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Health Disparities:
 Don’t Despair,
   Be Aware!

Jacqueline Leskovec, MLIS, MA, RN
     National Network of Libraries of Medicine
             Greater Midwest Region

               DSLC St Mary’s College
                   March 2013
Objectives
Participants will:
•Understand the meaning of health disparities
•Be able to identify 4 population groups affected by
health disparities
•Learn 4 resources for promoting health equity
National Network of Libraries of
Medicine Greater Midwest Region                                     Who We Are




     This project has been funded in whole or in part with Federal funds from the National Library of Medicine, National
     Institutes of Health, Department of Health and Human Services, under Contract No. HHS-N-276-2011-00005-C with
                                             the University of Illinois at Chicago.
THE LITERATURE OF
  PRESCRIPTION




 MARCH 08, 2014 - APRIL 19, 2014
Getting to Know You
What happened?
Culture & Health
Culture and Patient
            Health
• Beliefs about objects, symbols, food, the body,
  blood, non-traditional medicine, etc.
• Communication styles and norms
• Role of relationships
• Ways of learning new information
• Role of translations and interpreters
The 4 C’s of Culture
1.   What do you call your problem?
2.   What do you think caused your problem?
3.   How do you cope with your condition?
4.   What are your concerns regarding the condition
     and/or recommended treatment?

                                           ~The 4 C’s of Culture:
                        A Mnemonic for Health Care Professionals
Health Equity
• [The] attainment of the highest level of health for all
  people. Achieving health equity requires valuing
  everyone equally with focused and ongoing
  societal efforts to address avoidable inequalities,
  historical and contemporary injustices, and the
  elimination of health and health care disparities.

                                  ~Healthy People 2020
                                    HealthyPeople.gov
Health Disparities
Definition
• “A population is a health disparity population if
  there is a significant disparity in the overall rate of
  disease incidence, prevalence, morbidity, mortality
  or survival rates in the population as compared to
  the health status of the general population.”
   o    Minority Health and Health Disparities Research and Education Act United
       States Public Law 106-525 (2000), p. 2498
Unique Health Issues
African Americans
• Heart disease, stroke, high cholesterol, HTN
• Cancer, diabetes, unintentional injuries, maternal
  and infant health, teen pregnancy,
• Smoking and tobacco use, overweight/obesity,
  nutrition, physical activity, HIV/AIDS
• Seasonal influenza, asthma, TB
Hispanic/Latino
• Asthma, chronic lower respiratory disease, influenza
  & pneumonia
• Chagas Disease
• Unintentional injuries, homicide
• Teen pregnancy
• Smoking & tobacco use
• Stroke
• Diabetes
• Chronic liver disease/cirrhosis
Immigrants/refugees
•   Lack of health insurance
•   Lack of immunizations
•   Unfamiliarity with Western medicine
•   Pesticide & other hazards exposure
Emerging Populations
 ~http://rhin.org/
American Indian/Alaskan Native
•   Higher unemployment rate
•   Shorter life expectancy
•   IHS
•   High rates of alcohol use, diabetes, infant mortality,
    HIV/AIDS, obesity, mental health concerns, smoking
    & tobacco use
Asian Americans
•   Myth of the model minority
•   Certain types of cancer, TB, hepatitis B
•   Language & cultural barriers
•   Stigma associated with certain conditions
•   Lack of health insurance
Women’s Health Issues
•   Heart disease
•   Maternal and child health
•   Breast and cervical cancer
•   Binge drinking
•   Intimate partner violence




                                 http://www.cdc.gov/women/lcod/2009/index.htm
Men’s Health Issues
•   Tendency to smoke & drink > women
•   Shorter life expectancy
•   Job related stress
•   Prostate cancer
•   Low testosterone
LGBTI

    Social stigma

    Rejection by family members

    Abuse and violence

    Unfair treatment in the legal system

    Hiding some or all aspects of one’s life

    Lacking health insurance

    Shortage of culturally competent health providers
Senior Health Issues
•   Balance problems, risk for falls
•   Diseases and injuries to bones and joints
•   Hearing loss
•   Diabetes
•   High blood cholesterol
•   Kidney disease
•   Problems with smell, taste; dry mouth
•   Stroke
•   Peripheral arterial disease
Health Information
    Resources
Scholarly Resources/Databases
• PubMed
  o MeSH Terms

• Google Scholar
• CINAHL
• PsycINFO
ARRA & ACA
• Proposed Data Collection Standards
• Plan for Health Data Collection on Lesbian, Gay,
  Bisexual and Transgender (LGBT) Populations
• Preventive care, coordinated care, diversity and
  cultural competency, health care providers for
  underserved communities, ending insurance
  discrimination, affordable insurance coverage
MedlinePlus
•   http://medlineplus.gov
•   Health Topics
•   Drugs & Supplements
•   Videos & Cool Tools
•   Medical dictionary
•   Population groups
    o African-American, Latino/Hispanic, Asian Americans, American Indians,
      Alaskan Natives, LGBT, seniors, children’s health and more
• En español
• Free!
CDC
• Health & Safety Topics
   o Diseases & Conditions; Healthy Living; Emergency Preparedness &
     Response; Injury, Violence & Safety
   o Data & Statistics: FastStats

• For Specific Groups
   o Travelers’ Health; Life States & Populations; State, Tribal, Local & Territorial

• Office of Minority Health & Health Equity
• Women’s Health
• http://www.cdc.gov
• Racial and Ethnic Disparities in Health knowledge
  path
• Health professionals, program administrators,
  policymakers, and researchers
• Racial and ethnic health disparities, health equity,
  and removing barriers to care;
  http://www.mchlibrary.info/KnowledgePaths/kp_race.ht
Men’s Health
• CDC Men’s Health
  o http://www.cdc.gov/men/

• NIH Men’s Health Topics
  o http://health.nih.gov/category/MensHealth/

• AHRQ Healthy Men
  o http://ahrq.gov
NIH Senior Health
• Basic health and wellness information
• Topics of concern for seniors
   o   Bones and Joints
   o   Cancer
   o   Diseases and Conditions
   o   Healthy Aging
   o   Heart and Lungs
   o   Memory and Mental Health
   o   Treatments and Therapies
   o   Vision and Hearing




                                  http://nih.seniorhealth.gov
http://go4life.nia.nih.gov/
LGBT
MedlinePlus
•http://
www.nlm.nih.gov/medlineplus/gaylesbianbisexualandtransgend
National Institutes of Health: Gay/Lesbian Health
•http://health.nih.gov/topic/GayLesbianHealth
AIDS.gov: http://aids.gov
AIDSinfo / infoSIDA: http://aidsinfo.nih.gov
GMHC: http://www.gmhc.org/
Lesbian Health & Research Center
  •   http://www.lesbianhealthinfo.org/
The Mautner Project
  •   http://www.mautnerproject.org/
RHIN
Refugee Health Information Network
•http://www.rhin.org
•Multilingual health information (more than 80
languages) for health providers, refugees and asylees
•Large section on cultural guidance
•Country Conditions Reports
•Multiple formats (print, audio, video)
EthnoMed
• http://ethnomed.org
• Merged material from former 24 Languages Project
• Background information on cultures and cultural
  competency
• Patient education materials
DiversityRx
Improving Health Care for a Diverse World
•http://www.diversityrx.org
•Webinars
•Cultural Competence
o http://www.healthyroadsmedia.org/
o Multiple languages; multiple formats
   • Includes iPod video and multimedia
Health Information
      Translations
o http://healthinfotranslations.org/
o Health topics include Diagnostic Tests and
  Disaster Preparedness
o Linked to from MedlinePlus!
Follow, Fan and Connect
        with NLM
• http://www.nlm.nih.gov/socialmedia/index.html
Others?
Questions?
Comments?
Thank you!
Jacqueline Leskovec
SMC Class of 1974
leskovec@uic.edu
1.800-DEV-ROKS

Slideshare: leskovec

NN/LM Greater Midwest Region
http://nnlm.gov/gmr/

This project has been funded in whole or in part with Federal funds from the National Library of Medicine, National Institutes of
Health, Department of Health and Human Services, under Contract No. HHS-N-276-2011-00005-C with the University of Illinois at
                                                           Chicago.

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Health Disparities: Don't Despair, Be Aware

  • 1. Health Disparities: Don’t Despair, Be Aware! Jacqueline Leskovec, MLIS, MA, RN National Network of Libraries of Medicine Greater Midwest Region DSLC St Mary’s College March 2013
  • 2. Objectives Participants will: •Understand the meaning of health disparities •Be able to identify 4 population groups affected by health disparities •Learn 4 resources for promoting health equity
  • 3. National Network of Libraries of Medicine Greater Midwest Region Who We Are This project has been funded in whole or in part with Federal funds from the National Library of Medicine, National Institutes of Health, Department of Health and Human Services, under Contract No. HHS-N-276-2011-00005-C with the University of Illinois at Chicago.
  • 4. THE LITERATURE OF PRESCRIPTION MARCH 08, 2014 - APRIL 19, 2014
  • 8. Culture and Patient Health • Beliefs about objects, symbols, food, the body, blood, non-traditional medicine, etc. • Communication styles and norms • Role of relationships • Ways of learning new information • Role of translations and interpreters
  • 9. The 4 C’s of Culture 1. What do you call your problem? 2. What do you think caused your problem? 3. How do you cope with your condition? 4. What are your concerns regarding the condition and/or recommended treatment? ~The 4 C’s of Culture: A Mnemonic for Health Care Professionals
  • 10. Health Equity • [The] attainment of the highest level of health for all people. Achieving health equity requires valuing everyone equally with focused and ongoing societal efforts to address avoidable inequalities, historical and contemporary injustices, and the elimination of health and health care disparities. ~Healthy People 2020 HealthyPeople.gov
  • 12. Definition • “A population is a health disparity population if there is a significant disparity in the overall rate of disease incidence, prevalence, morbidity, mortality or survival rates in the population as compared to the health status of the general population.” o Minority Health and Health Disparities Research and Education Act United States Public Law 106-525 (2000), p. 2498
  • 13.
  • 15. African Americans • Heart disease, stroke, high cholesterol, HTN • Cancer, diabetes, unintentional injuries, maternal and infant health, teen pregnancy, • Smoking and tobacco use, overweight/obesity, nutrition, physical activity, HIV/AIDS • Seasonal influenza, asthma, TB
  • 16. Hispanic/Latino • Asthma, chronic lower respiratory disease, influenza & pneumonia • Chagas Disease • Unintentional injuries, homicide • Teen pregnancy • Smoking & tobacco use • Stroke • Diabetes • Chronic liver disease/cirrhosis
  • 17. Immigrants/refugees • Lack of health insurance • Lack of immunizations • Unfamiliarity with Western medicine • Pesticide & other hazards exposure
  • 19. American Indian/Alaskan Native • Higher unemployment rate • Shorter life expectancy • IHS • High rates of alcohol use, diabetes, infant mortality, HIV/AIDS, obesity, mental health concerns, smoking & tobacco use
  • 20. Asian Americans • Myth of the model minority • Certain types of cancer, TB, hepatitis B • Language & cultural barriers • Stigma associated with certain conditions • Lack of health insurance
  • 21. Women’s Health Issues • Heart disease • Maternal and child health • Breast and cervical cancer • Binge drinking • Intimate partner violence http://www.cdc.gov/women/lcod/2009/index.htm
  • 22. Men’s Health Issues • Tendency to smoke & drink > women • Shorter life expectancy • Job related stress • Prostate cancer • Low testosterone
  • 23. LGBTI  Social stigma  Rejection by family members  Abuse and violence  Unfair treatment in the legal system  Hiding some or all aspects of one’s life  Lacking health insurance  Shortage of culturally competent health providers
  • 24. Senior Health Issues • Balance problems, risk for falls • Diseases and injuries to bones and joints • Hearing loss • Diabetes • High blood cholesterol • Kidney disease • Problems with smell, taste; dry mouth • Stroke • Peripheral arterial disease
  • 25. Health Information Resources
  • 26. Scholarly Resources/Databases • PubMed o MeSH Terms • Google Scholar • CINAHL • PsycINFO
  • 27. ARRA & ACA • Proposed Data Collection Standards • Plan for Health Data Collection on Lesbian, Gay, Bisexual and Transgender (LGBT) Populations • Preventive care, coordinated care, diversity and cultural competency, health care providers for underserved communities, ending insurance discrimination, affordable insurance coverage
  • 28. MedlinePlus • http://medlineplus.gov • Health Topics • Drugs & Supplements • Videos & Cool Tools • Medical dictionary • Population groups o African-American, Latino/Hispanic, Asian Americans, American Indians, Alaskan Natives, LGBT, seniors, children’s health and more • En español • Free!
  • 29.
  • 30. CDC • Health & Safety Topics o Diseases & Conditions; Healthy Living; Emergency Preparedness & Response; Injury, Violence & Safety o Data & Statistics: FastStats • For Specific Groups o Travelers’ Health; Life States & Populations; State, Tribal, Local & Territorial • Office of Minority Health & Health Equity • Women’s Health • http://www.cdc.gov
  • 31.
  • 32.
  • 33. • Racial and Ethnic Disparities in Health knowledge path • Health professionals, program administrators, policymakers, and researchers • Racial and ethnic health disparities, health equity, and removing barriers to care; http://www.mchlibrary.info/KnowledgePaths/kp_race.ht
  • 34. Men’s Health • CDC Men’s Health o http://www.cdc.gov/men/ • NIH Men’s Health Topics o http://health.nih.gov/category/MensHealth/ • AHRQ Healthy Men o http://ahrq.gov
  • 35. NIH Senior Health • Basic health and wellness information • Topics of concern for seniors o Bones and Joints o Cancer o Diseases and Conditions o Healthy Aging o Heart and Lungs o Memory and Mental Health o Treatments and Therapies o Vision and Hearing http://nih.seniorhealth.gov
  • 37. LGBT MedlinePlus •http:// www.nlm.nih.gov/medlineplus/gaylesbianbisexualandtransgend National Institutes of Health: Gay/Lesbian Health •http://health.nih.gov/topic/GayLesbianHealth AIDS.gov: http://aids.gov AIDSinfo / infoSIDA: http://aidsinfo.nih.gov GMHC: http://www.gmhc.org/ Lesbian Health & Research Center • http://www.lesbianhealthinfo.org/ The Mautner Project • http://www.mautnerproject.org/
  • 38. RHIN Refugee Health Information Network •http://www.rhin.org •Multilingual health information (more than 80 languages) for health providers, refugees and asylees •Large section on cultural guidance •Country Conditions Reports •Multiple formats (print, audio, video)
  • 39. EthnoMed • http://ethnomed.org • Merged material from former 24 Languages Project • Background information on cultures and cultural competency • Patient education materials
  • 40. DiversityRx Improving Health Care for a Diverse World •http://www.diversityrx.org •Webinars •Cultural Competence
  • 41. o http://www.healthyroadsmedia.org/ o Multiple languages; multiple formats • Includes iPod video and multimedia
  • 42. Health Information Translations o http://healthinfotranslations.org/ o Health topics include Diagnostic Tests and Disaster Preparedness o Linked to from MedlinePlus!
  • 43. Follow, Fan and Connect with NLM • http://www.nlm.nih.gov/socialmedia/index.html
  • 45. Thank you! Jacqueline Leskovec SMC Class of 1974 leskovec@uic.edu 1.800-DEV-ROKS Slideshare: leskovec NN/LM Greater Midwest Region http://nnlm.gov/gmr/ This project has been funded in whole or in part with Federal funds from the National Library of Medicine, National Institutes of Health, Department of Health and Human Services, under Contract No. HHS-N-276-2011-00005-C with the University of Illinois at Chicago.

Editor's Notes

  1. Immigrant: chooses “to move in order to improve the future prospects of themselves and their families,” usually for employment or education opportunities. ~Immigration and Nationality Act Refugee: “a person who is unable or unwilling to return to his or her country of nationality because of persecution or a well-founded fear of persecution on account of race, religion, nationality, membership in a particular social group, or political opinion.” ~United Nations High Commissioner for Refugees (UNHCR) website Refugees experience a number of unique health issues: May be less likely to have health insurance and/or coverage may be inadequate. May not be current with immunizations (adults and children) May have been exposed to high levels of pesticide. May be suspicious of Western medicine and avoid treatment. May also have different view of alternative/complimentary treatments. Higher rates of malnutrition, infection, lead poisoning, and mental disorders. May have been victims of trauma (including violence) and high levels of stress. 1) psychiatric disorders precipitated by the refugee experience 2) infectious and parasitic diseases endemic to countries of origin 3) chronic diseases endemic to host countries