and improves access by addressing both financial and non-financial barriers to care.

A combined dental and vision team provided care within three Head Start locations between June and August 2014. Eligibility included low-income and uninsured children.  Outreach, scheduling, exam, diagnosis, treatment, supportive services, referral, health education and anticipatory guidance were provided for over 400 preschoolers who were examined back-to-back within the vision and dental ‘clinics’. Visits lasted no longer than a typical dilated eye exam (roughly 45 minutes) as children received oral health assessments while their eyes were dilating. A medical, vision, and dental home was made available via Cherry Health for future care. Data sets across both services are reported.

Mobile, school-based, integrated health delivery models are a viable way to improve access to vision and oral health care, educate families, and provide vulnerable children with a "head start" to healthy learning and development.