Elena Rios, MD, MSPH President & CEO, National Hispanic Medical Association Congressional Briefing October 12, 2011

Hispanics and Prevention Strategy Largest ethnic group in the U.S. at over 50 million and 16 percent of the population Health disparities are due to limited health care, wellness care, prevention services cultural competence for relevant health education Hispanic physicians, nurses, dentists, etc. Income, jobs, education, networks to policymakers Hispanics do embrace disease prevention: They want to be healthy to take care of their families so that their children have a better future…but healthier communities and access to quality health/wellness care and leadership are needed to make this a reality.

Decreasing Costs is Critical Cardiovascular disease accounts for 20% medical expenditures; 30% Medicare expenditures Persons with diabetes receive one out of every five US health care dollar on their care ---and that doesn’t include all the family members who are not yet diagnosed We need better policies to decrease obesity, increase activity in communities and healthy eating habits and changing the food supply – decrease sodium, increase subsidies for fruit and vegetables, and control HTN and diagnose diabetes and cancer earlier

Federal Leadership The Obama Administration has provided the leadership, starting with the First Lady’s Let’s Move Campaign and its initiatives: Sustainable Communities (HUD, EPA, Transportation) Great Outdoors (Interior, EPA, Ag) Food Initiatives (Ag, FDA, FCC) National Prevention Strategy (Surgeon General) Affordable Care Act – Prevention Fund +++ Offices of Minority Health expanded to reach Hispanics and other minority populations at CDC, CMS, HRSA, NIH, SAMHSA, FDA and Regional Councils, State OMH

NHMA Priorities for Prevention Improve our communities and options for healthy lifestyle and decreased stress Increase the affordability and availability of health care, oral health, mental health services including disease prevention, secondary prevention that are culturally competent Increase the Hispanic health workforce in public health and other health professions

Change Behavior among Hispanic Populations where they live To change behavior, we must address the social determinants of health – the social, built and physical environment that influences behavioral choices among a population and document the evidence 2009 NHMA OMH Disparity Summit Prevention Recommendations Start with Children = School curriculum, Use schools for the community, families Doctors to educate community and policymakers (now working with Kellogg Foundation; OMH) Mass media campaigns

Hispanic Health & Culture Barriers Poverty and lack of education Maternal nutrition - traditional foods & cooking fatalism about diabetes, cancer belief about not having to lose weight Opportunities Changing diets with traditional food –new food fruits and vegetables Families - support systems Hispanic community-based health research

Healthier Hispanic Communities Affordable healthy food & safe places for physical activity (schools, malls) Decrease stressors in air, water, job market, housing, transportation, teen pregnancy, gangs, crime Community coalitions and leadership Literacy programs and English programs to include basic health information Programs for strong social networks who take care of each other ----needs to be through FACEBOOK for the next generation and led by OMH

Quality Hispanic Health Care Services for Hispanics (Eng/Bilingual/Spanish ) & public/private partnerships linked to health care Cultural competence Modules of OMH, CLAS Standards, Hispanic health collaboratives Integrative health care in safety-net (Medicaid, Medicare reimbursement) & evidence base Health Information Technology E-med record, patient online resources, calls/texting education systems, insurance &community services

Hispanics in Public Health Public Health and Prevention Programs about Hispanic populations need to be part of new Interprofessional Training for health professions & allied health students and in CME, CEU courses Spanish must be required in medical education and health professions education Leadership development is critical for Hispanic public health leaders – from all health professions to serve in Federal, State decision-making positions, to provide recommendations to the policymakers, corporate leaders in the health care industry

National Quality Care Strategy Healthy People Cultural beliefs and traditional healing Families, decision-making, care giving Healthy Communities Community redesign for safety, watch programs Increase jobs and education programs Affordable Healthcare Agencies for prevention in the community that can be linked to ADA, AHA, ACS, primary care education and referrals

Prevention Helps Communities Prevention leads to timely and effective diagnosis and treatment that reduces demands on the medical system, and it enables people to contribute to the community environment through work and civic participation. An effective health care institution will provide preventive care and encourage community services and policies that keep people healthy. An effective health care institution can also improve the local economy by hiring local residents, purchasing local products, investing in the community, leveraging partnerships and leadership.

Last Word SAVE the HEALTH CAREER OPPORTUNITY PROGRAM (HCOP) Last week, both the Senate and House Appropriations Committee s recommended dissolving the one Federal program that supports recruitment and academic preparation of minority students to medicine, public health and other health professions. Go to Legislative Action Center (NHMAMD.org) and send a letter to your Senator and Congressman ! Tell your colleagues to help NHMA Save HCOP