We’re Facing an Oral Health Crisis. Here’s How Funders and Advocates Can Create Lasting Change

As leaders of organizations that fund, support and engage with health and justice advocates at every level, from community health centers all the way to the halls of Congress, we know the importance of community engagement in addressing inequity. Unfortunately, we are also keenly aware of how often historically marginalized communities are left out of decision-making processes that determine what’s best for them. The lack of meaningful engagement in health policy results in a system that does not deliver what people want and need, a reality that hurts us all.

This is particularly alarming in the nation’s oral healthcare system, where widespread disparities in access to oral health coverage and care cause some people to disproportionately suffer from untreated dental disease and related health complications. Structural and institutional barriers mean these inequities disproportionately affect Black, Indigenous and people of color, low-income populations, older adults, people with disabilities, and LGBTQ+ populations.

With Congress discussing adding dental care to Medicare and an adult dental benefit to Medicaid, they are helping to shine a bright light on the oral health crisis facing our nation. Now more than ever, embracing community engagement and leadership is essential to securing policies that advance oral health equity.

Grassroots organizing and advocacy have been the driving force behind every foundational moment in healthcare policy, including the creation of Medicare, Medicaid and the Affordable Care Act. With coordinated mobilization among funders, community-based organizations and advocates, we could yield some of the most important advances for oral health in decades at the local, state and national levels.

That’s why, with the support and partnership of CareQuest Institute for Oral Health, Community Catalyst embarked on a year-long research project to examine key aspects of how funders, CBOs and advocates can best come together to center community voice in the advancement of effective health policy, particularly in the oral health space.

This meant speaking with statewide advocacy organizations, CBOs and funders in 12 states—the people who understand the demands of meaningful community engagement in advocacy—and listening to what the field needs to do this work successfully.

Our findings, contained in a new report, serve as a roadmap for both funders and advocacy organizations to more effectively build partnerships that promote sustainable, equity-informed, community-driven advocacy.

We found that among oral health advocacy organizations and CBOs, 85% of participants reported that health equity was a factor in making decisions about policy priorities. Further, 75% reported that community engagement was a factor. Similarly, almost two-thirds of funders indicated the priorities of underserved communities or CBOs were involved in their decision to fund oral health work.

Our interviews yielded seven ways that advocates, CBOs and funders can work together to address oral health inequities. We encourage funders and advocates alike to think about the following principles when it comes to creating lasting change:

1. Cultivate funders outside of oral health.

Funders may consider strategies for doing outreach and education to other, non-oral health funders to maximize their investments and further diversify the needed resources for longer-term systems-change initiatives.

2. Invest in effective coalition building.

Many advocacy organizations and CBOs are skilled and interested in power building, but often don’t have dedicated resources to invest in coalition building or staff an effective campaign structure in oral health. Funders may consider direct funding to advocacy groups and CBOs aimed specifically at coalition and partnership development.

3. Strengthen advocates’ competency in community engagement.

Advocacy organizations often bring experience and processes for coalition and campaign building, but they may need to invest in training and capacity building around equity and community engagement. Investments in these capacities may help ensure advocacy organizations are engaging communities authentically and respectfully.

4. Equitably boost resources for community-based organizations.

CBOs are a source of community voice, through their direct or indirect connections to communities. Funding efforts that prioritize resourcing these types of organizations, especially in collaboration with advocacy organizations, may contribute to successful community-informed policy change that is grounded in equity.

5. Evaluate if advocacy strategies are centering communities.

To address inequities, advocates, CBOs and funders may need to work together to assess how policy agendas are being set and ensure community voice is being centered in decisions. This can balance power dynamics in coalition spaces, creating the opportunity for greater community involvement in advancing systems change.

6. Dedicate funding for long-term success.

Funding efforts that bring flexible and multi-year grants as well as direct funding to CBOs and grassroots groups can provide the needed foundation for the longer-term planning and resources needed to advance successful policy initiatives.

7. Assess progress in many ways.

Incorporating process-related and longer-term measures of success in evaluating oral health advocacy efforts is one way for funders to set oral health policy initiatives up for long-term success.

These findings can guide institutional thinking on how to meaningfully invest and support this critical work, including the prioritization of multi-year funding.

For advocates, these findings reinforce that community engagement, relationship-building, and policy change all take time, and multi-year grants and flexible funding are critical to support this work. It also underscores the importance of broad-based partnerships in advancing oral health advocacy, both of which require time, staff and resources.

When historically marginalized communities have real influence in decision-making processes, powerful and positive disruption can occur. If we work together to make sure resources go to the communities that need it most, we can create meaningful, equitable and lasting change in healthcare.

Emily Stewart is executive director of Community Catalyst. Dr. Myechia Minter-Jordan is president and CEO of CareQuest Institute for Oral Health.

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