The Importance of Strong Leadership
Compared to previous HHS efforts to improve oral health, the OHI 2010 involves many more HHS agencies and programs at multiple levels. The NOHI further calls for each agency to involve individuals at the staff level, a strategy that veterans of previous initiatives have said can be helpful. However, this also presents the challenge of organizing and directing multiple agencies that are highly autonomous and may not always act in concert. The NOHI presents an additional challenge in that it calls for the increased involvement of and collaboration with leaders from the private sector and other segments of the public sector. The committee believes that the current leadership at HHS is capable of meeting these challenges.
Regardless of how an initiative is structured, much of its long-term viability depends on the interests and efforts of the individuals leading the agencies and HHS, which can change in unpredictable ways over time. For example, a key factor may be whether it can survive a change in presidential administrations, particularly one involving a change in parties. Long-term viability depends on HHS itself making and keeping oral health a priority issue. While the OHI 2010 reflects yet another attempt to enhance the prominence of oral health in HHS, several warning signs have arisen that could contribute to a loss of momentum. For example, in early 2011, the committee learned of the proposed downgrading of the CDC’s Division of Oral Health into a branch of the Division of Adult and Community Health. In addition, despite the announcement of the OHI 2010, the CDC’s Division of Adolescent and School Health does not list oral health among the “important topics that affect the health and well-being of children and adolescents” and the Administration on Aging does not have any specific initiatives related to the oral health of older adults. Similar to the need for consistent messages to patients and health care professionals about the importance of oral health, HHS needs consistent messaging within its own organization that oral health is a priority across the life span.
Involving Multiple Stakeholders
While HHS should look for ways to be a leader, a range of stakeholders have roles in the success of the NOHI. Collaboration with and learning from the private sector; other public sector entities at the local, state, and national levels; and patients themselves is essential toward achieving the goal of improving the oral health care and, ultimately, the oral health of the entire U.S. population.