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Health Care Disparities
The World Health Organization (WHO)
defines health disparities as:
Differences in health outcomes ...
It’s Been Said
“Of all the forms of inequality,
injustice in healthcare is the
most shocking and
inhumane “
Rev. Dr. Marti...
Disparity
The lack of similarity or equality;
any quality difference;
the condition of being unequal
Definitions
Health: state of complete physical, mental and social
well-being.
Healthcare: the prevention, treatment and
ma...
Determinants of Health
1. Behavior
2. Physical environment
3. Social environment
4. Biology
5. Individual
Social Determinants
1. Education
2. Food
3. Decent and Safe Housing
4. Affordable Public Transportation
5. Health Insuranc...
Leading Causes of Death
Heart Disease
Cancer
Accidents
Diabetes
Important Indicators of
Community Health
1. Health Disparities
2. Health Inequalities
3. Health Inequities
Overview of Racial and Ethnic
Health Disparities
Murray et al show a difference of 33 years between the longest living and...
The 8 Americas
Economic Burden
$1.24 trillion
The combined costs of health inequalities
and premature death in the United States
between ...
Sources of Disparities in Care
• Patient level
– i.e. patient preferences
• Healthcare systems level
– i.e lack of interpr...
Measures of Health Care Disparities
• Prevention Quality
– Indicators, Ambulatory Care, Sensitive Conditions
• Vital Stati...
Health Care
According to the Institute of Medicine:
Minorities are significantly less likely than the
rest of the populati...
By the Numbers
• 1/3 of the U.S population Minorities
• 50 million people Uninsured
• 50% are minorities ~25 million peopl...
Factors That Influence Health Status
Race or Ethnicity
Religion
SES
Gender
Age
Mental Health
Disability
Sexual Orientation...
Major Considerations in
Healthcare Disparities
Care
Workforce
Population
Data Collection and Research
Disparities in the Health and Human
Services Infrastructure and Workforce
Hispanics ~ 16% of the U.S. population
< 6% of U...
Noted Success
National Health Service Corps (NHSC) invests in the healthcare
workforce by placing health professionals in ...
US Census 2010
People QuickFacts Hempstead,NY
Population (2010) 53,891 19,378,102
Population (2012) 54,883 19,570,261
Population Hempstea...
Successful Note
CDC’s Racial and Ethnic Approaches to Community Health
(REACH)
• seek better health
• change local healthc...
Race and Medical Care
Minorities receive fewer procedures and poor
quality medical care than Whites
Mechanisms:
• Institut...
Community Ranking Pediatric Preventative
Care Sensitive Hospitalizations per 100,000
Pediatric Population (2013)
How It’s Going
Community with Highest Admission Rate: Hempstead
Preventable pediatric admission rate 22 times the rate
of ...
411
• Black are 2-4 times more likely than Whites and Hispanics
to be hospitalized for a potentially preventable condition...
Head Start Program
Minorities make up 79% of the population served by Head
Start administered by the Administration for Ch...
Kathleen G. Sebelius, Secretary,
Health & Human Services
“It is time to refocus, reinforce, and
repeat the message that he...
References
American community survey; Hofstra University University
Centers for Disease Control and Prevention
Disparities...
Health Disparities Power Point FINAL
Health Disparities Power Point FINAL
Health Disparities Power Point FINAL
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Health Disparities Power Point FINAL

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Health Disparities Power Point FINAL

  1. 1. Health Care Disparities The World Health Organization (WHO) defines health disparities as: Differences in health outcomes that are closely linked with social, economic, and environmental disadvantage — are often driven by the social conditions in which individuals live, learn, work and play
  2. 2. It’s Been Said “Of all the forms of inequality, injustice in healthcare is the most shocking and inhumane “ Rev. Dr. Martin Luther King
  3. 3. Disparity The lack of similarity or equality; any quality difference; the condition of being unequal
  4. 4. Definitions Health: state of complete physical, mental and social well-being. Healthcare: the prevention, treatment and management of illness and the preservation of mental and physical well-being; services offered by the medical and Allied health professions
  5. 5. Determinants of Health 1. Behavior 2. Physical environment 3. Social environment 4. Biology 5. Individual
  6. 6. Social Determinants 1. Education 2. Food 3. Decent and Safe Housing 4. Affordable Public Transportation 5. Health Insurance 6. Clean Water, Sanitation and Non-Polluted Air
  7. 7. Leading Causes of Death Heart Disease Cancer Accidents Diabetes
  8. 8. Important Indicators of Community Health 1. Health Disparities 2. Health Inequalities 3. Health Inequities
  9. 9. Overview of Racial and Ethnic Health Disparities Murray et al show a difference of 33 years between the longest living and shortest living groups in the U.S. This research found that:: Disparities in mortality across the eight Americas, each consisting of millions or tens of millions of Americans, are enormous . The observed disparities in life expectancy cannot be explained by race, income, or basic health-care access and utilization alone. Because policies aimed at reducing fundamental socioeconomic inequalities are currently practically absent in the US, health disparities will have to be at least partly addressed through public health strategies that reduce risk factors for chronic diseases and injuries. Murray CJL, Kulkarni SC, Michaud C, Tomijima N, Bulzacchelli MT, et al. (2006) Eight Americas: Investigating Mortality Disparities across Races, Counties, and Race-Counties in the United States. PLoS Med 3(9): e260. doi:10.1371/journal. pmed.0030260.
  10. 10. The 8 Americas
  11. 11. Economic Burden $1.24 trillion The combined costs of health inequalities and premature death in the United States between 2003 and 2006 Source: Joint Center for Political and Economic Studies
  12. 12. Sources of Disparities in Care • Patient level – i.e. patient preferences • Healthcare systems level – i.e lack of interpretation and translation services • Provider level – i.e. bias clinical uncertainty
  13. 13. Measures of Health Care Disparities • Prevention Quality – Indicators, Ambulatory Care, Sensitive Conditions • Vital Statistics – Population, Births, Deaths • Access – Health Insurance, Geography • Demographics – Socioeconomic Status • Clinical Indicators – Co-morbidity (i.e obesity and diabetes)
  14. 14. Health Care According to the Institute of Medicine: Minorities are significantly less likely than the rest of the population to have health insurance. Lack of insurance negatively affects the quality of health care received by minority populations.
  15. 15. By the Numbers • 1/3 of the U.S population Minorities • 50 million people Uninsured • 50% are minorities ~25 million people • 56 million people experience rates of preventable hospitalizations • 2 times that of non-Hispanic Whites • 19 million patients served by Health Services and Resources Administration (HRSA): • 63% are Minorities • 92% have Income Below Federal Poverty Level SOURCE: www.hrsa.gov/ Health Services and Resources Administration
  16. 16. Factors That Influence Health Status Race or Ethnicity Religion SES Gender Age Mental Health Disability Sexual Orientation or Gender Identity Geographic Location
  17. 17. Major Considerations in Healthcare Disparities Care Workforce Population Data Collection and Research
  18. 18. Disparities in the Health and Human Services Infrastructure and Workforce Hispanics ~ 16% of the U.S. population < 6% of U.S. physicians African Americans ~ 24% of the U.S. population ~ 6% of U.S. physicians 24 million adults with limited English proficiency Minorities are more likely than non-Hispanic Whites to report experiencing poorer quality patient-provider interactions
  19. 19. Noted Success National Health Service Corps (NHSC) invests in the healthcare workforce by placing health professionals in Health Professional Shortage Areas to care for underserved populations. 7,000 NHSC clinicians provide healthcare services in underserved areas in exchange for loan repayment or scholarships: ~ 33% of these clinicians are minorities 50% serve in Community Health Centers (CHC)
  20. 20. US Census 2010
  21. 21. People QuickFacts Hempstead,NY Population (2010) 53,891 19,378,102 Population (2012) 54,883 19,570,261 Population Hempstead, NY New York State Population % change (4/1/2010-7/1/2012) 1.8% 1.0% < 5 years old 8.5% 6.0% < 18 years old 25.6% 22.3% White 21.9% 65.7% Black or African American 48.3% 15.9% Two or More Races 5.0% 3.0% Hispanic or Latino 44.2% 17.6% Foreign 39.2% 21.8% Language other than English at home (age +5) 46.9% 29.5% High school graduate or higher (age +25) 69.5% 84.6% Bachelor’s degree or higher (age +25) 16.5% 32.5%
  22. 22. Successful Note CDC’s Racial and Ethnic Approaches to Community Health (REACH) • seek better health • change local healthcare practices • implement evidence-based public health programs Communities Putting Prevention to Work (CPPW) • support statewide • community-based policy • nutrition, physical activity, and tobacco control
  23. 23. Race and Medical Care Minorities receive fewer procedures and poor quality medical care than Whites Mechanisms: • Institutional Discrimination • Socioeconomic Status • Segregation • Internalized Racism • Inability to Communicate
  24. 24. Community Ranking Pediatric Preventative Care Sensitive Hospitalizations per 100,000 Pediatric Population (2013)
  25. 25. How It’s Going Community with Highest Admission Rate: Hempstead Preventable pediatric admission rate 22 times the rate of the community with the lowest rate (Melville).
  26. 26. 411 • Black are 2-4 times more likely than Whites and Hispanics to be hospitalized for a potentially preventable conditions • Black men and women are more likely to die from heart disease vs. all other racial ethnic groups • Minority women have lower rates of breast cancer than White women but are more likely to die from the disease • Life expectancy differs by nearly 10 years between Black men (70 years) and White women (80+ years)
  27. 27. Head Start Program Minorities make up 79% of the population served by Head Start administered by the Administration for Children and Families (ACF) Goals of the program: • Promote the social and cognitive development of children • Provide educational, health, nutritional, social and other services to enrolled children and families • Help parents make progress toward their educational, literacy, and employment goals • Engages parents in their child’s learning
  28. 28. Kathleen G. Sebelius, Secretary, Health & Human Services “It is time to refocus, reinforce, and repeat the message that health disparities exist and that health equity benefits everyone.”
  29. 29. References American community survey; Hofstra University University Centers for Disease Control and Prevention Disparities across Races, Counties, and Race-Counties in the United States. PLoS Med 3(9): e260. doi:10.1371/journal. pmed.0030260. Healthy People 2020 Health Services and Resources Administration www.hrsa.gov/ Long Island index 2015 Murray CJL, Kulkarni SC, Michaud C, Tomijima N, Bulzacchelli MT, et al. (2006) Eight Americas: Investigating Mortality National centers for health statistics 2005 Rev. Dr. Martin Luther King US Census 2010 US Census 2015 http://www.countyhealthrankings.org/app/new-york/2015/county/snapshots/059

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