Elena Rios, MD, MSPHPresident & CEO,

National Hispanic Medical Association Congressional Briefing

October 12, 2011

Hispanics and Prevention Strategy Largest ethnic group in the U.S. at over 50 million

and 16 percent of the populationHealth disparities are due to limited

health care , wellness care, prevention servicescultural competence for relevant health educationHispanic physicians, nurses, dentists, etc.Income, jobs, education, networks to policymakers

Hispanics do embrace disease prevention:They want to be healthy to take care of their families

so that their children have a better future…but healthier communities and access to quality health/wellness care and leadership are needed to make this a reality.

Decreasing Costs is CriticalCardiovascular disease accounts for 20% medical

expenditures; 30% Medicare expendituresPersons with diabetes receive one out of every

five US health care dollar on their care ---and that doesn’t include all the family members who are not yet diagnosed

We need better policies to decrease obesity, increase activity in communities and healthy eating habits and changing the food supply – decrease sodium, increase subsidies for fruit and vegetables, and control HTN and diagnose diabetes and cancer earlier

Federal Leadership • The Obama Administration has provided the

leadership , starting with the First Lady’s Let’s Move Campaign and its initiatives:• Sustainable Communities (HUD, EPA,

Transportation)• Great Outdoors (Interior, EPA, Ag)• Food Initiatives (Ag, FDA, FCC)• National Prevention Strategy (Surgeon General)• Affordable Care Act – Prevention Fund +++• Offices of Minority Health expanded to reach

Hispanics and other minority populations at CDC, CMS, HRSA, NIH, SAMHSA, FDA and Regional Councils, State OMH

NHMA Priorities for PreventionImprove our communities and options for

healthy lifestyle and decreased stressIncrease the affordability and availability of

health care, oral health, mental health services including disease prevention, secondary prevention that are culturally competent

Increase the Hispanic health workforce in public health and other health professions

Change Behavior among Hispanic Populations where they live• To change behavior, we must address the social

determinants of health – the social, built and physical environment that influences behavioral choices among a population and document the evidence

• 2009 NHMA OMH Disparity Summit Prevention Recommendations• Start with Children = School curriculum, • Use schools for the community , families• Doctors to educate community and policymakers

(now working with Kellogg Foundation; OMH)• Mass media campaigns

Hispanic Health & CultureBarriers

Poverty and lack of educationMaternal nutrition - traditional foods & cookingfatalism about diabetes, cancerbelief about not having to lose weight

Opportunities Changing diets with traditional food –new food

fruits and vegetablesFamilies - support systemsHispanic community-based health research

Healthier Hispanic CommunitiesAffordable healthy food & safe places for physical

activity (schools, malls)Decrease stressors in air, water, job market,

housing, transportation, teen pregnancy, gangs, crime

Community coalitions and leadershipLiteracy programs and English programs to

include basic health informationPrograms for strong social networks who take care

of each other ----needs to be through FACEBOOK for the next generation and led by OMH

Quality Hispanic Health CareServices for Hispanics (Eng/Bilingual/Spanish )

& public/private partnerships linked to health care

Cultural competence Modules of OMH, CLAS Standards , Hispanic health collaboratives

Integrative health care in safety-net (Medicaid, Medicare reimbursement) & evidence base

Health Information TechnologyE-med record, patient online resources,

calls/texting education systems, insurance &community services

Hispanics in Public HealthPublic Health and Prevention Programs about

Hispanic populations need to be part of new Interprofessional Training for health professions & allied health students and in CME, CEU courses

Spanish must be required in medical education and health professions education

Leadership development is critical for Hispanic public health leaders – from all health professions to serve in Federal, State decision-making positions, to provide recommendations to the policymakers, corporate leaders in the health care industry

National Quality Care StrategyHealthy People

Cultural beliefs and traditional healing Families , decision-making, care giving

Healthy CommunitiesCommunity redesign for safety, watch programsIncrease jobs and education programs

Affordable HealthcareAgencies for prevention in the community that

can be linked to ADA, AHA, ACS, primary care education and referrals

Prevention Helps Communities• Prevention leads to timely and effective diagnosis

and treatment that reduces demands on the medical system, and it enables people to contribute to the community environment through work and civic participation.

• An effective health care institution will provide preventive care and encourage community services and policies that keep people healthy. An effective health care institution can also improve the local economy by hiring local residents, purchasing local products , investing in the community, leveraging partnerships and leadership.

Last WordSAVE the HEALTH CAREER OPPORTUNITY

PROGRAM (HCOP)Last week, both the Senate and House

Appropriations Committee s recommended dissolving the one Federal program that supports recruitment and academic preparation of minority

students to medicine, public health and other health professions.

Go to Legislative Action Center (NHMAMD.org) and send a letter to your Senator and Congressman !Tell your colleagues to help NHMA Save HCOP