The US Department of Health and Human Services has launched Healthy People 2020, a document representing the federal government’s public health agenda for the coming decade. A “What’s New for 2020” page summarizes major developments relative to Healthy People 2010. Among them is a focus on addressing health disparities from a perspective that includes social determinants of health.
Healthy People 2020
HHS Launches Action Plan to Reduce Ethnic and Racial Health Disparities
From the announcement: “Goals of the HHS Action Plan include transforming health care and expanding access, building on the provisions of the Affordable Care Act related to expanded insurance coverage and increased access to care. The plan also calls for more opportunities to increase the number of students from populations underrepresented in the health professions, train more people in medical interpretation to help serve patients with a limited command of English, and train community workers to help people navigate the system.”
Hidalgo County to be Part of National Children’s Study
Approximately 1,000 children from Hidalgo County will be taking part in a study, sponsored by the National Institute of Child Health and Human Development, along with several other federal agencies. Women who are pregnant, or going to become pregnant will be chosen for the study, which will examine social and environmental factors (such as diet, pollutants, and poverty) on the children’s health and development. The children will be followed from their time in the womb until their 21st birthday.
“The goal of the study is to get a handle on all aspects of pregnancy and childhood….that includes biological, phyiscal, chemical and social factors.” according to Dr. Daniel Hale, an investigator with the study and pediatrics professor at the UT Health Science Center at San Antonio.
Hispanic Americans and Health Bibliography, 2007
The 2007 issue of the “Hispanic Americans and Health” bibliography series is now available and includes references to over 1000 articles culled from searches of MEDLINE, CINAHL (nursing and allied health) and PsycINFO. The bibliography includes articles added to the databases from approximately August 2006 through July 2007. The “Hispanic Americans and Health” series has been published by the UTHSCSA Libraries since 1979. The bibliography is available at http://www.library.uthscsa.edu/basics/hisbib.cfm. Older bibliographies in the series are available through this link as well.
Hispanic Heart Health discussed at the AHA Scientific Sessions
A recent study indicates that significant percentages of Hispanics have borderline high or high total cholesterol, low levels of good cholesterol, and borderline high or high levels of triglycerides. The study, which was based on the results of the 2007 Summer Heart Health Campaign survey and screening of almost 3,000 Hispanics in four cities (Chicago, IL; Houston, TX; Miami, FL; and New York/New Jersey metro area), was released at the American Heart Association’s Scientific Sessions. The recent survey and screening effort is part of the Alliance’s Para un corazón saludable (translation: For a healthy heart) campaign. The campaign, led by the National Alliance for Hispanic Health (http://www.hispanichealth.org/), and sponsored by an educational grant from AstraZeneca was launched to improve awareness and understanding of heart disease risk factors, including high cholesterol, in Hispanic communities. Leading Hispanic cardiologists will convene for the inaugural Hispanic Cardiologist Leadership Network meeting at the AHA 2007 Scientific Sessions to discuss these and other issues critical to the improvement of heart health among Hispanics.
Hispanic seniors less likely to receive necessary immunizations
Although elderly individuals have a high risk of complications from flu or pneumonia, a study recently reported in the journal Archives of Internal Medicine indicates that significant racial and ethic disparities exist for immunizations. Hispanic seniors are less likely to be immunized than non-Hispanic White seniors, with an especially striking difference for pneumococcal immunizations. The authors suggest several factors for these disparities:
- language preference is an important factor for immunization, with considerably larger disparities for Spanish-preferring than English-preferring Hispanic seniors
- geographic factors that determine whether Spanish-preferring seniors live in large Hispanic communities or in linguistically-isolated “new communities”
- type of available Medicare or managed care plan with respect to uniform preventive care
In terms of increasing immunization among Hispanic seniors, the article states that the findings “have important implications for increasing immunization among Hispanic seniors, suggesting that further efforts are needed to improve cultural and linguistic access to care. In particular, geographic targeting of the subgroups at greatest risk, in combination with surname lists and health literacy mapping, may help optimize outreach and targeting of vaccine resources.”
Haviland AM, Elliott MN, Hambarsoomian K, Lurie N. Immunization disparities by Hispanic ethnicity and language preference. Arch Intern Med. 2011, Jan. 24; 171(2): 158-65.
Hispanic Teen Parents and Intimate Partner Violence
Dr. Janna Lesser and others at UTHSC San Antonio recently published a study of teen parents’ experience managing intimate partner violence:
“At a young age they develop strategies to manage violence, but new challenges with violence manifest themselves as they enter into intimate partner relationships. For some of these youth, parenthood is perceived as a transforming experience that offers an opportunity for a positive change in their life trajectory.”
How Will Health Care Reform Affect the Use of Curanderismo?
Will easier access to health care affect the use of complementary and alternative medicine in the Valley? With changing health care reform, only time will tell whether it will have an effect on the use of folk healers among the Valley population. While some may use Curanderismo because they can’t afford conventional treatment, others choose this method of treatment because they don’t trust conventional doctors, or because of tradition. Still many, according to Albert Salinas, a curandero in Edinburg, see clients who use Curanderismo in conjunction with conventional treatments. Complementary use of the traditional healing arts may be the best way to take advantage of modern medicine while not abandoning one’s beliefs. According to Antonio Zavaleta, director of the Texas Center for Border and Translational Studies at the University of Texas-Brownsville, “We don’t want to discourage people from visiting curanderos. We only want them to stop if we see they are being harmed”.
Immigrants less likely to report family history of cancer
A new study indicates that immigrants are less likely to report family histories of cancer, and therefore might be missed by screening and prevention efforts that could otherwise benefit them. The study will appear in the 15 January issue of Cancer but is now online (see citation below). It is based on analysis of data from over 5000 respondents to the 2005 Health Information Trends Survey (HINTS). The analysis found that foreign-born respondents were two-thirds less likely to report a family history of cancer than US-born respondents — and that rate was consistent among immigrants regardless of the amount of time they had lived in the US or their degree of acculturation. Possible contributing factors discussed included:
- Lower incidence of cancer in countries of origin: “Lower incidence rates of cancer outside of the United States are thought to be attributable to younger age structures in these countries, behavioral and environmental exposures, and a pattern of underdiagnosing and under-reporting cancers in under-resourced countries.”
- Immigrants may have fewer opportunities to learn about family histories of cancer; distance from relatives, and some cultural beliefs (i.e. stigma) may inhibit exchange of information about cancer history.
- Immigrants may be less likely to have experienced medical care that emphasized knowing and reporting family history of illnesses — not just cancer, but other family history as well.
Orom H, Coté ML, González H, Underwood W, Schwartz AG. Family History of Cancer: Is it an Accurate Indicator of Cancer Risk in the Immigrant Population? Cancer [forthcoming 2008-01-15]. doi:10.1002/cncr.23173. http://dx.doi.org/10.1002/cncr.23173
Importance of Promotores de Salud in Fight Against Diabetes
The use of community health workers (promotores de salud) to better reach the Hispanic population in the fight against diabetes is being investigated in a study being conducted in San Antonio. These health educators can be found in a wide variety of locations such as community-based organizations, clinics, churches and schools. Therefore, it is easier for those in the most need to bypass some of the barriers (language, economics, and access to health care) that might keep them from obtaining the assistance they need in a more “conventional” health setting.
A partnership between Humana and the National Council of La Raza is behind the research. According to Dr. George Smith, president of Humana Senior Products in Texas, “There is evidence that community health workers can effectively engage, educate, and activate individuals with chronic diseases in ways that the formal health system cannot.”