Improving Community Health through Continuity of Treatment: A Case Study of Dental Services in the Mushkegowuk Territory and the Natural Progression towards Community-Based Dental Therapy
Bibliographic record
Abstract
Abstract / Resume This paper illustrates how continuity of dental health care treatment has resulted in significant improvement of Native health, in the Mushkegowuk Territory of northern Ontario, Canada. It is argued that positive gains accrued in this region, during a ten year period (1990-1999), should be maintained through the initiation of a community-based dental therapy program. First Nation community-based health care programs should be seen as a natural progression in health care, the end goal of all First Nation health care programs with a large preventive component. Self sufficiency is an integral part of the self-determination process. L'article decrit comment la continuite des soins dentaires s'est traduite par une amelioration importante de la sante des Autochtones sur le territoire Mushkegowuk, au nord de l'Ontario. On peut avancer que les gains obtenus dans la region au cours d'une decennie (1990-1999) devraient etre conserves en mettant en oeuvre un programme communautaire de dentotherapie. L'etablissement de programmes communautaires de soins de sante des Premieres nations devrait etre considere comme une etape naturelle et l'objectif final de tous les programmes de soins de sante des Premieres nations qui affichent une composante preventive importante. L'autosuffisance fait partie integrante du processus d'autodetermination. Introduction In Canada, the federal government recognizes a fiduciary responsibility to provide health care services, in addition to those supplied by provincial and territorial governments, to registered First Nation people (Weeneebayko Health Ahtuskaywin [WHA], 1996). These non-insured health benefits (i.e., dental services, non-emergency medical transportation, prescription drugs, and medical equipment) cost the federal government more than $500 million annually (Weeneebayko Health [WH] 1995). Although the Canadian federal government has invested a great deal of money in Native health care programs, Aboriginal people (Indian [status and non-status], lnuit and Metis) still have the poorest overall health status of any group in Canada (Federal, Provincial and Territorial Advisory Committee on Population Health, 1996; National Forum on Health [NFH], 1996; MacMillan et al. 1996; Tookenay, 1996). It is apparent that the delivery of health care must change in Canada to improve the state of Native health (Tsuji, 1998). A recent trend in the delivery of health care services in Canada emphasizes the need to move towards increased community-based services (NFH, 1996). However, it has been noted that many impediments exist for Aboriginal communities in the form of high unemployment rates, low incomes and...the long history of external control (NFH, 1996:3). In this paper, we will first show how Native health can be improved significantly through a dental health care program that stressed continuity of treatment and prevention. We will then describe why a community-based dental therapy program, in the Mushkegowuk Territory, is needed to maintain these positive gains in dental health. Lastly, we will describe possible applications of this type of approach to other Native environmental health issues. Study Area Aboriginal dental health care is administered through the First Nations and lnuit Health Branch (formerly, the Medical Services Branch) of Health Canada. The First Nations and lnuit Health Branch (FNIHB) divides Canada into prescribed regions made up zones. The Moose Factory Zone encompasses the western James Bay region of northern Ontario, Canada, and is also identified as the Mushkegowuk Territory. The Mushkegowuk Territory is home to approximately 10,000 First Nation Cree. The Dental Department of Weeneebayko General Hospital (WGH) supplies dental services to these First Nation communities of the Mushkegowuk Territory: Moose Factory, Fort Albany, Kashechewan, Attawapiskat, and Peawanuck (Tsuji, 1998). In 2001, dental staff of WGH included: three full-time dentists residing in Moose Factory and two longterm locums; all dentists are under contract to the Faculty of Dentistry, University of Toronto. …
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.007 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".