Aetna Presentation Latino Health Overview - Presentation Transcript
Latinos in the U.S. and Northeast Florida: A Health Overview Dr. Judith C. Rodriguez, RD, University of North Florida Mr. Daniel Santibanez, MPH Candidate, University of North Florida Mr. Radley Remo, (Duval County Health Department) - Health Data Feb. 25, 2005 This is part 1 of an 8 part series of seminars on Hispanic Health Issues brought to you by the University of North Florida’s Dept. of Public Health, College of Health, a grant from AETNA, and the cooperation of Duval County Health Department. For more information or register for the seminars, please call 620-1289.
National, state, and local health data Action Models and Initiatives Discussion
National Health Data
Why?
Health status affects quality of life
Poor health is costly for the individual
Poor health status is costly for the nation
Hispanics/Latinos…and Health
Many disease risk factors can be decreased
Need culturally appropriate information and approaches
Leading Causes of Death – Overall, U.S., 2002
heart disease: 696,947
cancer: 557,271
stroke: 162,672
chronic lower respiratory disease: 124,816
accidents: 106,742
diabetes: 73,249
pneumonia/flu: 65,681
Alzheimer’s disease: 58,866
kidney disease: 40,974
suicide: 33,865
Hispanic Health Issues
Heart disease
Diabetes
Overweight and obesity
Cancer
Environmental health
Other health issues
Leading Causes of Death for Hispanics, Duval County 2001-03
Heart Disease (n= 71)
Cancer (n=57)
Injuries (Accidents) (n=27)
Source: FDOH, Office of Vital Statistics, 2001-2003 (R.Remo DCHD)
Selected Death Rates by Race/Ethnicity, Duval County Source: FDOH, Office of Vital Statistics, 2001-2003 Source Hispanic Population Estimates: Claritas 2003 Source Duval County Population Estimates: Demographic Estimating Conference Database, 4/2004 (R.Remo DCHD)
Health Issues - Cardiovascular Disease
For Hispanics, too, heart disease the primary cause of mortality/death
Heart disease and stroke mortality average about 30% or more each year
Health Issues - Cardiovascular Disease
Percent of total deaths
28% of male deaths
34% of female deaths
For MA:
about 29% for men
about 27% of women
American Heart Association (2004) Heart Facts 2004: Latino/ Hispanic Americans & AHA 2001 Heart & Stroke Statistics; AHA Hispanics and CVD
Health Issues - Cardiovascular Disease
Death Rates for CVD
1980 1990 1995-97
All ages, age adjusted 40.8 27.7 26.3
Males, age adj 44.9 30.2 28.4
White males, age adj 41.9 27.7 26.1
Black males, age adj 77.5 56.1 50.5
Hispanic males, age adj ---- 22.7 22.4
Health Issues - Cardiovascular Disease
Serum Cholesterol
1988-94 1988-94
Both sexes 203 203
Males 202 Females 204
White male 202 White f 205
Black male 199 Black f 203
Mexican male 204 Mex f 203
Health Issues - Hypertension
1976-80 1988-94
Both sexes, age adj 39.0 23.1
Males, age adj 44.0 25.3
White male, age adj 43.5 24.3
Black male, age adj 48.7 34.9
Mexican male, age adj 25.0 25.2
Healthy People 2010 Goals
12-Heart Disease and Stroke
12-1 Reduce coronary heart disease deaths
Baseline- 208 deaths per 100,000
Hispanics-145 deaths per 100,000
12-11 Increase the proportion of adults with high blood pressure who are taking action to help control their blood pressure
Baseline- 82% of adults aged 18+
Hispanics- 74% of adults aged 18+
12-15 Increase the proportion of adults who have had their blood cholesterol checked within the preceding 5 years
Baseline- 67% of adults aged 18+
Hispanics- 59% of adults aged 18+
Healthy People 2010; www.health.gov/healthlypeople/
Discussion
What are your experiences related to Hispanics and CVD in the NE Florida area?
Health Issues - Diabetes
About one third of total diabetes among Hispanic Americans is undiagnosed (NHANES III; www.niddk.nih.gov)
Health Issues - Diabetes
Health Issues - Diabetes Based on 1997 American Diabetes Association criteria % of population 20% 12% 10% 12%
Healthy People 2010 Goals
5-2 Prevent Diabetes
Baseline- 3.5 new cases of diabetes per 1,000
Hispanics- 5.7 new cases of diabetes per 1,000
5-5 Reduce the diabetes death rate
Baseline- 75 deaths per 100,000
Hispanics-86 deaths per 100,000
Healthy People 2010; www.health.gov/healthlypeople/
Discussion
What are your experiences related to Hispanics and diabetes in the NE Florida area?
Health Issues - Overweight and Obesity
Healthy wt Overwt Obesity Overwt*
Both sexes 41.7 54.6 22.6 65.2
Males 39.1 59.4 19.9 68.8
White Male 38.0 60.5 20.3 69.5
Black Male 40.2 57.0 20.9 62.0
Mexican Male 31.6 67.0 23.1 74.1
Health Issues - Overweight and Obesity
Healthy wt Overwt Obesity Overwt*
Both sexes 41.7 54.6 22.6 65.2
Females 39.1 59.4 19.9 68.8
White Female 38.0 60.5 20.3 57.0
Black Female 40.2 57.0 20.9 77.5
Mex. Female 31.6 67.0 23.1 71.4
Health Issues - Overweight and Obesity
Latinos: higher prevalence than the general population
Obesity is prevalent among Hispanics, especially women (Dairy Council Digest, Jan/Feb 2001; www.nationaldairycouncil.org )
Health Issues - Overweight and Obesity
Among U.S. Groups: Hispanics had the most growth in prevalence of obesity
Hispanic ethnicity
11.6% to 20.8% 1991-1999
Health Issues - Overweight and Obesity
Mexican-American children ages 6-11 were more likely to be overweight (22 percent) than non-Hispanic black children (20 percent) and non-Hispanic white children (14 percent).
What are your experiences related to Hispanics and overweight or obesity in the NE Florida area?
Health Issues - Physical Activity 50% 57% 65% 58% 25% 36% (Mex. American) % of Population
Health Issues - Cancer
Cancer incidence rates, age adjusted, per 100,000, all sites
All persons 457.1
White male 542.2
Black male 642.9
Hispanic male 399.5
White female 418.2
Black female 378.4
Hispanic female 294.3
Health Issues - Environmental health http://www.cdc.gov/nchs/products/pubs/pubd/hestats/asthma/asthma.htm
Discussion
The Hispanic population is scattered throughout the area with little or no data collected beyond some basis census and health information, and even those figures are incomplete, controversial, or questionable.
What measures should be taken to better assess the situation? Whose responsibility should it become (i.e., Health Dept. or City)?
What can your agency or program do?
Other health issues
Mental Health
HIV/AIDS
Osteoporosis
Lactose intolerance
Food safety
Health care access
Mental Health
Substance abuse
Acculturation and self identity
Coping strategies
Other health issues - HIV/AIDS
HIV/AIDS per 100,000 pop.
Group, all ages/ adjusted Death rates Cases
White male 4.3 13.6
Black male 33.3 109.2
Hispanic male 9.1 37.2
White female 0.9 2.2
Black female 13.4 49.0
Hispanic female 2.6 11.3
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Health Issues - Osteoporosis
Minority women are at a higher risk of developing osteoporosis than previously believed
Health Issues - Osteoporosis
55.5% of Hispanic, postmenopausal, women have low bone mineral densities and in 4.3% of these women, osteoporosis was identified (Diary council Digest, Jan/Feb 2001; www.nationaldiarycouncil.org )
Health Issues - Lactose Intolerance
Lactose maldigestion occurs in about 53% Mexican Americans (Dairy Council Digest, Jan/Feb 2001; www.nationaldairycouncil.org )
Prevalence among minority groups is not clear
Health Issues - Food Safety
Listeriosis occurs at higher prevalence rate among Latinos than in overall population
Hispanic infants had a 12 times greater incidence
Hispanic women age 30 to 34 had a 13 times greater incidence
16-6 Increase the proportion of pregnant women who receive early and adequate prenatal care
Baseline-
a. Care beginning in the first trimester; 83% of live birth
b. Early and adequate prenatal care; 74% of live births
Hispanics-
a. 74% of live births
b. 66% of live births
Healthy People 2010; www.health.gov/healthlypeople/
Health Issues - Maternal and Child Care
6-Maternal, Infant, and Child Health
16-10 Reduce low birth weight and very low birth weight
Baseline-
a. Low birth weight; 7.6%
b. Very low birth weight; 1.4%
Hispanics-
a. Low birth weight; 6.4%
b. Very low birth weight; 1.1%
Health Issues - Maternal and Child Care
Prenatal care for live births
Group % of live births
All 83.7
Hispanic/Latino 76.7
Mexican 75.7
Puerto Rican 79.9
Cuban 92.0
Central and South American 78.7
Other/Unknown 76.7
Health Issues - Maternal and Child Care
Infant, neonatal, and postneonatal mortality rates
Group % of live births
All 7.0
Hispanic/Latino 5.6
Mexican 5.4
Puerto Rican 8.2
Cuban 3.7
Central and South American 5.1
Other/Unknown 7.1
Other health issues - Infant Mortality, Florida: 1997-2001 Note: Five year average number of deaths and death rates per 1,000 live births. Infant deaths by Hispanic mother of origin, rate per 1,000 live births. Source: Florida Department of Health, Office of Vital Statistics, 1997-2001 and Florida Department of Health, Office of Planning, Evaluation and Data Analysis and Health Planning Council of N.E. Fla., Health Plan 2003-2006 12.8 2,916 5.6 4,119 4.7 1,033 7.2 7,133 Rate Num. Rate Num. Rate Num. Rate Num. Black White Hispanic All Races
Other health issues - Infant Mortality Region IV, 1997-2001 Note: Five year average number of deaths and death rates per 1,000 live births. Source: Florida Department of Health, Office of Vital Statistics, 1997-2001 and Florida Department of Health, Office of Planning, Evaluation and Data Analysis and Health Planning Council of N.E. Fla., Health Plan 2003-2006 12.4 42 5.6 106 5.8 14 Volusia 17.5 11 6.1 33 0.0 0 St.John’s 13.2 4 5.4 18 0.0 0 Nassau 7.4 2 6.4 10 0.0 0 Flagler 16.4 339 7.1 266 6.2 16 Duval 14.0 11 7.5 60 7.2 3 Clay 8.7 2 6.1 9 0.0 0 Baker Rate Num. Rate Num. Rate Num. Black White Hispanic Area
Discussion
What do you think contributes to the differences in infant mortality among the different Hispanic groups?
Other health issues - Health care access
44.3 million persons lacked health insurance in 1998 (CDC)
This represents a continuing increase in the number of uninsured persons (CDC)
Latinos (35%) are more likely to report being without health insurance
Other health issues - Duval County (Mr. Radley Remo, DCHD)
Leading Causes of Hospitalization for Hispanics, Duval County 2003
Single, live born, w/o cesarean (n=274)
Single, live born cesarean (n=107)
Pneumonia (n=48)
Leading Causes of Ambulatory Care for Hispanics, Duval County 2003
Benign neoplasm of the colon (n=71)
Colon screening (n=41)
Unspecified cataract (n=40)
2002 Florida Behavioral Risk Factor Surveillance System
Statewide Self-Reporting Survey
Used to monitor health behavior & health status
18 years & older
Behavioral Risk Factors for Hispanics
Risk Factors
Overweight & Obese
Physical Activity
Smoking
Health Care Coverage & Access
Risk Factors by Race/Ethnicity, Florida 2002 Red indicates statistically significant 13.6 40.1 (-) No Health Care Coverage 23.9 21.1 Smoking (current) 22.5 39.2 (-) No Physical Activity 21.4 20.8 Obese % White, Non-Hispanic % Hispanic Risk Factor
Behavioral Risk Factor for Hispanics
Disease Prevention
Annual Flu Shot
Mammograms & Pap Tests
Colorectal Cancer Screenings
Blood Stool Test
HIV/AIDS Tests
Disease Prevention by Race/Ethnicity, Florida 2002 Red indicates statistically significant (R.Remo DCHD) 44.2 53.0 (+) Ever been tested for HIV 48.8 31.4 (-) Ever had Blood Stool Test 93.5 88.8 Ever had Pap Smear Test 29.9 14.2 (-) Received Flu Shot w/I 12mo. % White, Non-Hispanic % Hispanic Disease Prevention
Behavioral Risk Factors for Hispanics
Chronic Conditions
High Blood Pressure
Cholesterol
Asthma
Diabetes
Chronic Conditions by Race/Ethnicity, Florida 2002 Red indicates statistically significant (R.Remo DCHD) 8.0 8.2 Have Diabetes 11.1 11.4 Ever Had Asthma 37.7 30.5 Had High Cholesterol 28.7 20.2 (+) Had High Blood Pressure % White, Non-Hispanic % Hispanic Chronic Condition
Discussion
With the lack of sufficient specific ethnic data available at the regional and local level, what changes seem appropriate?
Knowing the wide range of intragroup diversity, is it appropriate to consider and document acculturation and SES among Hispanics?
Examples of Action Models and Initiatives - Research
Hispanic/Latino Genetics Community Consultation Network HLGCCN project is a combined effort of Redes En Acción (Networks in Action), which is a major Special Populations Network effort of the NCI, Baylor College of Medicine, the National Institute of General Medical Sciences (NIGMS), and the National Human Genome Research Institute (NHGRI).
Who? NCLR Institute for Hispanic Health National Heart, Lung and Blood Institute (NHLBI) of the NIH
Focus? Multilevel strategies outreach model which provides heart health education. Relies on promotores de salud (lay health educators) who disseminate educational and prevention awareness materials.
Who? NCLR Institute for Hispanic Health and Centers for Disease Control and Prevention
Focus? Sharing lessons learned and building capacities of parents of youth and community-based organizations (CBOs) to develop culturally competent HIV/AIDS prevention programs.
Thank you! Any questions? This seminar is part 1 of an 8 part series of seminars on Hispanic Health Issues brought to you by the University of North Florida’s Dept. of Public Health, College of Health, a grant from AETNA, and the cooperation of Duval County Health Dept. For more information or register for the seminars, please call 620-1289 .
Latinos in the U.S. and Northeast Florida: A Health more
Latinos in the U.S. and Northeast Florida: A Health Overview
Feb. 25, 2005
This is part 1 of an 8 part series of seminars on Hispanic Health Issues brought to you by the University of North Florida’s Dept. of Public Health, College of Health, a grant from AETNA, and the cooperation of Duval County Health Department. less
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