Category Archives: Umair Shah

Local Public Health Spreads Importance of Good Oral Health during Children’s Dental Health Month

By Umair A. Shah, MD, MPH, NACCHO President and Executive Director of Harris County Public Health in Houston, Texas

The oral cavity, including the teeth and surrounding structures, are necessary for adequate nutrition, proper speech and a positive self-image.  Although tooth decay is largely preventable, it continues to be the most common chronic disease of early childhood.1  Dental health can impact school performance when a child has untreated tooth decay with resulting pain that affects their ability to concentrate, sleep at night or even attend school, “more than 51 million school hours are lost each year to dental related illness.”2 Taxpayers share approximately 11% of the $113.5 billion spent nationally on dental care expenditures, a percentage that has increased over the years as dental care utilization continues to increase among children.3  Children with cavities in their primary (baby) teeth are three times more likely to develop cavities in their permanent (adult) teeth which could contribute to broader health problems including diabetes and cardiovascular disease.4

All year long, many local health departments work to ensure children have access to quality oral health care. February is Children’s Dental Health Month, a time to spread awareness of good oral health habits and highlight the importance of beginning and maintaining oral hygiene in the early childhood years as soon as the first tooth appears.

Start Oral Care Early

In children, maintaining oral health is critical, even before adult teeth begin to form. The way in which primary or “baby” teeth are cared for shapes the way permanent teeth develop, making it important for children to learn effective oral health habits early. The type of care primary teeth receive can affect a child’s speech development, how they chew, and their confidence. Cavities are very common among children in the U.S. Untreated cavities lead to infections that can cause difficulties with eating, speaking, and even learning. A more serious and painful consequence of improper maintenance of primary teeth is formation of an abscess. When an abscess occurs, pus accumulates in a cavity to block an infection from spreading. This accumulation typically causes swelling and can be very painful.5

Making Oral Health a Priority for Children with Special Healthcare Needs

Over ten million children in the U.S. have special healthcare needs.6 Oral healthcare has been identified as one of the most common unfulfilled requirements among children with special healthcare needs (CSHN). Over the years, healthcare and public health professionals, lawmakers, and other advocates have been working to improve access to oral healthcare for CSHN.

NACCHO hosted a webinar titled, “Oral Health Considerations for Children and Youth with Special Health Care Needs,” which focused on oral health problems in CSHN, identified barriers to care, and brainstormed ways to address needs. The webinar also highlighted state and local examples that are working to improve the oral health of CSHN.

Local Health Departments Bridge Access to Dental Care

Luckily, cavities and other oral diseases are preventable through daily brushing with fluoride toothpaste, dental sealants, fluoride varnishing, and fluoridated tap water. Local health departments across the nation are playing their part in promoting good oral health through dental care services and programs.

In 2017, the Clinton County Health Department (CCHD) in New York won NACCHO’s Model Practices Award for their initiative to implement a fluoride varnish program in 100% of pediatric primary care practices in the county for children under the age of five. Their goal was to decrease the number of early childhood cavities and prevent developmental delays, diseases, self-esteem issues, and the prevalence of tooth decay in adulthood. CCHD staff worked with the New York State Association of County Health Officials to learn an overview of implementing a fluoride varnish program including application and billing. Once CCHD staff was trained, 100% of the pediatric provider offices were trained on screening, assessment, proper application, possible barriers, billing, and research, and all agreed to implement fluoride varnish application in their practice.

In Tioga County, NY, the Tioga County Health Department established a school-based mobile dental services program, designed to provide preventive and restorative dental care for underserved children and adults who lack insurance and access to a dental provider. Throughout the school year, the mobile unit travels to schools throughout the county and in the summer, it is stationed at a community center. Mobile unit dental staff perform exams, cleanings, fillings, x-rays, sealants, extractions, and fluoride treatments. Since the program’s inception, thousands of clients have received dental care through this program, many of whom had Medicaid, CHIP, or no insurance at all.

Throughout Harris County, TX the Harris County Public Health (HCPH) Dental Health and Prevention Services utilizes a multifaceted programming approach to improve the oral health of children. The dental programming includes:  dental clinical services for children, adolescents and expectant mothers; a population based oral health education and promotion program that reaches 15 school districts and over 300 schools each year and a school-based early prevention program which provides oral health education, oral assessments, fluoride varnish treatments, referrals and case management to thousands of children in underserved populations throughout Harris County. Recently HCPH embarked on this mission of “taking public health to the public” and acquired several mobile units that can provide a variety of public health services and education where people live, learn work, worship and play. Our Mobile Dental Unit will allow increased opportunities to provide access to dental care for children and promote the importance of oral health at community events.

NACCHO and CDC Launch Joint Local Water Fluoridation Project

The Centers for Disease Control and Prevention (CDC) says, “Children living in communities with fluoridated tap water have fewer cavities than children whose water is not fluoridated.”1 Water fluoridation can be delivered to whole communities regardless of income level or access to oral care. In January 2017, NACCHO, together with the CDC, launched a program called, “Building Capacity for Oral Health: Fluoridation Equipment in Local Communities,” which offers funding and technical assistance to support the replacement of aging water fluoridation equipment or the installation of new equipment. Nearly 30 organizations across 13 states applied, signifying the need for the project. Ultimately, six applicants were awarded based on their community’s need. In all, the oral health of nearly 450,000 people will be positively affected. In October 2017, NACCHO and CDC opened another round of funding for community water fluoridation systems. A total of 17 organizations were awarded funding, furthering efforts in providing communities with fluoridated water, thus improving and maintaining oral health.

Preventing Oral Health Problems

While public health professionals and policymakers work to address barriers in access to dental care, parents and caregivers can prevent oral health problems in their children by ensuring they drink fluoridated water, applying fluoride varnish and dental sealants to teeth, and simply brushing with fluoridated toothpaste. This National Children’s Dental Health Month, let’s champion optimal oral health among all children and promote healthy dental habits, so that America’s children have equal opportunities for success.



  1. Centers for Disease Control and Prevention. 2015. Oral Health Basics. Retrieved from
  2. S. Dept of Health and Human Services. Oral Health in America: A Report of the Surgeon General. Rockville, Md. U.S. Dept of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health; 2000:12.
  5. Children’s Dental Health. The Importance of Caring for Baby Teeth. Retrieved from
  6. Maternal and Child Health Bureau. 2007. The National Survey of Children with Special Health Care Needs Chartbook 2005– 2006. Rockville, MD: Maternal and Child Health Bureau.

Public Health Advocacy: Informing Lawmakers about What Matters Most in Our Communities

By Umair A. Shah, MD, MPH, NACCHO President and Executive Director of Harris County Public Health in Houston, Texas

The Journal of School Health defines health advocacy as “The processes by which the actions of individuals or groups attempt to bring about social and/or organization change on behalf of a particular health goal, program, interest, or population.” 1 It is also one of the main pillars of public health. Local health departments depend on policymakers to enact laws that make our communities safe and promote healthy living. Every day, federal, state, and local decision-makers discuss a myriad of issues, including those related to public health. Through the power of advocacy, we have seat belt, tobacco prevention, safe drinking water, and nutrition labeling laws, just to name a few. For the betterment of our communities, it is imperative that public health professionals who possess expertise and experience in the field, educate lawmakers through evidence-based research. Continue reading

Health Equity Matters: Bridging the Gap between Underserved Populations and Access to Care

By Umair A. Shah, MD, MPH, NACCHO President and Executive Director of Harris County Public Health in Houston, Texas

What is Health Equity?

Public health is built on the foundation that all people have a right to health. Health equity is the principle that every person should have the opportunity “to attain their full health potential,” regardless of social, economic or environmental conditions. Achieving health equity requires valuing all individuals and populations equally, acknowledging and repairing historical injustices, and investing in those communities. Across the United States, state and local jurisdictions have made it their mission to reduce and eliminate health inequities in their communities. There are many root causes of health inequities, including racism, class-based oppression, gender inequity, and other forms of systematic injustices. These create societal conditions that influence an individual’s health such as: the quality of education, housing, neighborhood environment, and employment opportunities leading to disproportionate health outcomes, to name a few. Continue reading

American Diabetes Month: Local Health Departments Work to Mitigate the Burden of Diabetes Across the Nation

By Umair A. Shah, MD, MPH, NACCHO President and Executive Director of Harris County Public Health in Houston

Today, over 30 million people in the United States live with diabetes—the seventh leading cause of death in the nation.1 Every day, local health departments (LHDs) work with community partners including schools, city planners, businesses, and restaurants to educate the public about diabetes and develop programs and policies to aid prevention, screening, and management.

November is American Diabetes Month, a time for the nation’s LHDs and other healthcare organizations to bring awareness to their efforts in preventing, screening, and managing diabetes. Continue reading

Convening Cross-Sector Partnerships to Implement Health in All Policies at the Local Level

By Umair A. Shah, MD, MPH, NACCHO President and Executive Director of Harris County Public Health in Houston

Local health departments (LHDs) play a critical role in ensuring that communities across the nation are healthy. We work every day to ensure the safety of the water we drink, the food we eat, and the air we breathe. Over time, many LHDs have broadened their missions and scope of services to address the root causes that influence health. It’s becoming commonly understood that factors like our socioeconomic status, education, the physical environmental, employment status, social supports, and access to care all play a part in shaping our health and quality of life. In addition to addressing infectious disease and chronic disease, we’re now focusing our efforts on the social determinants of health. With this increasingly complex view of health, it is imperative that LHDs move beyond the walls of our health departments to collaborate with the myriad other organizations that impact the social determinants of health and help them take into account how their policies and programs affect the health of communities. One promising tool for engaging in this work is the Health in All Policies (HiAP) framework. Continue reading

National Preparedness Month: We Have the Power to Prepare

By Umair A. Shah, MD, MPH, NACCHO President and Executive Director of Harris County Public Health

This September marks the fourteenth annual National Preparedness Month, created to raise public awareness about the importance of preparedness and encourage Americans to plan for emergencies. Each year during the month of September, more than 3,000 national, state, and local organizations commemorate National Preparedness Month by promoting guidance and resources that help communities effectively prepare for, respond to, and recover from disasters and other catastrophic events. Ultimately, National Preparedness Month helps to ensure every resident in our nation has the skills they need to protect themselves and their families during an emergency. Continue reading

Incoming NACCHO President Dr. Umair A. Shah Shares How His Health Department Uses the Principles of Innovation, Engagement, and Equity to Advance Population Health

Interview by Lindsay Tiffany, Lead of Publications, NACCHO

On July 1, Umair A. Shah, MD, MPH, Executive Director of Harris County Public Health in Houston, became NACCHO’s President. Dr. Shah is a long-standing and enthusiastic member of NACCHO and has served on a variety of different advisory groups including the Health Equity and Social Justice Committee, the Global Health Workgroup, the Media Champions Network, and the Finance Committee. He has also represented NACCHO in a number of national initiatives, providing the voice of local public health. He has served on NACCHO’s Board of Directors since 2014. He recently spoke to NACCHO Voice about his career path, the challenges that keep him up at night, and how his agency is using innovative, non-traditional approaches to create the local health department of tomorrow. Continue reading