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CITY OF PORTLAND, MAINE
Health and Human Services Department, Public Health Division
Minority Health Program
COMMUNITY HEALTH OUTREACH WORKERS (CHOWs): ENSURING HEALTH ACCESS AND EQUITY
Presentation by
Kolawole A. Bankole, MD, MS and Nélida Berke, MLT, BS
Let’s celebrate diversity
Aim
Overview of ME demographics
Overview of CHW workforce
CHOW initiatives to improve policies, health and system
Challenges
If CHOW initiative were a movie?
Aim
To create awareness, understanding and importance of CHOWs in the elimination of Maine racial/ethnic minority health disparities.
Maine Summary Demographic State Data (and Source)
Population (2010 CB estimate): 1,328,361
Population (2009 CB est.): 1,318,301
Foreign-Born Population (2010 CB est.): 45,666
Foreign-Born Population (2000 CB est.): 36,691
Share Foreign-Born (2010 FAIR est.): 3.4%
Share Foreign-Born (2000): 2.9%
Immigrant Stock (2000 CB estimate): 139,000
Share Immigrant Stock (2000 estimate): 10.9%
Naturalized U.S. Citizens (2010 CB est.): 25,847
Share Naturalized (2010): 56.6%
Legal Immigrant Admission (DHS 2001-2010): 14,474
Refugee Admission (HHS 2000-2009) 1,774
Illegal Alien Population (2010 FAIR est.): 5,000
Projected 2050 Population (2006 FAIR): 1,480,000Source: FAIR (The Federation for Immigration Reform)
RACE Maine Aroostook Cumberland
One race 1,302,584 71,032 272,813
Two or more races 13,872 644 3,234
Total population 1,316,456 71,676 276,047
One race 1,302,584 71,032 272,813
White 1,268,930 69,034 260,931
Black or African American 13,588 466 5,780
American Indian and Alaska Native 7,889 1,055 1,175
Asian 11,693 456 4,768
Native Hawaiian and Other Pacific Islander 484 21 159
Two or more races 13,872 644 3,234
Race alone or in combination with one or more other races
White 1,282,333 69,653 263,911
Black or African American 17,777 608 6,960
American Indian and Alaska Native 14,410 1,429 2,323
Asian 15,421 605 5,958
Native Hawaiian and Other Pacific Islander 950 25 398
HISPANIC OR LATINO AND RACE
Total population 1,316,456 71,676 276,047
Hispanic or Latino (of any race) 16,814 790 5,028
Not Hispanic or Latino Total 1,299,642 70,886 271,019
White alone 1,253,951 68,332 256,617Source: US Census Bureau, Population Estimates Program, 2008
Overview of CHW workforce No statewide commitment
Cities & agencies: Recently and scattered
Portland Minority Health Program – 2 FTEs and 12 Per-diem CHOWs
Portland Frannie Peabody – 2 FTEs
Portland Community Counseling Center – 2 FTEs
Washington county Maine Migrant Health – Promotores
Bangor Penquis Cap - Care managers
Lewiston - Somali Women of Maine
Portland Public Health/Minority Health Program model approaches…A synchronicity of health promotion models:
CDCynergy Social Marketing Communication approaches
The Dayton Model
Comprehensive Care Model
Chronic Disease Self-Management Program
Strategic Prevention Framework (SPF-Table Talk Initiative)
Health Policy Implementations
Successes and Accomplishments Patient navigation (access to care) – Annual average of
500 clients interventions; free care/uncompensated care 200; MaineCare- 80
Policies: Dropping of requiring “Denial Letter” from undocumented clients
Community outreach & brokering initiatives
New hospital gown (Sarong) – Maine Medical Center
Community empowerment - Trainings
Health helplines in Somali and Spanish languages
Social determinants of health interventions: Latino soccer, farmers markets/WIC ethnic stores, SSBC, multicultural health fairs
•Implementation of a training curriculum
at colleges and university
•Funding
•Workforce need for CHOW
•Reimbursable CHOW services
•Technical supports
•Real appreciations for CHOWs work
Challenges To CHOW workforce
If CHOW initiative was a movie… SATIRICAL
Role play of CHOWs work in helping a 7-month pregnant undocumented 23-yr old Hispanic woman.
Conclusion
The challenge of eliminating disparities among the minority communities requires concerted efforts of health professionals and policy makers to address inequities in health as well as to amend the practice of providing culturally & linguistically appropriate services. The CHOW initiative is integral to the solution.
Interactive session
Q & A……
Contact info.Kolawole A. Bankole, M.D., M.S.
Access Project Director
Minority Health Program, Portland Public Health & Human Services Department
City of Portland, Maine
389 Congress St., Portland, ME 04101
Tel 207-874-8773, Fax 207.874.8913
Email: [email protected]
Web site: http://www.portlandmaine.gov/hhs/phminority.asp
Nélida Berke, MLT, BS
Latino Health Promotion Specialist/Community Health Outreach Worker
Minority Health Program, Portland Public Health & Human Services Department
City of Portland, Maine
389 Congress St., Portland, ME 04101
Tel 207-874-8452, Fax 207.874.8913
Email: [email protected]
Web site: http://www.portlandmaine.gov/hhs/phminority.asp