Arizona Health Disparities Profile Project 7 th National Conference on Quality Health Care for Culturally Diverse Populations Zipatly Mendoza, MPH Office

Arizona Health Disparities Profile Project

7th National Conference on Quality Health Care for Culturally Diverse Populations

Zipatly Mendoza, MPHOffice Chief

Arizona Health Disparities CenterOctober 19, 2010

Arizona Health Disparities Center

www.azminorityhealth.gov

• Project Overview• Methods• Challenges• Conclusion

Agenda



Data Profile Overview

• Compare leading health indicators among racial/ethnic populations relative to the general Arizonan population.

• Identify gaps and recommendations to guide a health equity agenda.

• Provide a framework for HP 2020 on the measurement and reporting of health disparities in Arizona.



Methods • Analyzed available health disparities and health indicator

definitions.

• Two new definitions were created: • Health Disparities are the differences in health status, impact of

diseases, and other health conditions that exist among different race/ethnic and other specific populations.

• Health Indicators are numerical measures that depict the health status on a core public health construct. Health indicators are influenced by factors such as socioeconomic status, behaviors, social support, discrimination, and environmental exposures.



Methods (cont.) • 1st phase: Engage and obtain support from ADHS’ offices

• 2 internal focus groups (August 2009)• Identified a health indicator list for each racial/ethnic population • Committed to data sharing

• 2nd phase: Engage health & social services providers• 5 external focus groups (Oct-Dec 2009)• Clearly state in own words – causes, impacts and solutions of

health disparities• Served as liaisons to communities



Methods (cont.) • 3rd phase: Engage health services “consumers” – or non-

health professionals• 7 focus groups (March – May 2010)• 2 of the sessions conducted in Spanish• Clearly state in own words – top health concerns, challenges to

being healthy, and overcoming challenges

• All focus groups were held in Coconino, Maricopa, Pima and Yuma Counties

• Secondary data sources



Results: Health & Social Services Providers

• Causes of Health Disparities1. Lack of knowledge among individuals2. Cultural divisions among individuals and providers3. Lack of availability and access to services4. Client discrimination5. Ineffective health systems or policies6. Missing or inadequate data

“From the domestic violence perspective, I don’t think a lot of people think of domestic violence as a health issue…we don’t even have that data.” -Phoenix Participant

“From the domestic violence perspective, I don’t think a lot of people think of domestic violence as a health issue…we don’t even have that data.” -Phoenix Participant



Results: Health & Social Services Providers

• Ways to Address Health Disparities1. Provide education2. Emphasize prevention3. Improve the healthcare providers and workforce4. Improve access to services5. Improve the healthcare system and policies

“The role of the community healthcare worker or promotora [is important], because those are the people that are in the community. They’re the ones that know the people, know the culture.” -Tucson Participant

“The role of the community healthcare worker or promotora [is important], because those are the people that are in the community. They’re the ones that know the people, know the culture.” -Tucson Participant



Results: Health & Social Services ProvidersHealth Indicators with Greatest Impact on a Community

Indicator Total (n=52)

Frequency

No Health Insurance Coverage 43 82.6%

Diabetes Incidence & Prevalence 34 65.3%

Depression 34 65.3%

Obesity 28 53.8%

Prevention Care 23 44.2%

Coronary Heart Disease Incidence & Prevalence 18 34.6%

Substance Abuse 18 34.6%

Teen Pregnancy (19 and younger) 16 30.7%

Physical Inactivity 15 28.8%

Cancer (Mortality) 14 26.9%

Diseases of Heart (Mortality) 14 26.9%



Results: Health Consumers

Top 6 Health Concerns among Consumers

1. Diabetes

2. Obesity

3. Cancer

4. Substance Abuse

5. Heart Disease

6. Teen Pregnancy

Other Health Concerns among Consumers

•Depression

•AIDS

•Sexually Transmitted Diseases

•Domestic Violence

•Other Mental Health Problems




• Why do these health concerns exist?

• Lack of Adequate Insurance and High Cost• Lack of Access to Services• Poor Quality of Medical Care• Lack of Health Knowledge Among Individuals




• What can be done about them?

• Provide Health Information• Improve the System of Medical Care for Patients• Develop a Public Health Action Plan• Advocate for Community Action



Challenges

• Providers uncomfortable using racial & ethnic definitions

• Focus groups capped at 12 individuals per session• Recruiting Consumer participants in Phoenix area• Questions developed for Consumer sessions• Definitions of “community” vs. “individual/family”



Conclusion

• Providers found it easier to provide ‘examples’ vs. a ‘definition’ of health disparities

• Some providers felt that standard racial & ethnic definitions contribute to health disparities

• Need to focus on prevention vs. medical model



Conclusion (cont.)

• Develop an public health action plan• Guide strategic planning process• Develop long-term strategies with the community

to institute: • policy • system• environment changes





Zipatly [email protected]

Arizona Department of Health Serviceswww.azdhs.gov

Arizona Health Disparities Centerwww.azminorityhealth.gov

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Arizona Health Disparities Profile Project 7 th National Conference on Quality Health Care for Culturally Diverse Populations Zipatly Mendoza, MPH Office