Happy New Year! I hope that you, your family and friends all enjoyed a healthy and safe Holiday Season. During this winter break we scattered literally around the world. Some of us made time to experience snow, beautiful warm beaches and international cities.  Many enjoyed quiet and reflective moments, and the joys of giving and receiving during this Holiday Season. Welcome back!

During this time we also had an opportunity to contemplate New Year 2008 and the continued military actions in Afghanistan and Iraq, the outlook for the US economy, the continued complex problems related to health care and the increasing national concerns for K-12 public education in America. These and other major problems continue to impact our lives. 

Meanwhile, during this time away from my normal professional routines, I made a little time to prepare a keynote lecture that I will present this February in San Luis Obispo at a conference that focuses on access to care and preventable non-communicable chronic diseases. As I read and reviewed my notes, I thought you might be interested in this complex topic as we continue or self-study related to the April 2008 Accreditation site visit.

Of course, from previous learning we know that there is a very real correlation between the prevalence of disease and socioeconomic status. Approximately 80 percent of preventable chronic non-communicable diseases are found in communities with low educational attainment and low-income.  We have learned that there are enormous disparities documented in children's tooth decay, obesity, and even type 2 diabetes rates. Tooth decay, obesity and diabetes rates for children in low-income communities with few recreational parks are nine-times higher than for children in affluent communities with abundant green space. This is true in many parts of Europe, Asia and, of course, North America. 

In Los Angles County, for example, Manhattan Beach has a very low prevalence of chronic non-communicable diseases and a median income of $100,750 and 5.7 acres of green space per 1,000 people. In contrast, the prevalence of these chronic diseases is 10 times greater in Maywood with a median income of $30,480 and 0.6 acre of green space per 1,000 people. South Central Los Angeles has an obesity rate of 29 percent and 0.4 acre of parkland per 1,000 people. In Los Angeles County, 23 percent of public school children in the 5th, 7th and 9th grades were overtly obese in 2005 and those rates have increased through 2007. Children are considered obese if their body mass index (BMI), calculated based on height and weight, exceeds the 95th percentile for their age and gender. In other terms, BMI is defined as weight (in kilograms) divided by the square of height (in meters). BMI correlates with body fat and also correlates with health risks, especially for cardiovascular risk factors.

Further, children of families with low-income and low educational attainment tend to live in communities with inadequate recreational facilities, green space and markets that offer fresh foods and overall healthy choices. We have some locations in Los Angeles County that do not have one single market, yet contain many dozens of fast food sources as well as liquor stores. The experiences of our mobile clinics in the Pico-Union area of downtown Los Angeles amplify this discovery.  As oral health professionals, we want to reduce the disparities in the prevalence of tooth decay in children. If children drink fluoridated drinking water (and "if" is a significant variable), tooth decay could be reduced by 30 percent. If poor children (perhaps 25 percent of the children of Los Angeles County) had access to comprehensive oral health care, tooth decay could be treated, dental pain could be eliminated or reduced, and school-readiness could be increased vis-a-vis a reduction in absenteeism due to dental pain. From another perspective, do we need to step back and consider tooth decay in children within the larger social and economic context that is being used to describe disparities seen in children's obesity and diabetes rates? I sense the answer is a resounding "yes."

Further, we need to gain much more knowledge and appreciation for cultural values of children and their caregivers. Beliefs about what is an attractive weight or a healthy weight, what foods are desirable or appropriate for parents to provide children, how families should share meals, the importance or enjoyment of physical activity, and the authority parents have over children at different developmental stages of life, as well as many other attitudes that affect lifestyle habits, are influenced by cultural values.

As we enter 2008 I am so proud of our faculty, staff and students and alumni at the USC School of Dentistry. We celebrate the doctoral dental Class of 2008 for achieving the highest student performance on Part 1 of the National Boards in the history of USC! We celebrate the untiring efforts of many faculty and alumni to successfully achieve fluoridation through the Department of Water and Power (DWP) for 17 million people who live in Southern California. We celebrate the success to enter Phase 2 funding from the California Endowment to increase the diversity of the oral health workforce and to increase access to care. We celebrate increased faculty success on federally-supported biomedical research—basic and applied research to improve health and well-being, health literacy, diagnostics, therapeutics and biomaterials, and clinical outcomes. We celebrate another excellent year in alignment with the Divisions of Biokinesiology & Physical Therapy and Occupational Science & Occupational Therapy. We also celebrate the pioneering efforts of Drs. Roseanne Mulligan and Hazem Seirawan in their new project "Oral Health Needs Assessment of Children in Los Angeles County" funded by The California Wellness Foundation, The Annenberg Foundation, First 5 and the California Endowment that begins in January 2008. Nan and her team will assess oral health disparities in LA County (Year 1) and then will advance a series of interventions to reduce oral health disparities by 50 percent for underserved children of LA County. We celebrate possibilities! And we celebrate the daily "miracles" that create smiles and wellness in many, many thousands of people every month and that reflect the hearts and minds of the USC Trojan Dental Community.

Happy New Year!