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With Cover the Uninsured Week under way, Carolinas battle with access, preventable ER visits—even of the dental variety
In Spartanburg County, S.C., one in 10 adults doesn’t have any teeth.
It’s a shocking statistic that local providers learned just last year when they began assessing barriers to care among low-income uninsured. “We asked, ‘How is this possible?’ ” said Renee Romberger, vice president of community health policy and strategy at Spartanburg (S.C.) Regional Healthcare System.
As the only safety net hospital in the county, not-for-profit Spartanburg Regional spent about $1 million last year on unreimbursed emergency dental care.
But officials there didn’t know the extent of the problem the uninsured face in terms of dental care and other unmet health needs until they embarked on a communitywide assessment of local health services.
They learned that there are no adult dental providers for the uninsured in the county. About once a month, a dentist visits a homeless center in the area and does tooth extractions free of charge. Tooth-pulling is, for many uninsured, the only low-cost solution to the painful, chronic problem of tooth decay.
The dire need for adult dental care isn’t isolated to Spartanburg, a rural county near the North Carolina border.
Untreated tooth decay is the No. 1 reason for preventable emergency room visits in South Carolina’s rural counties among uninsured adults aged 18 to 64. In South Carolina overall, dental care is the third most common reason why uninsured adults visit ERs.
“This was not something we expected,” said Amy Martin, deputy director of the South Carolina Office of Rural Health, at the University of South Carolina. “Dental is a huge unmet need. It’s not a high-dollar ER visit, but it’s a high-volume ER visit.”
Providers recognized immediately that the dental crisis in the region reverberates through the local economy.
“It’s very hard to get a job if you don’t have teeth,” Martin said. With the manufacturing, textile and tobacco sectors shrinking, tourism has become a leading jobcreator in South Carolina. But nobody in the tourism industry wants to hire workers without teeth, Martin said. “Adult dental care is so important from an economic standpoint,” Martin said. “But there has been a certain hopelessness around adult dental.”
Now, some providers in the Carolinas are working together to turn that hopelessness around.
They are embarking on a new, coordinated push to serve the uninsured, thanks to longterm support from the Duke Endowment in Charlotte, N.C., and the South Carolina Hospital Association, among others.
Martin: Dental is “not a high-dollar ER visit,” but it’s high-volume.
Melanie Matney, executive director of AccessHealth SC, says the goal is to create networks of care to improve access.