Promoting Smiles in Greater Minnesota: U of M alumni support rural communities who lack access to dental care.

Access to proper health care includes access to quality dental care. Yet according to the 2018 report Strengthening the Oral Health System in Rural Minnesota, published by the Minnesota Department of Health’s Office of Rural Health and Primary Care, poor access to oral health services in Minnesota is “a silent epidemic in Minnesota’s rural communities.”

That’s another area where the U of M is finding ways to meet identified needs. At the School of Dentistry, the Community Outreach Experience places students in rural dental clinics across the state and region for 10 to 12 weeks during their fourth year of dental school. It’s headed by Paul Schulz (D.D.S. ‘86, M.P.H. ‘05), an associate clinical specialist who directs the Department of Primary Dental Care.

Schulz attended the U of M’s dental school in the 1980s on a scholarship that required him to work in an underserved area for three years after graduation. That brought him to Palm Springs, California, where he treated “migrant populations and hitchhikers” at a clinic in the Coachella Valley. Then he came back to Minneapolis to work at the Indian Health Board, where he stayed for the next 13 years.

Along the way, Schulz fell in love with caring for underserved populations. “It’s so satisfying,” he says.

In 2002, Schulz landed a full-time position with the School of Dentistry heading a mobile clinic, driving students around different parts of the state to provide care in understaffed areas. Still, Schulz wanted his students to have more opportunities to work with groups in Greater Minnesota who need more care than is available locally. He pitched an idea to the dental school’s then-dean to create a more structured outreach program. The Community Outreach Experience has now been a requirement for U dental students for the past 17 years.

For Chad Wagner, who expects to graduate next spring, the outreach program gave him a chance to get more hands-on experience than he gets doing clinical rotations on campus. For his outreach, Wagner worked and lived in Willmar, Minnesota, population roughly 20,000, during the beginning of last summer.

In WiIlmar, Wagner’s patient load increased dramatically. He went from seeing one patient a day on campus to five or six a day. Compared to his metro patients, Wagner says his Willmar patients saw a dentist less frequently because of poor access. He also estimates that roughly one out of every five patients also needed a larger procedure like a root canal.

The dearth of dental care felt familiar to Wagner. He grew up in Oak Grove, a city of about 8,000 people located an hour’s drive north of the Twin Cities. He recalls his hometown having one dentist as he was growing up, leaving many residents to drive to the metro for service. He notes that Willmar is about twice as far from the metro than Oak Grove.

“Just with any rural population anywhere, it’s spread out over such a large area,” Wagner says. “It’s tougher to have a clinic that people have access to.”

Facing Tough Times Together: U of M alumni address stress, mental health needs in rural areas.

This past spring, U of M Extension—which maintains 11 regional offices throughout the state—announced it had formed a new rural stress task force in response to a pressing local issue surfacing in the communities it serves: stress in the agricultural sector.

Extension Dean Bev Durgan says the task force was formed because farmers and others in the agricultural arena are facing challenges ranging from a weak farm economy to day care shortages to substance abuse issues—all of which heighten stress. And loan delinquency rates in farmers are at a six-year high, according to the American Farm Bureau Federation, another issue causing significant stress.

Emily Wilmes, (B.S. ’13, M.E. ’18) is an Extension educator based in St. Cloud and the daughter of a former dairy farmer in the area. Dairy farms have been hit particularly hard in recent years as the commodity prices for milk have fallen below the price of production. Wilmes says her family made the wrenching decision to sell their dairy herd a couple of years ago.

Wilmes says farmers are often reluctant to admit they need help
because they are used to relying on themselves. Through the Task
Force, she says Extension is proactively disseminating information throughout rural areas of the state about where people can go to for help coping with their stress.

One resource is the Upper Midwest Agricultural Safety and Health Center, housed in the U of M’s School of Public Health. UMASH is one of nine such centers across the country that are funded federally through the National Institute for Occupational Safety and Health. The center hosts several projects, from 4-H STEM programs that teach rural children how to not get sick from livestock to instructional videos on how to safely handle animals.

In June 2018, UMASH hosted a forum at the U’s Twin Cities campus in St. Paul about mental health and rural stress, depression, and suicide. Unique challenges facing women in agriculture came up. That drew the attention of Megan Roberts (B.S. ‘10, M.S. ‘12), who works as an educator in agricultural business management at Extension, and Doris Mold (BS ‘85, M.S. ‘94) who runs her own consulting firm, Sunrise Agricultural Associates.

Both Roberts and Mold connected with UMASH and ultimately led a program through it called “Cultivating Resiliency for Women in Agriculture.” The project, which lasted from December 2018 through July 2019, anonymously surveyed roughly 300 women agricultural workers across the
state. “Not surprisingly, it showed that agriculture is a big stressor right now,” Roberts says.

One woman’s comment—that she felt stretched thin between full-time work on the farm, part-time work in town, volunteering, and raising kids—encapsulated the issues Roberts and Mold came across in their research. Their questionnaire to participants also included a self-screener
tool used to detect depression. The average response was 6.5, which shows possible mild depression.

The project ultimately produced nine webinar sessions for agricultural women workers, giving tips on subjects like reducing stress, building relationships in stressful times, and finding community support. More than 1,000 people participated in the webinars, Roberts says.