The UCSF Fresno Center for Medical Education and Research is developing and testing best practices which aim at breaking down the communication barriers than can compromise care. Hablamos Juntos, a project funded by the Robert Wood Johnson Foundation, seeks to improve the quality of health care for Latinos ” the largest ethnic minority (~ 38.8 million) in the United States. Approximately 14 million speak English with limited proficiency. One of the projects has developed symbols for health signage that provide more effective guidance for patients. These 28 health care symbols are available in the public domain and free to anyone to download. There are no fees associated with their use and written permission is not needed.
Staying Well. Connected.
Universal Symbols
Health Literacy & Winter Texans
It’s that time of year again: the Great Migration has begun, and the RVs can be spotted headed southbound on I-35, I-37, US-77 and US-281. Although the high fuel prices might mean fewer Winter Visitors this year, South Texas will once again welcome thousands of retirees escaping the Frozen North (today’s forecast for MN-WI-upper MI: 6-10″ of lake effect snow, but Harlingen’s looking mostly sunny with a high of 89!).
To help us serve Winter Texans’ health information needs, the HHS Office of Disease Prevention and Health Promotion has just released a helpful tool called the Quick Guide to Health Literacy and Older Adults. In a national assessment of health literacy, only three percent of the older adults surveyed were found to be proficient in health literacy. Persons with limited health literacy have more adverse health outcomes including less frequent use of preventive services, higher hospitalization rates, and more emergency room visits. For older Americans, difficulties with health literacy can complicate already challenging health problems since as many as 80 percent of older Americans have at least one chronic disease. The Quick Guide to Health Literacy and Older Adults is designed to provide useful strategies and suggestions to professionals who work with older adults to help bridge the communication gap between professionals and older adults. [thanks to Siobhan for the tip]
Halloween Candy Buy-Back
Here’s an interesting public health idea that I hadn’t come across before. Last week, on the day after Halloween, Driscoll Children’s Hospital’s Orthodontics Department in Corpus Christi held a Halloween Candy Buy-Back. The organizers paid kids $2 per pound (with a 5-pound limit) to hand over their candy. Dr Deji Fashemo BDS MPH explains, “We can’t do anything orthodontically unless kids have strong healthy teeth and good gums,” and says he hopes the event will educate youngsters on the bad things candy can do to teeth, and encourage them to moderate their candy-eating and especially stay away from sticky, hard candies and taffy-like candies.
A little websearching suggests that Halloween Candy Buy-Back events like this are now happening all over the country, including one group of dentists across the US and Canada who bought back candy for $1 a pound and then sent it off to overseas soldiers. Regardless of the direct effect of such an event on kids’ candy intake, it certainly seems like an interesting and effective way to promote awareness and discussion about the effects of candy on dental health!
Partnering for a Difference in Nueces County
The UT Health Science Center-San Antonio, in conjunction with the South Texas Colonia Initiative, is training a group of Nueces County colonias residents about health risks and resources, in hope they will spread the information with others. Health concerns being addressed through the program include hypertension, obesity, renal failure and early detection of different forms of cancer. Similar programs along the Texas-Mexico border have helped decrease cardiovascular disease and complications from diabetes.
Dr. Thelma Hurd, a surgical oncologist with the UT Health Science Center, is involved in training the community volunteers, who will hopefully be able to spread the information on the resources and assistance avaible to those in need. In Dr. Hurd’s words….”We educate the community and give them the skills to educate the rest of the community”.
CDC Statistics show low level of regular leisure-time physical activity among Hispanic Adults
A recent report by the CDC, available at http://www.cdc.gov/nchs/data/nhis/earlyrelease/200706_07.pdf, indicates that only 22.6% of Hispanic adults engages in regular leisure-time physical activity. Physical activity is one of the Leading Health Indicators for the Healthy People 2010 project, which has as its primary goal to help to help individuals of all ages increase life expectancy and improve their quality of life. Read more about the Healthy People 2010 project at http://www.healthypeople.gov/.
Health Literacy – Presentation by Oralia Bazaldua, PharmD
Last month Oralia Bazaldua provided an excellent overview of health literacy, with a focus on health literacy in South Texas. The video and slides are available from the UTHSCSA Department of Family and Community Medicine’s grand rounds online library.
CDC’s enhanced Spanish-language site
From the press release:
“The Centers for Disease Control and Prevention (CDC) Spanish”l anguage Web site, CDC en Español, has been re”launched with a new look and new features that will make it more usable and functional.”
“The redesigned CDC en Español represents a vital source of health promotion and information for Spanish speakers,” said Dr. Julie L. Gerberding, Director of CDC. “CDC’s ongoing commitment to public health worldwide is expressed through our efforts to provide translation of vital information into Spanish to better serve all of our audiences for information. About half of the 16 million Hispanics online in the United States have expressed preference for Spanish”language Web sites and we are pleased to offer this improved tool.”
[Thanks to Siobhan Champ-Blackwell at Bringing Health Information to the Community.]
November is National Diabetes Month
Diabetes can strike in all age groups and socioeconomic levels. However, according to the American Diabetes Association (ADA), Mexican Americans are more than twice as likely to have diabetes as non-Hispanic whites of a similar age. And diabetics utilize healthcare resources at a rate of three times higher than patients in the non-diabetic population.
Diabetes was the sixth leading cause of death in Texas, and nationally, from 2002 through 2004. In 2004, 5,426 deaths were directly attributed to diabetes. The disease is believed to be under-reported on death certificates in Texas and the nation, both as a condition, and as a cause of death.
According to the Texas Diabetes Council (TDC), 30 people per 100,000 who have diabetes are likely to die from it. The mortality rates for blacks and Hispanics are more than double that of whites. Type 1 diabetes affects one in every 400 to 600 Texas children and adolescents. Type 2 diabetes, in persons less than 18 years old, has been increasing in recent years, TDC addresses issues affecting people with diabetes in Texas and advises the Texas Legislature about the statewide system of education services for all people with diabetes and the health care professionals who care for them.
More than 14 percent of Valley residents have diabetes – more than twice the national average. Many area deaths from heart disease, kidney failure, and other organ shutdowns occurred because diabetes opened the door.
Upcoming diabetes educational events in South Texas:
11/2/07 & 11/3/07
2007 Southwest Diabetes Symposium
Texas Diabetes Institute in San Antonio
11/7/07
6:00 pm to 8:00 pm
The Rio Grande Valley Diabetes Association (RGVDA) and the McAllen Hispanic Chamber of Commerce have gathered several experts on diabetes to make a presentation to the public on the dreaded disease. Healthy refreshments and educational information will be available.
McAllen Heart Hospital Conference Room located at 1900 S. “D” Street
For more information on the workshop and/or to register call the MHCC at (956) 928-0060.
Communicating With LEP Patients
The American Medical Association has released the 2nd edition of its Official Guide to Communicating with Limited-English-Proficient Patients [608 KB PDF]. It’s a very brief guide — only 11 pages of text in a foldover 8 1/2″ by 5 1/2″ booklet — but it’s packed full of very practical information covering questions like:
- What does the term “LEP” mean?
- How do I know if I have LEP patients in my practice?
- How do language barriers affect quality of care and patient safety?
- What is the relationship between language assistance and cultural competency?
- What current and emerging strategies exist that can help physicians care for LEP patients?
- How should physician offices handle telephone calls to and from LEP patients?
- What can your office do to improve access to services for LEP patients?
- How can physician offices finance language assistance services?
Besides its own practical information, the booklet also includes useful references to further information, including:
- The Cross-Cultural Health Care Program
- National Center for Cultural Competence [note: the URL in the booklet is incorrect; this is a correct link]
- National Health Law Program – see their Library of Resources on Cultural and Linguistic Access to Health Care
- The Addressing Language Access Toolkit by the California Academy of Family Physicians
- The Health Care Language Services Implementation Guide by the HHS Office of Minority Health
Table 1 of that booklet (p. 4) emphasizes that bilingual health-care practitioners provide an option with high interpreting quality and a high patient comfort level, that is appropriate for all healthcare settings. This September 2007 article from NurseZone describes the success of one such program at the University of California-Davis Medical Center that includes nurses who are fluent not only in English, but also in Spanish, Russian, or Hmong.
Change in Change Agents
An article in the October issue of Preventing Chronic Disease describes the evolution of the University of Arizona’s community engagement around issues related to border health: “Over 5 years, the coalitions made the transition, in varying degrees, from a programmatic focus to a policy planning and advocacy focus. The coalitions raised community awareness, built community capacity, encouraged a process of ‘change in change agents,’ and advocated for community environmental and policy shifts to improve health behaviors.”
