REDUCING HEALTH INEQUITIES

THROUGH THE IMPROVEMENT OF BIRTH OUTCOMES

9/13/2004

PRESENTOR

SHIRLEY SHELTON

CALIFORNIA BLACK INFANT HEALTH PROGRAM

COORDINATOR

INSIGHTS

CRITICAL KNOWLEDGE

PROGRESS

Life has improved for most racial and ethnic groups in California over the last 30 years, but not for all or on all dimensions.

Despite real progress in social, political, and economic equity, deep disparities persist.

On the whole, Whites and Asians are healthier, more educated, economically better off, and less likely to be victims of violent crime than AA’s and Hispanics.

POPULATION

California = 34 million people California’s population is one of the world’s most

diverse. 50.0% Female 50.3% non-Hispanic 30.8% Hispanic 11.5% Asian and P/I 6.8% African-American 0.6% American Indian

EDUCATION

The education gap between AA’s and Whites diminishing.

College initiation and completion rates remain lower for AA’s than for Whites.

U.S. born Hispanics have lower high school and college completion rates than do AA’s, Asians, and Whites.

ECONOMIC STATUS

Asian and White family incomes are substantially higher than those for AA’s and Hispanics. Lower income translates into higher poverty and public assistance rates for AA’s and Hispanics.

CRIME

African-Americans in California continue to experience the highest risk of arrest and incarcerations. African-Americans are also more likely than others to be victims of violence.

African-Americans along with Hispanics are more likely to be killed than Whites.

POVERTY

Poverty Wealth The pursuit of Happiness

HEALTH STATUS

Chronic health conditions increase with age. African-Americans fare worse than other

racial and ethnic groups in California. Life expectancy for White males and females

was 74 and 80 years respectively; 79 and 86 years for Hispanic; 80 and 86 years for Asian/Pacific Islander, and 67 and 74 years for Black males and females respectively.

HEALTH STATUS CONT.

Life expectancy is related to family income and having the means to adequately provide for and respond to the needs of the household.

People with lower income die younger. Children from higher income families are

more likely to have health insurance coverage.

PROBLEM STATEMENT

It’s a familiar but a disheartening story. Black women are not well and die younger and faster than their peers.

Likewise, African-American babies are twice or more likely to die during infancy as other babies.

African-American women experience the highest level of maternal mortality.

TROUBLING TRENDS

Obesity a nationwide epidemic with disproportionate rates in the African-American community.

Diabetes, the sixth leading cause of death and constitutes over 18 million cases in American and 2 million in California.

HIV/AIDS

TROUBLING TREND (cont.)

Preventive Health Behaviors/Poor Health Practices Mammography Pap Smear General Health Check-up

BARRIERS

Acknowledge and address barriers Barriers include more than lack of coverage

Making end meet/survival (priorities) Different realities (the press of family issues) Transportation and child care Transience Lack of support (lack of partner or family support) Lack of knowledge/awareness of symptoms Trust Cultural inefficiencies (lack of reflective/like personnel and

differential treatment) Discrimination

PATHWAYS

Initial steps Recognition Understanding Throne abandonment Seek real partnership w/target community Respect, Value, & Honor

PATHWAYS CONT.

Cultural Advisors expertise (what’s their thinking, what do they know that you need to know, what would they do)

Standardized state-of-the-art strategies Community awareness Linkage to appropriate and quality services Follow-up Other interventions

(Social Support/Empowerment, Role of Men)

Assessment/Evaluation/Re-evaluation Cultural Advisors buy-in

PROGRAM IMPROVEMENTS

Political/public will Cultural and professional competence Committed resources Standardized strategies Stabilized time investment 33 percent infant mortality decline

EQUITY

Respect, Value, and honor is vital! Willing! Doing!! Going!!! Acting!!!!