Latino Health Disparities and Cultural Competency Issues

1. Latino Health Disparities and Cultural Competency Issues Del. Ana Sol Gutiérrez Maryland House of Delegates District 18, Montgomery County, MD Diversity Rx Conference --Oct 21, 2010

2. Moving Toward Health Equity for Minority Communities in Maryland • Identifying Health Disparities for Latino Families, Women, and Children • Key Legislative Initiative- Cultural Competency Bills • Understanding Diversity, Language Access & Cultural Competency Diversity Rx Conference --Oct 21, 2010

3. Overall Goals and Objectives • To Promote Healthy Latino Communities and Eliminate Disparities in Health Care • Identify and Monitor Latino Health Care Gaps • Establish Accurate Latino Health Measures and Outcomes • Close Gaps in Latino Health Access and Services Diversity Rx Conference --Oct 21, 2010

4. Today’s Situation: Discrepancies Abound • Over-representation in Key Preventable Health Problems: Diabetes, Cancer, Cardiovascular disease, etc. • According to the CDC, cancer, HIV/AIDS, cardiovascular disease and diabetes are among the leading causes of illness among Hispanics. • The risk factors for these diseases are also much higher among the Hispanic population. Diversity Rx Conference --Oct 21, 2010

5. Latino Health Disparities are caused by many factors • Lack of cultural competence among care providers • Lack of access to preventive care and absence of health insurance are among the most important issues facing the community. • Gaps in access, services, and outcomes Diversity Rx Conference --Oct 21, 2010

6. Latino Health Disparities (Cont.) These disparities are also evident across Hispanic subgroups. • Mexican Americans carry a disproportionate burden of disease from diabetes. • Puerto Ricans have a low birth weight rate that is 50% higher than that for non-Hispanic whites, and also suffer from higher rates of asthma, HIV/AIDS, and infant mortality. Diversity Rx Conference --Oct 21, 2010

7. How Did We Get Here? • Old Assumptions: No difference between White and Black and Latino Health Needs and Priorities • Lack of Focus on Latino Health Issues • Lack of Accurate and Complete Data • Lack of Cultural Competency • Lack of Understanding of Diversity Among Latinos Diversity Rx Conference --Oct 21, 2010

8. Four Major Challenges Challenge I: Taking Services to Consumers Challenge II: Providing Language-Appropriate Services Challenge III: Integrating Families in Treatment Challenge IV: Recognizing Diversity among Latinos Diversity Rx Conference --Oct 21, 2010

9. Challenge I: Taking Services to Consumers • To improve access to services, we must bring services to consumers • Anecdotal and research evidence suggests that reaching out to consumers can lead to positive outcomes. • Empirically validated approaches can be taken to communities with large proportions of Latinos Diversity Rx Conference --Oct 21, 2010

10. Challenge II: Providing Language-Appropriate Services • For Latinos in the health system, improving language appropriate services may have the biggest impact on the quality of services offered. • Assessment of primarily Spanish-speaking persons, speaking Spanish may reduce errors in clinical evaluations and improve outcomes • Human resource implications • Training Spanish-speaking providers • Having professional interpreters available Diversity Rx Conference --Oct 21, 2010

11. Challenge III: Integrating Families in Treatment Existing health care does a poor job of integrating families in treatment • This may be particularly problematic for Latinos • Family connections may be especially important to Mexican American families, especially those who are immigrants. • Family connections are essential in adapting to a foreign and sometimes hostile setting • Suggests that family based interventions may be particularly useful with some Latinos Diversity Rx Conference --Oct 21, 2010

12. Challenge IV: To Recognize Diversity among Latinos • Exercise “Which of the following families are Mexican?” • Photo # 1 2 3 4 5 6 7 8 9 10 Diversity Rx Conference --Oct 21, 2010

13. Effective Strategies • Legislation must address key challenges to guide delivery of health care policies for Latinos • Main strategies • Take services to the consumer • Do so in a linguistically appropriate manner • Integrate families in treatment whenever possible • But as we consider these challenges, it is important to appreciate the rich heterogeneity of Latinos • Reduce the likelihood of applying stereotypes & increase the likelihood of working within the specific cultural context of the diverse Latino communities Diversity Rx Conference --Oct 21, 2010

14. Effective Legislation: Cultural and Linguistic Competence • Increasing cultural and linguistic competence among health care providers is critical to closing the health disparities gap. • These skills empower caregivers and patients to engage in meaningful dialogue about health concerns and more accurately diagnosis symptoms. • Physicians who can accurately see, hear and understand their patients’ cues and interpret the unique cultural nuances of multicultural Hispanic populations, can deliver better quality care and improve health outcomes. Diversity Rx Conference --Oct 21, 2010