August 7, 2017

School of Public Health researchers and colleagues detail the organization, outcomes and health policy implications of the 2014 Mid-Maryland Mission of Mercy and Health Equity Festival (Mid-MOM) hosted at the Xfinity basketball arena on the University of Maryland (UMD) campus in College Park in the June issue of the American Journal of Public Health. The UMD School of Public Health, working in partnership with Catholic Charities Archdiocese of Washington and the Maryland State Dental Association, formed teams of dental, medical, and public health professionals to create the event, which served more than 1000 patients who received clinical services valued at $1.2 million.

“We rooted our approach in public health ethics and a desire to increase access through health equity action research,” the paper, written by Dr. Stephen Thomas, director of the Maryland Center for Health Equity, and colleagues states. “With the knowledge of the interrelationship between oral health and chronic disease, our goal was to provide oral health services and (1) screening for chronic disease risk factors, (2) health promotion services, and (3) expanded patient data collection.”

The article describes the economically diverse, “majority-minority” Prince George’s County, where the University of Maryland is located, which includes numerous impoverished communities experiencing some of the highest chronic disease rates in the state. The majority of MOM participants came from the county, with others travelling from bordering Maryland counties, the District of Columbia, and Virginia. Notably, some even came from as far as Delaware, West Virginia, Pennsylvania, North Carolina, and New York.  About 1000 more had to be turned away. It also details how the event was planned and implemented (with more than a year planning and more than 1400 volunteers), and provides selected outcomes and measures of success. Patient surveys revealed comorbidity risks as well as percentages of patients with medical and/or dental insurance, and employment status. “Our patients were not, on the whole, indigent or homeless. Many were employed (53%) and had the resources to drive themselves (57%) to the event,” the study reads.

The organizers acknowledge the overarching problem with the need for events like MOM: “The confluence of factors that result in hundreds of people lining up outside a basketball arena to receive emergency care is deeply problematic. Yet, in the absence of policy-level solutions, MOM events will continue.” They discuss efforts to maximize effectiveness and minimize volunteer exhaustion, and to standardize the collection of patient data “so that we might be able to more fully describe the problem. We are hopeful that our mapping of patients will motivate hospitals and health care systems to act on the knowledge of patient needs in their catchment areas in the context of Maryland’s global budget model. As hospitals incur costs associated with dental emergency room visits, there is a business case for better coordination between dental and medical care services.”

They also describe how this specific MOM event, which emphasized building community capacity and integrating population health, while not a replacement for policy-level solutions, is worthwhile and central to the mission of public health. The Health Equity Festival, which provided health screenings, referrals, and social and public health services, was organized as a series of booths staffed by clinical teams, wellness programs from the School of Public Health, a team from the University of Maryland School of Law (which provided consultations on medical debt), and groups from the US Public Health Service Commissioned Corps, Cigna Inc., Walgreens Pharmacy, and several nonprofit health education organizations (Lions Club, American Heart Association, American Diabetes Association).

Plans are underway for the 2017 Mid-MOM on September 8-10, again happening at UMD’s Xfinity Center.

“The 2014 Mid-Maryland Mission of Mercy Dental Clinic: Building Community Capacity and Complementing Public Policy” was written by Stephen B. Thomas, PhD, Susan R. Passmore, PhD, Devlon N. Jackson, PhD, MPH, Alice M. Horowitz, PhD, Erica Casper, MA, James Nalls, BS, and Dushanka V. Kleinman, DDS, MScD.

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The 2014 Mid-Maryland Mission of Mercy Dental Clinic: Building Community Capacity and Complementing Public Policy
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Stephen B. Thomas, Susan Racine Passmore, Alice Horowitz, Dushanka V. Kleinman