88 American Dental Association Established by the U.S. Department of Health and Human Services in 1996, the Community Preventive Services Task Force develops and disseminates guidance on which community-based health promotion and disease prevention intervention approaches work, and which do not work, based on available scientific evidence. The Task Force issues findings based on systematic reviews of effectiveness and economic evidence. The Guide to Community Preventive Services (“The Community Guide”) is a collection of evidence-based findings of the Community Preventive Services Task Force and is designed to assist decision makers in selecting interventions to improve health and prevent disease.20 The Community Guide reviews are designed to answer three questions: 1. What has worked for others and how well? 2. What might this intervention approach cost, and what am I likely to achieve through my investment? 3. What are the evidence gaps?20 The Community Preventive Services Task Force recommends community water fluoridation to reduce tooth decay.21 Reports have been released by the U.S. Department of Health and Human Services that encourage the use of preventive interventions to improve the overall and oral health of the nation.22,23 Specific to oral health, two reports issued in 2011 by the Institute of Medicine acknowledge water fluoridation is an effective intervention for the prevention of tooth decay. Advancing Oral Health in America24 referred to water fluoridation as an effective prevention intervention, while Improving Access to Oral Health Care for Vulnerable and Underserved Populations25 acknowledged that evidence regarding community water fluoridation programs continues to validate its effectiveness, safety and cost-saving benefits. 59. Does water fluoridation reduce disparities in dental health? Answer. Yes, evidence indicates water fluoridation helps to reduce the disparities in dental health at the community level. Populations with lower socioeconomic status (SES) who live in fluoridated communities have less tooth decay than their peers in nonfluoridated communities. Fact. In the first ever Surgeon’s General Report on Oral Health issued in May 2000, U.S. Surgeon General David Satcher noted that community water fluoridation is safe and effective in preventing dental caries in both children and adults. Fluoridation benefits all residents served by community water supplies regardless of their social or economic status.10 In 2001, Dr. Satcher issued a statement on fluoridation in which he noted: …community water fluoridation continues to be the most cost-effective, practical and safe means for reducing and controlling the occurrence of dental decay in a community…water fluoridation is a powerful strategy in efforts to eliminate health disparities among populations.11 “…water fluoridation is a powerful strategy in efforts to eliminate health disparities among populations.” Established by the U.S. Department of Health and Human Services, Healthy People 2020 provides a science-based, comprehensive set of ambitious, yet achievable, ten-year national objectives for improving the health of the public and reducing health disparities.17 Starting with Healthy People 2000, one of the overarching goals of Healthy People has focused on disparities. With Healthy People 2020, that goal was expanded to achieve health equity, eliminate disparities, and improve the health of all groups.25 Healthy People 2020 provides the following definitions. Health disparity — a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage. Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic
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