challenges and opportunities from health disparities to health competency challenges and...

From Health Disparities to Health Competency

Challenges and OpportunitiesChallenges and Opportunities

Norma J. Goodwin, M.D.Founder, President & CEO

Health Power, Inc.Director, www.Healthpowerforminorities.org

11.3.06 NYBGH Seminar 2

www.healthpowerforminorities.org

U.S. Census Bureau Projection:

Multicultural U.S. populations, combined, will account for almost 90 percent of all population growth in the U.S. from 1995 to 2050.

The Context:



The Context: A Rapidly Changing Picture

Source: U.S. Census Bureau

Trend: An increasing racially and ethnically diverse national population.

Thus: A racially and ethnically more diverse workforce

Likely Short-term Effect (or longer): A less healthy workforce because of well documented racial and ethnic health disparities.



Key Terms: Health Disparities

Unfavorable or unequal differences in certain conditions among certain population groups such as

Incidence Prevalence Mortality or death rate Nature of care received



Representative Incidence/Prevalence Racial and Ethnic Health Disparities

African-Americans: highest prevalence of hypertension in the U.S. – AHA 2005

African-Americans have the highest self-reported prevalence of diagnosed diabetes – AHA 2005

Cuban Americans: 50 to 60% higher rates of diabetes than non-Hispanic Whites – www.preventdiabetes.com

Mexican Americans and Puerto Ricans: 110 to 120% higher rates of diabetes than Whites.- www.preventdiabetes.com



4.5

9.3

4.62.9

20

11.3

5.1 5.46.8 6.1 6.4

11.5

0

5

10

15

20

<9 9-11 12 >12

Years of Education

Per

cen

t o

f P

op

ula

tio

n

Whites Blacks Mexican Americans

* Sources: NHANES III: 1988-94; JAMA 1998;280:356-62

Examples of Health Disparities:Prevalence of Non-Insulin-Dependent [Type 2] Diabetes In Women by Race/Ethnicity and Education ages 25-64



Examples of Health Disparities:Age-Adjusted Prevalence of Physician-Diagnosed Diabetes in Americans Above 20 Years by Race/Ethnicity and Sex

6.2

4.7

10.3

12.6

10.411.3

0

2

4

6

8

10

12

14

Men Women

Pe

rce

nt

of

Po

pu

lati

on

NH Whites NH Blacks Mexican Americans

Sources: CDC/NCHS/NHANES 1999-2002; NHLBI.



Examples of Health Disparities:Trends in Obesity: Age-Adjusted Prevalence of Obesity in Americans Ages 20-74 Years [by Sex and by Selected Time Period]

12.2 12.8

20.6

28.1

34.0

15.710.7

16.8 17.1

26.0

0

10

20

30

40

Men Women

Pe

rce

nt

of

Po

pu

lati

on

1960-62 1971-74 1976-80 1988-94 1999-2002

Sources: Health, United States, 2004 CDC/NCHS

Note: Obesity = BMI above 30



IOM report: U.S. Health Care Disparities

Institute of Medicine Report 2002:

Multicultural populations receive lower Multicultural populations receive lower quality health care than Caucasians even quality health care than Caucasians even when insurance status, income, age and when insurance status, income, age and severity of conditions are comparable.severity of conditions are comparable.



U.S. Health Care Disparities

Kaiser Family Foundation Report 2002

68 of 81 studies on healthcare

Comparisons found that multicultural patients experience more disparities compared to Caucasian patients.



Health Disparities Increase the Likelihood of Secondary Effects in the Workplace

Associated decreased productivity from:

Uncontrolled major diseases such as diabetes, hypertension, heart disease obesity, and stress

Intermittent On-the-Job Inefficiency Increased absenteeism



Potential Secondary Effects of Increased Racial and Ethnic Health Disparities in the Workplace

Potential increased costs associated with: Provision of medical care

for the individual for the employer for the taxpayer (Medicaid and Medicare subsidies)

Family and environmental effects



Key Terms: Health Competency

• Self-confidence in one’s ability to manage self-care, and achieve results that are adequate for him/her.

• A person’s feeling of confidence in his/her ability to manage and control most of his/her health problems.

• A sense of self-efficacy (effectiveness)

• A demonstrated ability to effectively handle a variety of health related needs.



Multicultural Workforces: Employers can increase health competency

Key Health Disparities• Hypertension & Heart

Disease• Diabetes • Obesity• Depression• Asthma• Some Cancers

• Access to care: hours, availability

• Literacy: Care plan understanding

Collaboration with: • Credible and culturally

competent resources• Successful Employers

and Employee Groups

Employee Needs: • Health Literacy • Culturally competent

health education and healthcare services

• Worksite support and access to relevant services

Employer Based/ Sponsored Services:

Walking groups Peer Support Groups/

“Talk Outs” On-site health workshops



Key Terms: Cultural Competency

Ability to understand, appreciate and effectively work with individuals and groups who have cultures and belief systems that are different from one’s own.

Culturally competent individuals are non-judgmental about persons of different races, ethnicities, languages, social norms, values, histories, socioeconomic status, perceptions and preferences.



Multicultural Workforces: Employers Benefit from Cultural Competency

A More Diverse Workforce• Richness of differences • Wide range of differences• Race/ethnicity, gender, age,

socioeconomic status, etc.

Narrowing the Digital Divide, which Increases:• On-the-job potential and productivity• Increased self-concept• Socioeconomic potential • Better healthcare and personal care choices

A Healthier Workforce: • Physically • Mentally • Spiritually

Through web-based Information:• Increased Health Knowledge• Enhanced Health communication

- with Providers- with Peers - with Family

XYZ Corporation



Welcome to Health Power®

A nationally unique corporation founded by Norma J. Goodwin, M.D.

Committed to improving the health of multicultural populations through:

Health information Health promotion Health consultations & trainings Strategic partnerships & alliances

Norma J. Goodwin, MD

Founder, Presidentand CEO



Key Health Power Web Site Features

Women’s, Men’s, & Aging Health Channels

Food and Fitness Channel

Racial and Ethnic Channels (5)

What It Means: Our Glossary

Our Major Killers and Disablers

Mental and Spiritual Health Channels

Cross-linked Web Partners – A developing network

Relevant Resource & Trend (data) Tables



New York Area Diabetes Resources

American Diabetes Association, New York Affiliate

American Association of Diabetes Educators, New York Regional Office

New York City Department of Health – Occupational component

New York State Department of Health funded NYC programs

New York Business Group on Health



New York Area Diabetes Resources

Academically affiliated institutions with specialties in Diabetes or Obesity - St. Luke’s Roosevelt Obesity Research Center - Mount Sinai School of Medicine - Cornell Cooperative Extension

Diabetes Resource Coalition of Long Island National Association for Mental Illness, NYC

Metro



Collaborative efforts with Health Power, focused on: Eliminating racial and ethnic health disparities, thus Ensuring a healthy and productive future workforce.

Collaborative efforts with key health improvement organizations: NYBGH GlaxoSmithKline Aetna

Future OpportunitiesFuture Opportunities



Since many of us are able to make a difference in the health of multicultural populations, we

underscore the reality, just as we do for those served, that:

KNOWLEDGE + ACTION = POWER!™

Health Power: A Unique Web Site, Plus Much More


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