Addressing dental and maternal health outcomes for Minnesota’s communities of color

Minnesota has significant disparities in several health measures, from asthma to cancer survival rates, dental health, and maternal and infant mortality rates. The Blue Cross and Blue Shield of Minnesota Foundation hope to improve outcomes in two areas: dentistry and childbirth through grants to four organizations in the state.

The four $100,000 grants are part of Blue Cross Blue Shield’s Equitable Care and Coverage Program, which provides funds to non-profit organizations focused on providing care to people eligible for public program coverage under Medical Assistance and MinnesotaCare. Minnesota’s Blue Cross Blue Shield also funds MinnPost’s race and health benefits, but does not factor into editorial decisions.

Where does the money go?

Three of the beneficiaries focus on achieving birth equality, and one aims to improve access to the dentist for those who experience barriers to dental services.

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Gaps in dental care are highly visible across the country. Between 2011 and 2016, 17% of children ages 2 to 5 from low-income households had untreated cavities in their baby teeth, which was three times the percentage of children from higher-income households, according to CDC data.

Apple Tree Dental has plans in the works to create a dental care and referral ecosystem, focusing on communities that are uninsured, underinsured or insured through Medicaid.

Many dentists do not accept public insurance, making it more difficult for lower-income families to get care. In 2019, 40% of Minnesota’s approximately 3,000 dentists did not accept public insurance.

Apple Tree Dental has initiatives where it delivers dental care in senior homes and nursing homes, schools and private outpatient clinics, and the programs take different approaches depending on the barriers these communities face, said Dr. Michael Helgeson, the CEO of Apple Tree Dental.

“The barriers are different when we are in rural Minnesota; there are different types of barriers. When we’re dealing with people who have mental health issues and chemical dependency issues, they have barriers,” Helgeson said.

Reaching the uninsured

Apple Tree will use funding from this grant to address the barriers that affect low-income families and children in the Twin Cities metro area, especially those who are uninsured.

“A lot of them worry about their immigration status and things that keep them from even getting any kind of cover,” Helgeson said. “The differences in dental conditions are often even greater than in other forms of healthcare. That’s a big problem for our society, and I think we need to get to the point where everyone can get the health education and health services they need.”

The organization will partner with Ready, Set, Smile, a nonprofit organization that provides dental services in 33 early childhood education centers and schools that enroll high percentages of low-income children whose families lack access to dental care and oral health education.

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Ready, Set, Smile employs community health workers who come from the same ethnic groups as the patients and are trained to provide oral health education to students and families.

According to dr. Adele Della Torre, the organization’s executive director, 96% of the children they helped last year were 96% of color, more than 50% were from immigrant families, and 38% were uninsured.

Ready, Set, Smile can provide education and prevention services such as applying silver diamine fluoride to teeth to temporarily stop cavities. Children with dental problems, such as sore or inflamed teeth or large cavities, may require a filling or extraction, which requires the resources of a dental office. Those children can then receive follow-up care at one of Apple Tree’s three clinical sites in the Twin Cities — or at other private practices that have agreed to take referrals for those without insurance and those without pay.

“Dental disease rates in these kids are dramatically higher than their wealthier counterparts who are in other school settings,” Helgeson said.

Funding will also go to Apple Tree Dental’s telehealth services, allowing families to make their first visits virtually. Helgeson said doing a phone or computer visit can save both the clinic and the family time and resources.

“What that does is it avoids all the time, cost and hassle of waiting to get an appointment and physically coming in in the first place. And then the cost of transportation, maybe having to go to daycare, taking other kids with you, only to visit to find out you have to come back again and get the procedure you need done,” Helgeson said.

Outcomes in mother and child

The other three recipients of the Blue Cross Blue Shield grant focus on birth equity — improving baby and maternal outcomes for Black and Indigenous families.

From 2017-2018, Black Minnesotans made up 13% of the state’s natal population but were responsible for 23% of maternal deaths. According to the 2022 Maternal Mortality Report, Native Minnesotans, who made up 2% of the birth population, were responsible for 8% of maternal deaths.

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A portion of the funding will go to the Northwest Indian Community Development Center in Bemidji, which focuses on improving infant and maternal outcomes among Native families in northwestern and northern Minnesota by connecting families with antenatal care, cultural lessons , breastfeeding resources and building a continuing care network for families with babies.

The African American Babies Coalition is another recipient of the grant. Since 2005, the coalition has focused on creating education around brain development and childhood education for black and brown families.

“To have healthy children, we need healthy parenting and (healthy) mothers and babies,” said Sameerah Bilal-Roby, the founder and executive director of the African American Babies Coalition in St. Paul.

The coalition is working with various groups involved in African American communities to transfer knowledge about supporting brain development and healthy child development practices.

Roots Community Birth Center will use the funding to support culturally-focused reproductive health services, mental health services, screenings and immunizations for families experiencing poor health outcomes in Minneapolis, Brooklyn Park and Brooklyn Center. The funding also enables the center to provide antenatal care to people regardless of their insurance type or financial capacity.

Blue Cross Blue Shield hopes to provide more than just funding by partnering with host organizations.

“We don’t have unlimited resources, but we believe our resources can make an impact,” said Bukata Hayes, the vice president of racial and health equity at Blue Cross Blue Shield. “I think the partnership, the resources beyond the grant that we provide to our beneficiary partners, is going to be really critical.”

Addressing dental and maternal health outcomes for Minnesota’s communities of color

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