Challenges and Opportunities From Health Disparities to Health Competency Challenges and Opportunities Norma J. Goodwin, M.D. Founder, President & CEO Health Power, Inc. Director,

NYBGH Seminar 2 U.S. Census Bureau Projection: Multicultural U.S. populations, combined, will account for almost 90 percent of all population growth in the U.S. from 1995 to The Context:

NYBGH Seminar 3 The Context: A Rapidly Changing Picture Source: U.S. Census Bureau Trend: An increasing racially and ethnically diverse national population. Thus: A racially and ethnically more diverse workforce Likely Short-term Effect (or longer): A less healthy workforce because of well documented racial and ethnic health disparities.

NYBGH Seminar 4 Key Terms: Health Disparities Unfavorable or unequal differences in certain conditions among certain population groups such as Incidence Prevalence Mortality or death rate Nature of care received

NYBGH Seminar 5 Representative Incidence/Prevalence Racial and Ethnic Health Disparities African-Americans: highest prevalence of hypertension in the U.S. – AHA 2005 African-Americans have the highest self-reported prevalence of diagnosed diabetes – AHA 2005 Cuban Americans: 50 to 60% higher rates of diabetes than non-Hispanic Whites – Mexican Americans and Puerto Ricans: 110 to 120% higher rates of diabetes than Whites.-

NYBGH Seminar 6 * Sources: NHANES III: ; JAMA 1998;280: Examples of Health Disparities: Prevalence of Non-Insulin-Dependent [Type 2] Diabetes In Women by Race/Ethnicity and Education ages 25-64

NYBGH Seminar 7 Examples of Health Disparities: Age-Adjusted Prevalence of Physician-Diagnosed Diabetes in Americans Above 20 Years by Race/Ethnicity and Sex Sources: CDC/NCHS/NHANES ; NHLBI.

NYBGH Seminar 8 Examples of Health Disparities: Trends in Obesity: Age-Adjusted Prevalence of Obesity in Americans Ages Years [ by Sex and by Selected Time Period] Sources: Health, United States, 2004 CDC/NCHS Note: Obesity = BMI above 30

NYBGH Seminar 9 IOM report: U.S. Health Care Disparities Institute of Medicine Report 2002: Multicultural populations receive lower quality health care than Caucasians even when insurance status, income, age and severity of conditions are comparable.

NYBGH Seminar 10 U.S. Health Care Disparities Kaiser Family Foundation Report of 81 studies on healthcare Comparisons found that multicultural patients experience more disparities compared to Caucasian patients.

NYBGH Seminar 11 Health Disparities Increase the Likelihood of Secondary Effects in the Workplace Associated decreased productivity from: Uncontrolled major diseases such as diabetes, hypertension, heart disease obesity, and stress Intermittent On-the-Job Inefficiency Increased absenteeism

NYBGH Seminar 12 Potential Secondary Effects of Increased Racial and Ethnic Health Disparities in the Workplace Potential increased costs associated with: Provision of medical care for the individual for the employer for the taxpayer (Medicaid and Medicare subsidies) Family and environmental effects

NYBGH Seminar 13 Key Terms: Health Competency Self-confidence in one’s ability to manage self-care, and achieve results that are adequate for him/her. A person’s feeling of confidence in his/her ability to manage and control most of his/her health problems. A sense of self-efficacy (effectiveness) A demonstrated ability to effectively handle a variety of health related needs.

NYBGH Seminar 14 Multicultural Workforces: Employers can increase health competency Key Health Disparities Hypertension & Heart Disease Diabetes Obesity Depression Asthma Some Cancers Access to care: hours, availability Literacy: Care plan understanding Collaboration with: Credible and culturally competent resources Successful Employers and Employee Groups Employee Needs: Health Literacy Culturally competent health education and healthcare services Worksite support and access to relevant services Employer Based/ Sponsored Services:  Walking groups  Peer Support Groups/ “Talk Outs”  On-site health workshops

NYBGH Seminar 15 Key Terms: Cultural Competency Ability to understand, appreciate and effectively work with individuals and groups who have cultures and belief systems that are different from one’s own. Culturally competent individuals are non-judgmental about persons of different races, ethnicities, languages, social norms, values, histories, socioeconomic status, perceptions and preferences.

NYBGH Seminar 16 Multicultural Workforces: Employers Benefit from Cultural Competency A More Diverse Workforce Richness of differences Wide range of differences Race/ethnicity, gender, age, socioeconomic status, etc. Narrowing the Digital Divide, which Increases: On-the-job potentialand productivity Increased self-concept Socioeconomic potential Better healthcare and personal care choices A Healthier Workforce: Physically Mentally Spiritually Through web-based Information: Increased Health Knowledge Enhanced Health communication - with Providers - with Peers - with Family XYZ Corporation

NYBGH Seminar 17 Welcome to Health Power® A nationally unique corporation founded by Norma J. Goodwin, M.D. Committed to improving the health of multicultural populations through: Health information Health promotion Health consultations & trainings Strategic partnerships & alliances Norma J. Goodwin, MD Founder, President and CEO

NYBGH Seminar 18 K ey Health Power Web Site Features Women’s, Men’s, & Aging Health Channels Food and Fitness Channel Racial and Ethnic Channels (5) What It Means: Our Glossary Our Major Killers and Disablers Mental and Spiritual Health Channels Cross-linked Web Partners – A developing network Relevant Resource & Trend (data) Tables

NYBGH Seminar 19 New York Area Diabetes Resources American Diabetes Association, New York Affiliate American Association of Diabetes Educators, New York Regional Office New York City Department of Health – Occupational component New York State Department of Health funded NYC programs New York Business Group on Health

NYBGH Seminar 20 New York Area Diabetes Resources Academically affiliated institutions with specialties in Diabetes or Obesity - St. Luke’s Roosevelt Obesity Research Center - Mount Sinai School of Medicine - Cornell Cooperative Extension Diabetes Resource Coalition of Long Island National Association for Mental Illness, NYC Metro

NYBGH Seminar 21 Collaborative efforts with Health Power, focused on: Eliminating racial and ethnic health disparities, thus Ensuring a healthy and productive future workforce. Collaborative efforts with key health improvement organizations: NYBGH GlaxoSmithKline Aetna Future Opportunities

NYBGH Seminar 22 Since many of us are able to make a difference in the health of multicultural populations, we underscore the reality, just as we do for those served, that: KNOWLEDGE + ACTION = POWER!™ Health Power: A Unique Web Site, Plus Much More