(hepe) introduction to health disparities 1
DESCRIPTION
Many youth leaders are compelled to do work with community based non-profit and local public health agencies as both a service learning and philanthropic component in their development as young professionals. However, despite invaluable experiential learning, students often don\'t comprehend key overarching issues such as health disparities, social determinants of health, health policy and community organizing. To address this gap and optimize their community based work, the Health Disparities Student Collaborative (HDSC), a Boston-based student group under Critical MASS for eliminating health disparities and the Center for Community Health Education Research and Service Inc. (CCHERS), developed a curriculum for students designed to broaden their perspectives while working with local public health, non-profit/community organizations and to develop their interest and ability to visualize the power of their collective voice as students and contributors to social justice work. The curriculum utilizes peer education and webinar software and covers three main topics: Current State of Health Disparities, Social Determinants of Health, and Youth Activism on Health Disparities/Social Determinants of Health. HDSC has collaborated with local partners CCHERS/Critical MASS and the Community Based Public Health Caucus (CBPHC) Youth Council to develop this comprehensive “Health Equality Peer Education” training.TRANSCRIPT
Introduction to Health Disparities
Health Equality Peer Educator Training (HEPE)
By: Travis Howlette B.S., Jeff Wisniowski B.S., MPH and Kelsey Anilionis B.S.
SPONSORS
OUR OTHER HOSTS
Kelsey AnilionisBachelors Of Health Science 11’
Travis HowletteBachelors Of Health Science 11’
STUDENT SPEAKERIntroduction to Health
Disparities
Jeff Wisniowski
Health Science 11’/MPH 12’ Candidate at NEU
TIME LINE OF POWER POINT PRESENTATIONS
Introduction to Health Disparities March 13th
Introduction to Social Determinants March 20th
Of Health
Youth Activism on Health Disparities March 27th
/Social Determinants of Health
Each webinar time is 8-9pm (EST) 5-6 (PST)
Aim and Purpose of This Lecture Series
Be able to define health disparities and identify current trends in disparities among populations
Understand what social determinants are and how they can impact your health
Feel empowered as students who can do something about these injustices
Goals of: Introduction to Health Disparities
Be able to define health disparities and understand the difference between inequity and
inequality
Learn how multiple systems impact health disparities
Identify current trends in health disparities
Types of Health Professionals
Allied HealthPublic Health
Complimentary Health
Primary Care Providers
Who is the most responsible for your individual health?
1. Allied Health ProfessionalsPhysical Therapists, Radiologist
Technicians
2. Public HealthState Health Department Workers, Health
Policy Makers
3. Complimentary Health ProvidersAcupuncture Specialists, Message Therapy
4. Primary Care DoctorsFamily Physicians, General Practitioners
5. You/The Individual
History of Disparities in the US Tuskegee Experiment (1932-1972) Puerto Rico Sterilization Campaign (1930’s-1970’s) Red-lining of poor neighborhoods (1960’s) Secretary’s Task Force on Black and Minority Health (1985) DHHS establishes Office of Minority Health (1985) 2010 Healthy People introduces goals on reduction of health
disparities (2000) Shifting the framework of health disparities research from an
epidemiological approach to a human rights inspired paradigm (James, 2009)
The “Un” Populations
UnderservedUndeserved
Underprivileged Unemployed Underclass Uninsured
Underinsured Undocumented Undereducated
Uniformed
What are Health Disparities?
“Differences in health status between advantaged and disadvantaged populations that are considered unfair and avoidable.”
“A difference in health among segments of the population that occur by gender, race, ethnicity,
education, income, disability, geography or sexual orientation.”
Health Disparities Terms
InequalityInequality The quality of being unequal or uneven, The quality of being unequal or uneven, disparity of distribution or opportunitydisparity of distribution or opportunity UnavoidableUnavoidable
HEALTH DISPARITIES TERMS
InequityInequity Favoritism or bias, an unfair circumstanceFavoritism or bias, an unfair circumstance Unfair and unjustUnfair and unjust
Disadvantaged Groups / Questions
Classification of Race/Ethnicity
American Indian/Alaska Native (AI/AN)American Indian/Alaska Native (AI/AN) Asian AmericanAsian American Black or African AmericanBlack or African American Hispanic or LatinoHispanic or Latino White/Non-HispanicWhite/Non-Hispanic Native Hawaiian or Other Pacific Native Hawaiian or Other Pacific Islander (NHOPI)Islander (NHOPI)
Income Exercise:
Minimum Wage Hispanic Mother with One Child
Salary: 15,000
Income Exercise:Single Black Mother with Two Children
Salary: 30,000
Income Exercise:The White College Grad
Salary: 50,000
visualeconomics.com
Break Down of Average Health Care Spending
Minimum wage with one child
Secretary with two children
College Graduate
5.7% Per Year
$855 1,710 2,850
Per Month $71.25 $142.5 $237.5
Exercise: Given this amount of money…
Who are you supporting? Where do you come up with money for co-pays, prescriptions?
What health products do you purchase eg.vitamins, toothpaste?
What if you have a surgery or costly medical bill?
FAIR OR POOR HEALTH STATUS BY RACE/ETHNICITY AND INCOME, 2007
NOTES: Respondents assessed their health status as excellent, very good, good, fair, or poor. The federal poverty level for a family of four in 2007 was $21,203 (http://www.census.gov/hhes/www/poverty/threshld/thresh07.html).DATA: Centers for Disease Control and Prevention/National Center for Health Statistics, National Health Interview Survey.SOURCE: Health, United States, 2009, Table 57.
Share reporting fair or poor health:
How does income influence the following…
Education level One’s ability to continue school
Jobs opportunities Job vs. career stability
Access to care Do you use a primary care physician or the ED?
Dependents What if your children get sick? How do you pay for child care while you must work?
Ability to afford care What quality of care can you purchase?
How does poverty effect health?
Obesity in the US
Poverty > Obesity > Diabetes
Yet Income Does Not Exist In A Vacuum
These factors are additive not just interactive
Fundamental Causes
Key Drivers of Health Disparities: Social, Institutional, Environmental
Institutional Laws and Policies Workplace Hospital settings
Social Racism Education level Poverty
Environment Air quality Housing Food Safety
Behavioral and Biological Risk Factors
Genetic Attributes and Gene Expression Family Histories
Sedentary Lifestyle Physical activity
Rates of Cigarette Smoking Nutrition Choices Alcohol and Drug Consumption Risk Taking Behaviors
Seat belts, injury, accidents
The Ecological Model
DEATH RATE DUE TO HEART DISEASE BY RACE/ETHNICITY, 2006
White, Non-
Hispanic
Hispanic AfricanAmerican
Asian and Pacific Islander
American Indian/ Alaska Native
White,Non-
Hispanic
Hispanic AfricanAmerican
Asian and Pacific Islander
American
Indian/ Alaska Native
NOTES: Rates are age-adjusted. DATA: Centers for Disease Control and Prevention/National Center for Health Statistics, National Vital Statistics System.SOURCE: Health US, 2009 Table 32.
Deaths per 100,000 population:
INFANT MORTALITY RATE BY RACE/ETHNICITY,
2005
Infant deaths per 1,000 live births:
NOTES: Births are categorized according to race/ethnicity of mother. DATA: Centers for Disease Control and Prevention/National Center for Health Statistics, National Vital Statistics System, Linked Birth/Infant Death Data Set.SOURCE: Health, United States, 2009, Table 17.
HEALTH INSURANCE STATUS, BY RACE/ETHNICITY: CHILDREN, 2008
White, non-Hispanic
44.1 million
AfricanAmerican,
non-Hispanic
11.3 million
Hispanic
17.2 million
Asian/Pacific
Islander
3.3 million
NOTES: “NSD” = Not sufficient data; “Other Public” includes Medicare and military-related coverage. The sample size for American Indian/Alaska Native was not large enough for reliable estimates. Totals may not add to 100% due to rounding. SOURCE: Urban Institute and Kaiser Commission on Medicaid and the Uninsured analysis of the March 2009 Current Population Survey.
Total Child
Population 2008
Two or More Races
2.2 million
Private (Employer and Individual) Medicaid and Other Public Uninsured
NO DOCTOR VISIT IN PAST YEAR FOR NONELDERLY ADULTS BY RACE/ETHNICITY AND INSURANCE STATUS, 2005-2006
SOURCE: Kaiser Family Foundation and Urban Institute analysis of the National Health Interview Survey, 2005 and 2006, two-year pooled data.
Why Are Disparities Important?Population Projections 2008-2050
46
15
1.6 25.1
9.215
30
66
14
0
10
20
30
40
50
60
70
80
90
100
2008 2050
% P
erc
en
t of
Tota
l U
.S. P
op
ula
tion
Non-Hispanic White
African American
American Indian / Alaska Native
Asian
Hispanic/Latino
Source: U.S. Census Bureau, 2008 National Population Projections, August 14, 2008http://www.census.gov/Press-Release/www/releases/archives/population/012496.html
Take Home Messages: Introduction to Health Disparities
Be able to define health disparities and understand the terms of inequity and inequality
Understand that multiple systems impact health disparities from the larger social
structures down to the individuals behavior
Identify current trends in health disparities and understand the importance of health disparities
as we look to the future of health care
Questions?
For he who has health has hope; and he who has hope, has everything.
~Owen Arthur
Of all forms of inequality, injustice in health care is the most shocking and inhumane.
~Rev. Martin Luther King, Jr.
Jeff Wisniowski: [email protected]
Summary Of Health Disparities
Long history of disparities in US “A difference in health among segments of the
population that occur by gender, race, ethnicity, education, income, disability, geography or sexual orientation.”
Disparities vs. Inequalities Diverse contributors dependent on several factor Social Condition and Behavioral Risk Factors
Overview Of Health Disparities
Growing Minority Populations Patient Accountability and Affordability Act Insuring the nation, shift to preventative care Health People 2020, looking forward CDC Interventions and How You Can Be Involved