Striving for La Vida Buena y Sana | Innovative Approaches for Latino Health EquityOpening Remarks: Latino Health Forum

David Reyes, DNP, MPH, RN, APHN-BCOctober 20, 2016

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La Vida Buena y SanaReyes_Opening Remarks_102016

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Determinants of Health

Health Be-haviors 30%

Access to Care 10%

Quality of Care 10%

Physical Envi-ronment

10%

Social & Economic Factors 40%

http://www.countyhealthrankings.org/Reyes_Opening Remarks_102016

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Source: http://www.pewhispanic.org/states/state/wa/; http://www.cdc.gov/nchs/data/hus/hus15.pdf

Hispanics/Latinos 12% of WA State Population

Life-expectancy for men= 79.2 yrs.

Child Poverty Rate: 29% Avg. Personal Earnings:

$22KHome Ownership: 42%

20% of all K-12 Students

21% w/out Health Insurance

Life-expectancy for women= 84 yrs.

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What is Health Equity?

“…Conditions that give everyone the opportunity to reach their best health. This requires valuing all individuals and populations equally. It means addressing inequities in the places where people are born, grow, live, work, learn and age.” (American Public Health Association)

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“The attainment of the highest level of health for all people.” (US DHHS)

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https://healthequity.sfsu.edu/ 8Reyes_Opening Remarks_102016

Inequity & DisparityInequities are created when barriers prevent individuals and communities from accessing these conditions and reaching their full potential. Inequities differ from health disparities, which are differences in health status between people related to social or demographic factors such as race, gender, income or geographic region. Health disparities are one way we can measure our progress toward achieving health equity. (American Public Health Association)

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AvoidableUnfairUnjust

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Poor vs. High In-

come

Black vs. White

Hispanic vs. White

AI/AN vs. White

Asian vs. White

65+ vs. 18-44

6% 14% 22%10%

24%44%

47%45%

39% 61%54% 18%

47% 41% 39%29% 26%

39%

Better Quality of CareSame Quality of CareWorse Quality of Care

AI/AN = American Indian or Alaska Native.SOURCE: AHRQ, “National Healthcare Disparities Report, 2011, http://www.ahrq.gov/qual/qrdr11.htm

Disparities in Quality of CarePercent of quality measures for which groups experienced worse, same, or

better quality of care:

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White Afr ican-American Hispanic Am. Indian/ A laska Native

Asian/ Pacific Islander

14%23%

36%29%

19%

9%

21%

18%22%

10%

77%

56%46% 49%

71%

Uninsured Medicaid Private/Other

NOTE: Includes women ages 18 to 64. Other includes Medicare, TRICARE, and other coverage.SOURCE: Kaiser Family Foundation and Urban Institute analysis of March 2013 Current Population Survey, U.S. Bureau of the Census.

Women of Color More Likely to be Uninsured or Covered by Medicaid, 2012

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Children who needed care right away for an illness, injury, or condition in the last 12 months who sometimes or never got care as soon as wanted, by

preferred language and ethnicity, 2002-2013

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

0

5

10

15

20

25Hispanic Non-Hispanic White

Perc

ent

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2013.Note: For this measure, lower rates are better. For 2010 and 2013, data for children who spoke a language other than English did not meet the criteria for statistical reliability, data quality, or confidentiality.

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16King County, 2015. 16Reyes_Opening Remarks_102016

A Model for Population Health

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Social Determinants

of Health

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Action for Equity & Social Justice

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Raise Voices, Join Together, Unexpected

Collaborations

INDIVIDUAL

SYSTEMCOMMUNITY

Determinants of Equity & Social Justice

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“To my inexperience it seemed certain that

conditions such as these were allowed because people did not know.”

~ Lillian Wald

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Gracias!Reyes_Opening Remarks_102016