Hispanics & Health Disparities Summit Series Recommendations

National Hispanic Medical Association

U.S. Department of Health and Human Services Office of Minority Health

2008

NHMA – Who are We?

Established in 1994 in DC, non-profit 501c6 association representing 36,000 Hispanic physicians in the U.S.

Mission: to improve the health of Hispanics and other underserved

NHMA Board of Directors Established its foundation, National Hispanic

Health Foundation, 501c3, for research and education activities – affiliated with NYU Wagner Graduate School of Public Service

NHMA Board of Directors Ciro Sumaya, MD, ChairDean, Rural Health Public Health School,

Texas A&M Elena Rios, MD, Pres & CEO Kathy Flores, MD, SecDir, UCSF-Fresno Latino Research Ctr,

CA AHEC Yolanda Partida, DrPH, TreasHablamos Juntos/RWJF Carol Brosgart, MDGilead Sciences Emilio Carrillo, MDPresident, NY-Presbyterian Health Plan Rogelio Lopez, MDVP, Presbyterian Hospital, CA

Jaime Rivera, MDDir, Public Health, Delaware Angel Seda, MDTreasurer, Wyeth Pharmaceuticals Reed Tuckson, MDVP, United HealthCare Alfonso Vargas, MDChair, NHMA Council of Medical Societies Advisory Council: Richard Carmona, MD, 17th Surgeon

General Henry Cisneros, CEO, CityView Ivelisse Estrada, VP, UNIVISION Linda Griego, Pres, Griego Enterprizes

NHMA Networks

NHMA Council of Medical Societies NHMA Council of Residents Medical Student members Hispanic Health Professional Leadership

Network – all national Hispanic health professional associations

American Latinos & Health Care

Largest ethnic group now and in new America 2050: America will be a nation >50% bicultural groups

Most uninsured (over one-third of all Hispanics) Most problems with disparities in health care

according to US DHHS 2006 Disparities Report Need for cultural, language, education services System lacks Hispanic researchers, providers

and leaders in public/private agencies

Think Future: how to prepare for a New America? The new America will consist of populations who

face severe lack of access to health care, lack of trust and knowledge, and are low-income, poorly educated with strong cultural and family values, limited English proficiency, mainly living in urban areas, suffering from high rates of obesity, diabetes, infectious and chronic diseases, and demanding health care reform.

THE FUTURE IS NOW… YOU ARE THE ANSWER

Planning

3 Regional Summits – New York Academy of Medicine, New York Sacramento, California Austin, Texas

November 2007 – March 2008 Planning Committee of OMH hdqts/regional

offices and NHMA Announce Recommendations at NHMA Annual

Conference, April 18th, DC to the Health Policy Advisors of Obama, Clinton, McCain

Stakeholder Participants

Clinics/Community agencies

Hospitals Medical Schools Foundations Pharma Cos. Insurance Cos. Government

Business – Corp + Media Unions Hispanic Chambers of

Commerce Physicians Consultants

Associations K-12

Access – Recommendations1. Financing Universal and affordable health insurance

coverage Expand eligibility for public programs –

families, undocumented, legal doc, FPL levelComprehensive benefits - preventive, mental

health, dental, educational services Individual mandates, automatic for allPortable, quality measures, accountable

Access – Recommendations1. Financing Public-Private partnerships with community

demonstrations for low cost care delivery (eg. Mobile clinics)– with understanding of poverty, social determinants of health, outcomes for increasing health equity, preventive services that are culturally/linguistically appropriate, mid-level providers, promotoras

Access – Recommendations2. Health Care System Enforce standards for Culturally and Linguistically

Appropriate Services (JACHO) Promote cultural competency provider training

(incentives, performance payments, Federal clearinghouse)

Language services – interpreters, pooling of resources, federal laws on access to services

Race/ethnicity/Language data --mandatory Support providers in underserved communities

Strengthen DSH payment system to private practice Expand NHSC or similar program

Access Recommendations2. Health Care System Invest in a diverse workforce

Fully fund HCOP, COEEmphasize diversity throughout the pipeline

Medical Home = CHCs for all + increase referral systems to tertiary care

Patient centered care

Access – Recommendations3. Education/Marketing Promote Awareness

Standard health education in K-12Use promotoras for community education

National Media Campaigns Incentives/reimbursement for patient

education

Prevention – Recommendations1. Education and Awareness Schools

Standardize K-12 wellness programs Provide healthy foods in schools

Community/parents Support community coalitions Increase green market penetration Cooking skills, food pyramid Clinics – increase diabetes and obesity focus

Policymakers – find our champions

Prevention – Recommendations2. Marketing Expand Social Marketing

Public/private partnership to promote healthy lifestyles

Major Hispanic marketing campaign about public health

Industry to ban marketing of unhealthy foods to kids

Prevention – Recommendations3. Nutrition Policy Federal policy for healthy foods

Provide USDA subsidies for healthier foods Make WIC and food stamp programs healthier Regulate unhealthy food marketing, labeling, and sales

Strengthen nutrition education Standardize evidence-based health education in schools Redefine traditional Hispanic foods as healthy

Schools Ban vending of junk food/sodas Report cards/incentives to good schools/state standards

Prevention – Recommendations4. Promote Physical Activity

Build a healthier environment to live inMore and safer parks, sidewalks, and gyms in

minority areas Increase availability of exercise programs

in and after school, communityat worksites & elsewhere - supported by

employers

Prevention Recommendations5. Health Care System Reimbursement/cpt codes for prevention (CMS

to increase focus on diabetes and obesity) Redesign for obese pts Low cost interventions (CDC, NIH) Healthy food in hospitals CME/cultural competence training Research – community-based Multidisc teams – include nutritionists, educators

Hispanics in the Health Professions Recommendations BUILD POLITICAL WILL Strengthen Educational Pipeline

Improve K-12 education in minority communities Target funds to low income school districts, increase

counseling and faculty awareness Health career tracks in high schools –magnets, tutoring

Provide more Hispanic mentors & role models in health professions at all educational levels

Support Hispanic students in higher education Provide more scholarships & loan repayment options

Hispanics in Health ProfessionsRecommendations Outreach to students/parents in low

income neighborhoods about health careers in a new programDevelop value of education; fundingLink to clinics, libraries, science museums

Media/marketing about health careers Public-Private partnerships in regions

HSIs linkage in regional efforts

Hispanics in the Health Professions Recommendations Changes in Health Profession Schools

Fund COE and HCOP & expand focus Change admissions – increase focus on

background, leadership, underserved interest vs #s

Improve minority representation – admissions (include community), faculty, leadership

Link recruitment to professionals, alumni

Obama Administration

CHIP Bill Economic Stimulus Bill – H-IT, Medicaid,

Medicare, Cobra, Workforce, Clinics, Comparative Effectiveness Research

Health Care Reform – Health Disparities Title VII reauthorization HHS Leadership & Hispanics OMH Leadership Summit – Feb. 26th

Affiliated with the Robert F. Wagner Graduate School of Public Service, New York University

Education Programs

NHMA Leadership Fellowship Childhood Obesity Education Program Hispanic Health Portal www.hispanichealth.info

Research and Research Training on Hispanic Health

Hispanic Health Professional Student Scholarship

What We Do - NHHF

What We Do - NHMA

Advocacy – health of Hispanics Leadership development of Hispanic

physicians and health professionals Policy forums – Summit Series 13th Annual Conference – Mar. 19-22nd

NY Marriott at the Brooklyn Bridgewww.nhmamd.org