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Advertising and its impact in our mouths



This session is part of an initiative funded by the Burdett Trust for Nursing and presented by learn with nurses, the Commonwealth Nurses and Midwives Federation, and C3 Collaborating for Health. We will be discussing the impact of inequalities and advertising on oral health and how they link to diabetes, with a focus on how nurses and healthcare professionals can be aware of and reduce these inequalities. We will also talk about how to be an advocate for improvements in social determinants of health and how to use professional associations to support these efforts. Join us as we explore these connections and create solutions that will help care for our most vulnerable populations.
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LWN founder and director Michaela Nuttall RGN MSc is joined by JILL ILIFFE RN, RM, Executive Secretary; Commonwealth Nurses and Midwifery Federation for an LWN In Conversation webinar discussing:

  • The impact of inequalities on oral health – why oral health outcomes are unequal across populations.
  • The impact of advertising on oral health – advertising of food, beverages, and oral hygiene products.
  • Practical solutions to level the playing field and a role for nurses and midwives.

A 40-minute live webinar that will be recorded and made available on demand.

Nurses and midwives are in a unique position to raise awareness about the importance of oral health and provide oral health education to individuals, families and communities. Implementing preventive measures early will alleviate individual pain, discomfort and disfigurement and reduce the economic burden of oral diseases on individuals and the health system.

A collaboration between C3 Collaborating for Health, the Commonwealth of Nurses and Midwifery Federation and Learn With Nurses.

Funded by Burdett Trust for Nursing.

Learning objectives

Learning Objectives: 1. Evaluate the impact of social determinants of health on health outcomes. 2. Recognize the differences in health outcomes among patients of differing socio-economic groups. 3. Understand the link between advertising and the development of oral diseases and noncommunicable diseases such as diabetes. 4. Advocate for the reduction of inequalities in health through understanding of social determinants of health. 5. Analyze examples of advertising and understand the influence that it has on vulnerable populations in relation to their oral health and noncommunicable diseases.
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Computer generated transcript

The following transcript was generated automatically from the content and has not been checked or corrected manually.

So welcome to those of you who are joining us live on another of our sessions. My name is Michaela Nuttall. I'm from learn with nurses, but this session is brought to you by way more than learn with nurses. Um If you're watching this on demand. Well, thank you for watching this on demand as well. I I'm just gonna ask Jill to introduce herself for a moment before I tell you a little bit more about our session. Hey, thanks. Um Thanks Michaella. Well, my name's Jill Iliff and I'm a nurse and a midwife and I'm currently Executive Secretary of the Commonwealth Nurses and Midwives Federation. Um Our registered office is with the Royal College of Nursing in London. Um But we are a network of uh nursing and midwifery associations in Commonwealth countries. Um And our main activities are um supporting leadership networking, nursing and mid for education and conducting in country projects. Thanks Michaela. Brilliant, brilliant. And I might ask you at the end to suggest how people if they want to get involved or follow, you know, newsletters and stuff, how they can do that. So we look at that. Absolutely. Why not? Why not, I'll do it for all this. I feel like this session has been brought to you today by. Well, it's an initiative that's been funded by the Burdett Trust for Nursing. And we are really grateful to those guys. And um it's a partnership between C three, collaborating for health. And at the end, I'll be telling you another advertisement on how you can join those guys. And it's a charity headed up by Christine Hancock for any nurses who are old enough and wise enough who remember Christine? Well, for many years and of course, ourselves from learning with nurses and Jill from CNN F. Now, this is a series of events that we've produced, looking at diabetes and oral health and the link between them. The, the, the, the. Yeah. Well, hopefully you've joined and watched some of the other sessions we've done at Jill's done a webinar at JU D Amazing Diabetes nurse specialist has done a webinar. They're going to be doing a joined up in conversation where they start discussing a lot of stuff too and we're just ready to start a series of podcasts. So you don't have to listen or join in these, in any particular order. But um but hopefully we will encourage you to want to come and learn a bit more. Now, this session, we're going to be talking about the impact of inequalities and advertising on oral health and you know, and, and this was one. Well, I'm very excited about this session. I would certainly say I'm going to start and I've got some questions that I'm going to ask, Jill, but please feel free to use the chat function if you've got any questions as well to put in. Now, remember those of you are watching on demand. You can't put questions in, unfortunately, but you can always message us over social media and, um, hopefully you've got all of our usual hashtags and at learns and at C NFS and stuff that's out there. But Jill I'm going to ask you to kick off thinking about just and explain to people who maybe don't know just what are the social determinants of health? Thank thanks, Michaela. Well, the social determinants of health are the nonmedical factors that influence health outcomes either positively or negatively. For example, education um housing where you live, whether it's urban or rural, um the physical environment, whether you've got access to clean water, sewage, electricity, um whether you've got access to um quality health care at um you know, a cost you can afford working conditions, unemployment, job insecurity, food insecurity, um discrimination, social isolation. Um All of those things are nonmedical factors which influence people's health. And there's, there's also the broader uh factors of political systems policies, cultural and social norms. Um The importance I think for nurses about um the social determinants of health is that in all countries, regardless of income level, the lower the socio economic position, the worse the health. And so addressing the impact of social determinants of health, particularly for people um who are marginalized, disadvantaged in the lower socioeconomic um position is fundamental um for improving health and reducing um inequalities in health. And so what would you say? I mean, because I, I my background is public health and so there's absolutely, it's totally there. You know, it's everywhere, it's every, it's, you know, it's what makes me me as it were trying to address and reduce those inequalities. But, and now we're thinking about some nurses that are out there, lots of nurses and healthcare professionals are out there that are saying all I can do is get through the day that, you know, we're stuck with short staffing. I haven't had a break. I haven't had a drink for 12 hours. How, how, how can we encourage nurses and healthcare professionals like that to be more aware? Is there some little things we can do to really be more aware of it? And I know this wasn't, this is only on the spot now. But um but I was just thinking about how do we get that? Because that's, you know, that's what it is, how, how can we, how can we help? I, I don't think that you can that in a, in a day to day providing care. Um you can do much about the social determinants of health, but it's really important that nurses and nurses are aware of the impact of them. So don't just look at the health of your patient or your client. Think about the broader picture of what could be impacting on their health outcomes. That's the first thing. And the second thing of course is being advocates for reducing inequalities. So don't just do your job um in a, in a narrow way, try and think about how you can um advocate for improvements in the social determinants of health for the people who are most vulnerable. And sometimes the best way to do that is being active in your professional association. Um, and, er, using your professional association or, or your specialist association, um, to start lobbying for improvements for people so that their health outcomes are better. Yeah, absolutely. And I, and I like that bit where you said it's about just being more aware and particularly about everyone you're seeing and actually it is about because often, you know, we don't want to think a one size fits all because we shouldn't. But when we're so busy then we end up just going through, you know, we've got to get this done, got to be safe, gotta do that and actually just being able to maybe pause for a moment and just think about, is there something little, is there something extra I can do? Am I just being really more aware of something health literacy? Say how I'm given that information, language barriers, people? Ok. Ok, so thank you. Sorry for throwing that one in. But I just thought, oh, how can we help apply that one? So anyway, I'm going to leave us now towards um, what are the title of the session is? And that's really thinking about advertising. Um And so Jill let us know all about it, the impact of advertising on diabetes, go for it. And then I'm gonna share with you with the experience I've had afterwards but good. Ok, so putting it in perspective, um both oral diseases and other non communicable diseases such as diabetes disproportionately affect the most vulnerable and disadvantaged population. Uh Research has demonstrated that for many, many years. So people of low, so economic status carry a high burden of oral diseases and this association remains across the life span. So from the time they are born, Children through to adults, through to old age, regardless of the country's income level. So in, in the UK, the people who are socially disadvantaged in low socioeconomic groups are more likely to have ncds um and oral diseases. Um, the link between um advertising um is that research has demonstrated that people who come from a lower socio socioeconomic background, what a mouthful that word is, are more, are more um uh influenced by advertising. Um And the influence of this advertising is um, is for a range of factors. Er, one is that uh there's often poorer education levels. Um the other is that they're, um, you know, they are likely to, um, be involved in because of, of, of a lack of, um, um, health promotion and, and, uh, education. Um, they're more likely to be involved in, uh, risky behaviors. Uh, common risk factors for oral diseases and, uh, noncommunicative diseases like diabetes, uh, which is unhealthy diets, uh, high level of sugar in their diets, uh, smoking, all sorts of, um, uh, cigarette, um, smoking, vaping, um, all sorts of tobacco use and harmful uses of alcohol. So, advertising, which encourages risky behaviors such as this unhealthy, eating tobacco use, um, harmful levels of alcohol, um, increase the incidence of, um, oral diseases and other ncds like diabetes. And a really good example of this is the advertising of foods and drinks which have a high sugar content and, you know, that, you know, that just a bounds, you know, all these one for cakes and chocolates and sugary drinks. Um, certainly not good for teeth and certainly not good. Um, for diabetes. Um, yeah, so advertising is advertising, um, is, is, uh, uh, unhealthy. Some advertising is really unhealthy. Yeah. And I, and I think, you know, we often think of advertising in very overt ways but I think advertising can happen in so many sort of covert ways that people don't realize that they're being advertised to. Um, so, and this is one of the, so I'm just gonna share, I've got a few examples. I'm writing down just for, I want because I want you to comment on them. Um, so many years ago I was involved in another initiative and it was looking at weight and it was looking at Weight in Children. And again, it was looking at examples of how this subli, well, it wasn't even, it was like slapped you around the face advertising. So schools didn't have enough money for all the books. And so chocolate companies would provide books to help Children to learn to count. But what you needed was the chocolate buttons and it wasn't chocolate buttons. It was these chocolate little counter type things, um, that you could use to count and it would say put 10 here and then take five away and then how many have you got left? So it was to help with mathematics, which in some way is really lovely, but it involved very bright colored promotion and the sweets to be able to make that happen. Now, I was absolutely appalled by this because I was thinking, well, this is outrageous, but then it also was helping Children to learn maths and they, and, and, and if they didn't have this, so I'd like to think that doesn't happen anymore in the UK. But actually does, is that the sort of thing you've come across before in different places? Certainly. And, and one of the things of course, that governments need to do or if you're, um, um, if it's at a local level where you can negotiate with the, with whoever's providing the funding is to say this is all well and good. And we're happy to say that, you know, you are funding us and give you all the credit for the funding. But we don't want little images that encourage people to think. Oh, well, you know, that, that looks nice. I'll go out and buy one. Yes. So, so there are ways around that. Um, I think that advertising companies will get away with whatever they can. But they also recognize that if you, if you, uh, negotiate strongly enough they generally come to the table and back down. Yeah. Yeah. Yeah, absolutely. And, and I want to just share with you an example from yesterday on how, um, I was in a sup, I was in a little supermarket. We have these little ones you go in, you do yourself scanning and stuff and you come out and they're just near train stations and things and I had my little basket and I was scanning a couple of things and I looked to the side and there was a mum and dad and three Children and I was thinking, do you know the mum and dad love these three kids? They absolutely do you know the way they were? But their basket was full of sugar. The basket was, I've never seen so many brightly colored drinks. There was cakes, there was cream packed sandwiches, there was sweets, you know, everything was brightly colored. And I thought, you know, now I, that's a great big treat, but actually, we shouldn't be seeing it as a great big treat. But would that those advertising catches the eyes and the deals and all of that, of things? That absolutely, it was, it was quite heartbreaking. And I said, do you know what you're doing my own? It's not a place to, to do that, not to do that. But, but that is the importance, that's the importance of education. And, you know, nurses are in such a unique position of this 1 to 1 with uh patients and clients that, you know, to get these messages across constantly. And I know that I know that, um, you know, you know, I'm a nurse and midwife, I've been there. Um I'm still there. But, uh, you know, you, while you're doing things, you can be talking to people and taking the opportunity. And one of the, you know, one of the best ways is to start looking in people's mouths and talking about or asking them about their oral hygiene routine, ask them about their, you know, their children's health, their, their, their children's, you know, what, where their teeth are up to and how are they looking after them and whether they've got any dental caries or not and what they can do, you know, there's lots of opportunities um to start educating people and, and counteracting the impact of advertising. Yeah. Yeah, absolutely. I think so. And you, you've just touched on something there that nurses and, and healthcare professionals are ideally placed to pass those messages on and to share and that's assuming they know themselves. So I'm going to give you, I'm gonna tell you another experience. I had just remind me I was teaching the other week at lovely group and there was a healthcare assistant there and we were talking, it was lots of different people. And so, and we were talking about different food um fast food joints as it were. And she suddenly said, you mean that that one isn't healthy? And she thought that the fast food joint she been taking her Children to regularly was OK because it, it was ok because you know, they do children's meals and they do this and I was saying it's a lot of sugar, there's a lot of salt, there's a lot of fat. So we almost have to educate ourselves before we can even move forward and educate in that way. How quite taken a back. Ok. So I'm going to put us back on track now. And um and so, but I think that's the way these things go, isn't it? And I'm gonna ask you a little bit more. I think you've, you've started to mention about how it links with inequalities totally. But I, I wanna go more towards now this social, this commercial determinants of health, which might be quite new as a concept for people to think about or understand. So please let us know so much more about that. The commercial determinants of health. Yeah, this is a program that the World Health Organization initiated maybe three years ago. Um and commercial determinants of health. Um They're defined as strategies and approaches used by the private sector to promote products and choices that are detrimental to health. However, the World Health Organization um maintains and I agree with them that um some uh commercial determinants of health, some uh private sector companies also provide products that influence health positively, not just negatively. So we've been talking about the negative ones, the chocolates and the high sugar content. But when you think about um uh personal hygiene products and oral hygiene products, some of those products are affecting people's health positively. So it's not all negative. So um the strategies and approaches used by the private sector can either affect the individual uh at a micro level as you've described with your experiences or it can affect uh communities at a national or international level. And I suppose tobacco use is an is is one of the best examples of that. So positive ex other positive examples um can be uh as I mentioned, the the personal hygiene products and the oral hygiene products, but some of the negative ones over the years have been breast milk substitutes, for example, um you know, foods and drinks with um high sugar content, tobacco use, alcohol use. So you can um you know, you can, you can think of, you can think of lots of examples. But the, the World Health Organization um identified four goals and countries, their, their member states are meant to be following up these goals at a national level. So the UK um is as a part of the World Health Organization should be following up these things. The first is to strengthen the evidence base. So look at the impact of the commercial de determinants of health um develop tools and capacity to address those impacts convene partnerships and dialogue. So that would be um negotiating with uh not just uh um the private sector um suppliers but also with health organizations and raise awareness and advocacy. And of course, that's one of the areas that nurses and midwives can be involved in. Yeah, brilliant and, and I'm just gonna come back to that one a little bit more because as I was sitting there and, and I'm thinking, yes, of course, there are all positive things and I hadn't, I, I had come into thinking about this session about all the negative stuff. So I'm sitting there thinking well, actually as a, as a cardiovascular nurse and that's, that's my bag. I'm always trying to persuade people that actually a couple of almonds every day would be really good for you. Not a big bag of dry roasted peanuts, but actually some nuts every day is really very good. And we don't get that, you know, we do get that advertising occasionally from like Walnut growers or something that way. But actually that's a positive one. And we do have the functional foods that's out there. So there are things that will help to, we, our cholesterol even. And I'm often getting asked about those and they're really, you know, and I, I work with a lot of those guys because see, it helps you, it's gonna help you. And I, so yeah, there's, I'm liking that we've done a bit of a balance there in thinking about those positive ones. So, um, how's it going then across the, with, with the who and those four goals? How, how have you got a flavor? I have to say, go like that. Go like that Jill for the world. How's it going? Oh, ok. Fair enough. That's not good. No, it's, it's, it's not been taken up really actively by many countries. Um, unfortunately that's, that often happens. Um, with world health organizing init initiatives, um, countries agree to them but when they get back home they don't do much about them. And, you know, that's another role for nurses is to call countries to account, but they have to be, they have to know what's going on at an international level, um, to be able to call countries to account. And it may well be that the, um, that the, uh UK government is doing something about it. Um Oral health is a really great example though uh for nurses and midwives to be interested in because all of this stuff that's going on at the World Health Organization in relation to oral health. Their vision which was reaffirmed at the 2023 World Health Assembly was um universal access to oral health care for all individuals and communities. By 2030. Now, that's not going to happen unless nurses and mid nurses and midwives get involved. It's just not gonna happen. So nursing organization should be right up there with the government um saying we can help, we can do this. We want your support, you know, we want to contribute to these outcomes. Yeah, and, and I, and, and, and I, I'm sorry, I'm stuttering them for a moment because I'm thinking, you know, we have, we have in the UK this massive access issue and I'm sure it's worse in so many other countries to NHS dentists. It's, it, it's absolutely impossible for many people to get there. And so, you know, there is the option of a private one but they cost money and if you haven't got much money, oh, you're, you're working out where to, you know, there's the cost of living going on your teeth isn't the thing that's top of the list I suspect or your mouth and oral health isn't top of the list. Um Well, I'm gonna, I'm gonna ask you another question about advertising because a lot of what we see I see for advertising now for mouth is about the look of a mouth, the white teeth, it's gonna be gorgeous and teeth whitening stuff that way. And don't get me wrong that you know, I'd like white teeth but I, I drink a lot of black coffee so that's the way it goes. Um How does, do, do you have any thoughts on how will that help? Because if people are pursuing whiter teeth, will that help oral health or not? Um I think that the people who are pursuing whiter teeth um have already invested in good um daily oral hygiene routines. So, um and they're also the people that can afford um to, you know, um invest in those products that uh that whiten teeth. I in actual fact, you know, oral hygiene doesn't have to be um and isn't expensive. Um There are, you know, once you've got a toothbrush, obviously, if you can, if you can afford a fluoride toothpaste, you're better off because the fluoride certainly protects the enamel. Um and and re uh prevents um decay of the enamel and actually can remineralize the, the enamel, but you need to clean your teeth, you need to brush your teeth um for two minutes twice a day. And even if you can't afford toothpaste, even brushing them with, uh water is better than not brushing at all. So all you need is a toothbrush and you can actually make toothbrushes out of, out of, they're called the Miss wax. You can actually make them out of twigs. If you can't even afford a toothbrush, you can just go and break off a twig, peel back the bark. The little fibers you need to soak the little fibers to make them soft and, and the, the advantage of those is that as they wear out, you can keep cutting them down. So, and making another one, most people in in the UK can afford a toothbrush and a, and a, a fluoride toothpaste if they can will help them, you know, that's, and nurses looking in mouths and picking up um dental caries or, or, or even the slightest sign of them um you know, can really help to improve um oral hygiene outcomes. Yeah. Yeah. So how are we going to um in our final few minutes? How are we going to energize those nurses? What can we do? Yeah. How can nurses get involved in? And I know you've been making reference to it but um because we're in the final couple of minutes, what would you have? You got any sort of a different level, how they can get involved? I think it's an individual responsibility to be informed. Um I'll just give you an example of a survey that we did. Um November, December last year in three African countries. Uh We had an online survey about oral health knowledge um nearly 4000 respondents and of those respondents, a S a 70 74% thought oral health was important, but 80% had not attended any CPD in the last two years. Now, the first thing you've got to do is to keep yourself informed, stay up to date with oral health research and initiatives. Take every opportunity to do an to look in somebody's mouth. It takes only a few minutes to look in someone's mouth, check their teeth, check their tongue, check their gums. Um give them some oral health information, give them some oral health advice. Um It, it's just so critically important because it, you know, oral diseases are linked to closely linked to noncommunicable diseases such as diabetes, heart disease, respiratory de disease, cardio, uh even cerebrovascular diseases such as dementia. So, you know, nurses have got to take responsibility for their own education and then share that with their patients and clients and it'll make a great difference. Well, and it's making that link, I think, isn't it? Because that we're getting quite, we're quite good at trying to think. We must help people to stop smoking. We're going to try and get people to be more physically active. We're going to get people to eat healthier diets. That's all part of our prevention agenda and this fits in with the prevention agenda. And I think we're really, we're still um I wanna say early days in the knowledge of this and the impact. So um, yeah, and, and with everything, you know, it takes a long time to get there but you have to start, don't we? We have to start and I think by getting it on the prevention agenda and seeing all the benefits, it's, it's adding that in to another bit and it does fit so well with the, the food that we eat, of course, and cigarette smoking and sugary drinks and things and then that impact it has on diabetes. So, um just before I wrap up, have you got any last messages, key messages to give any viewers now or anybody watching on demand before we do some plugs for the organizations and the other podcasts we're going to be called. Do you have any topics or anything? Look, there's only two things I think the first is to be informed, that's really important and, and these, these webinars are really excellent for um for nurses and midwives to be able to be informed. And secondly, to really think seriously about incorporating oral health assessment um into your routine activities, nursing and mid bray activities. Yeah, regardless of the age of the patient or client, tell them to open their mouth and have a look inside. Brilliant, brilliant. I love it. So, and thank you for that Jill and for everyone that's been watching or going to watch on man, I hate we've tic you to want to think a little bit more about oral health. I'm just gonna let you know about some of the podcasts we'll be developing and we've, and that's probably why it feels like we've touched on things, but then we haven't gone too far in it, um, because we're trying to get you to, to have this bite size learning in different ways. So, um Jill is going to be doing a session with Molly who um is a dental technician actually is a dentist who, and they're going to be discussing on a podcast, what should nurses be looking for in someone's mouth? Now, we know that lots of people like to listen as they're sitting on a train or going to work or something. So, yeah, so that's one session we'll be looking at now myself and Judy, who's our diabetes nurse specialist, we're gonna spend some time discussing. So why don't we look at people's mouths? You know, why don't we? And she's got some really interesting stories and interesting experiences about the pressures of times of appointments. And then there's another one that probably Judy and I are gonna do and we're gonna, we called it. What about the kids? What about the kids? Um And really that sort of if we're thinking about prevention, the earlier that we can. And um, and then we've got one by Jill and by Christine looking at, what about inside mouths across the world? Really giving us that big global perspective that's there. So, um Jill, how can people find out how to join up and sign up with the CNMF um in the UK. If you're a member of the Royal College of Nursing, you're automatically a member of uh the CNF, you can join as an individual. Um it's 80 lb for two years and you can join on the CNMF website. So just type in Commonwealth Nurses at Midwives Federation and then go to membership, right? And the links are actually gonna be where as well where people are going to be watching the podcast from all on the lo with nurses website. I forgot about that. But, and, and for people who, who if you learn with nurses, then you can either just find us on med or, or you can sign up for our newsletter to be able that lets us. So the amazing un sends out regular updates saying this is on this week, this is on tomorrow. You know, you can just click and join those that way. And of course C three collaborating for health. So their website is cree health dot org and there you can sign up for a new letter. Um We have some amazing. So I say we because I'm part of C three as well, we have some amazing international seminars where we get people from around the world doing some fantastic education sessions and discussions. So lots available for you all free. Um Obviously not with the not joining memberships, but a lot of education is freely available because we know that's really difficult for people to get to. So, uh there hasn't been any questions come in. That's fine, which means I just get to wrap it up to the for the day. So a huge thank you, Jill for being part of this initiative. Um A huge thank you to the bur just for nursing making this real because if it wasn't for their grant, we wouldn't be able to do this. And a huge thank you to anybody that's watching. Now, don't forget if you have watched us, whether it's live or on demand, please do an evaluation because of course, we have to report that we have to say, you know, how many people have watched, have they found it useful? But also it allows us to develop more sessions um based on your feedback. So, Jill, thank you very much for today. I'm going to click the not go live button at the the is that a thing not go live the stop broadcasting button? Um But if you can just stay on for me for a moment, that would be lovely. Thank you very much, everybody. Bye bye.