city of portland, maine health and human services department, public health division
DESCRIPTION
CITY OF PORTLAND, MAINE Health and Human Services Department, Public Health Division Minority Health Program HEALTH (CANCER) RISK ASSESSMENT: TELESCOPING THROUGH THE CULTURAL EYES Presentation by Kolawole A. Bankole, M.D., M.S. Let’s celebrate diversity. Contents. - PowerPoint PPT PresentationTRANSCRIPT
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CITY OF PORTLAND, MAINEHealth and Human Services Department, Public Health Division
Minority Health Program
HEALTH (CANCER) RISK ASSESSMENT: TELESCOPING THROUGH THE CULTURAL
EYES
Presentation by
Kolawole A. Bankole, M.D., M.S.
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Let’s celebrate diversity
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Contents
Project Aim / Goal Background/Demographic paradigm Diversity in Maine Methodology and Approach Results and Outcome analyses Clinical / Public health implications Minority Health Program’s
interventions Conclusion
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Project Aims / Goals
Reduce health disparities among Portland, Maine’s racial/ethnic minority through computerized health risk assessments, counseling and referral for quality and affordable services.
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Background/Demographic paradigm
Changes in the diversity of Portland, Maine demographics with > 57 different ethnic language groups
Increase in primary & secondary immigrants
Largest 11 ethnic/language groups: Khmer, Arabic, Spanish, Acholi, Somali, Serbian/Croatian, Vietnamese, Nuer, French, Chinese, and, Russian.
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Diversity in Maine
In 2005: 20,000 Hispanics 19,000 Asians 8,000 African
Americans 7,000 Native
Americans
– Source: www.pressherald.com
– National Center for Cultural Competence, 2004
ACS: American Community Survey
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City Fact sheet: Portland, Maine Summary City Data (and Source)Population (2003 CB est.): 63,635Population (2000 Census): 64,249 Foreign-born Population (2000 Census):4,895
Share Foreign Born (2000): 7.6%
Population Projection 2025 (FAIR*): 64,000
*FAIR: Federation for American Immigration Reform
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Journey to “Well-Being”Journey to “Well-Being”Link between migration & Link between migration &
resettlement health burden:resettlement health burden:
• Pre-migrationPre-migration:: exposure to exposure to infectious & parasitic infectious & parasitic diseases, physical & diseases, physical & psychic traumapsychic trauma
• During migrationDuring migration:: malnutrition, malnutrition, exposure to the exposure to the elements, physical & elements, physical & psychic traumapsychic trauma
• Post-migrationPost-migration:: increasing increasing susceptibility to chronic diseases, susceptibility to chronic diseases, problems of resettlement problems of resettlement ((racism, racism, unemployment, ESL, crime, etc.)unemployment, ESL, crime, etc.)
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Methodology and Approach
Exploratory, outreach/research Project ~ Aug. ‘05 – June, ’06.
Sample size: 202 individuals across 6 racial/ethnic groups
Africans~A/Americans: Somali, Sudanese, Great Lakes of Africa/French Asians: Cambodian, Vietnamese Caucasians: Russian
Eleven community meetings and outreach educational sessions held.
Confidential individualized health risk assessment (HRA) survey implemented
Survey results with computer software analyses (TRALE, Inc. software)
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Cancer / health risk variables assessed
Demography: Gender, Age, and Ethnicity Tobacco smoking status and Alcohol Nutrition and physical activity Stress and depression Current health status & medical care status Family history Women and Men’s health statuses Vehicle safety Readiness to change Biometric measures ~ height, weight, blood
pressure
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Results and Outcomes analyses
Overall wellness score was 67.– A score below 80 indicates elevated
likelihood of developing certain medical conditions
Individual variable scores below
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Overall Wellness: Score 67
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Risk Areas
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Demographic: Gender
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Demographic: Age
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Demographic: Ethnicity
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Cancer Risks
Controllable cancer risks: Weight, Nutrition, and Tobacco use
Uncontrollable cancer risks: Family history, age, race, and sex
Overall cancer score: 68
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Direct Cancer Risk effects
Overall Score: 68 Some cancers directly affected 3% of
the groups' population Runs in families:
Breast cancer 2%Ovarian cancer 24.8%Colon or Rectal cancers 11.4%
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Cancer Risk Factors
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Men’s Health
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Self-Testicular Exam
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Women’s Health
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Women’s Health
106 female participants 59.4% ~ Pap smear within past 3yrs 26.5% ~ Digital rectal exam within past
2yrs 61.2% ~ Mammogram within past 2yrs
(aged >40yrs) 2.8% ~ Have at least one immediate
relative who had breast cancer
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Tobacco
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Cigarette Smoking
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Physical Activity: Score 49
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Body Mass Index: Average Women~18.2; Men~17.2
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Weight Management
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Mental Wellness: Score 69
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Stress and Depression
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Nutrition: Score 51
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Nutrition Risk
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Alcohol: Score 94
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Blood Pressure: Score 51
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Diabetes: Score 61
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Self-reported Blood Sugar
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Heart Health
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Motor Vehicle Safety: Score 84
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Clinical / Public health implications
Qualitative health status information for public health interventions
Counseling and referrals for needed services
Improved racial/ethnic data collections Attempts to reflect goals & objectives
of Maine Comprehensive Cancer Control Plan/ ME CDC & Prevention
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Clinical / Public health implications
Improving awareness and understanding of health care services
Strengthening health care providers’ capacities to better understand risk areas and create infrastructure to meet health needs of communities
Acknowledge value of holistic approaches in health healing within ethnic minority communities
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Minority Health Program’s Interventions
“Latinos Exercise for Health and Love” event:
– 737 participants– 85 screened for diabetes & HPTn; 4 alarm values– 67 without PCPs; 41 now connected with PCPs
“3rd Annual Latino Soccer Tournament” 6 teams; 577 attended
“2nd Annual Festival of Nations’ Soccer Tournament”; 8 teams; ~655 attended
“Somali/Sudanese Walk for Life” event 65 participants
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Minority Health Program’s Interventions
“BRISK”/ breast cancer prevention project
Diabetes prevention & healthy nutrition DM prevention & mgt educational series “Let’s Go” Healthy Weight Initiative
“Somali/Sudanese Exercise for Health and Love” event: May 19, 2007
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Contact info.
Kolawole A. Bankole, M.D., M.S.Minority Health Program Coordinator /Access Project DirectorPublic Health DivisionHealth & Human Services DepartmentCity of Portland, Maine389 Congress St., Portland, ME 04101Tel 207-874-8773, Fax 207.874.8913Email: [email protected] site: http://www.portlandmaine.gov/hhs/phminority
.asp