Arizona Health Disparities Profile Project 7 th National Conference on Quality Health Care for Culturally Diverse Populations Zipatly Mendoza, MPH Office Chief Arizona Health Disparities Center October 19, 2010

Arizona Health Disparities Center Project Overview Methods Challenges Conclusion Agenda

Arizona Health Disparities Center 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.

Arizona Health Disparities Center 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.

Arizona Health Disparities Center Methods (cont.) 1 st 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 2 nd 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

Arizona Health Disparities Center Methods (cont.) 3 rd 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

Arizona Health Disparities Center Results: Health & Social Services Providers Causes of Health Disparities 1.Lack of knowledge among individuals 2.Cultural divisions among individuals and providers 3.Lack of availability and access to services 4.Client discrimination 5.Ineffective health systems or policies 6.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

Arizona Health Disparities Center Results: Health & Social Services Providers Ways to Address Health Disparities 1.Provide education 2.Emphasize prevention 3.Improve the healthcare providers and workforce 4.Improve access to services 5.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

Arizona Health Disparities Center Results: Health & Social Services Providers Health Indicators with Greatest Impact on a Community IndicatorTotal (n=52) Frequency No Health Insurance Coverage4382.6% Diabetes Incidence & Prevalence3465.3% Depression3465.3% Obesity2853.8% Prevention Care2344.2% Coronary Heart Disease Incidence & Prevalence1834.6% Substance Abuse1834.6% Teen Pregnancy (19 and younger)1630.7% Physical Inactivity1528.8% Cancer (Mortality)1426.9% Diseases of Heart (Mortality)1426.9%

Arizona Health Disparities Center 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

Arizona Health Disparities Center Results: Health Consumers 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

Arizona Health Disparities Center Results: Health Consumers 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

Arizona Health Disparities Center 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”

Arizona Health Disparities Center 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

Arizona Health Disparities Center 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

Arizona Health Disparities Center

Arizona Health Disparities Center Zipatly Mendoza Arizona Department of Health Services Arizona Health Disparities Center For More Information: