Healthy Gente 2010: History and Health Measures Sam Notzon National Center for Health Statistics

Topics to Cover:  Background information  Statistical considerations  History of Healthy Gente  Health measures

Dangers of Statistical Analysis: In a recent study of the effects of a new chicken food:  33.3% gained weight;  33.3% lost weight;  the other chicken ran away. (Source: anonymous reporter)

Statistical Issues:  Small number problem  Racial and ethnic identification

U.S. Counties Included in Border Region 2000 Population 55.1 million 6.6 million

Population trends in U.S.-Mexico border Population in millions Projections

*Persons of Hispanic/Latino origin may be any race. Source: Census 2000 Summary File 1, U.S.Bureau of the Census. Distribution of the population by specified race/ethnicity: United States, 2000 Black/African American, non-Hispanic American Indian/ Alaska Native, non-Hispanic Hispanic/Latino* White, non-Hispanic Asian/Native Hawaiian and Other Pacific Islander, non-Hispanic Percent

Percent of population that is Hispanic/Latino: United States and ten States with largest proportion of Hispanic/Latino residents, 2000 Source: Census 2000 Summary File 1, U.S.Bureau of the Census. Percent Selected States

Source: Census 2000 Summary File 1, U.S.Bureau of the Census. American Indian/Alaskan Native population, 1990 and AIAN Or Combination AIAN alone Number in millions (+25%) (+ 110%)

Socioeconomic Differentials

Percent with education less than 9 years, United States 2000 Source: 2000 Census, United States

Percent with education less than 9 years, United States 2000 Source: 2000 Census, United States.

Percent with no telephone access, United States 2000 Projections Source: 2000 Census, United States.

Per capita income, United States 1999 Projections Source: 2000 Census, United States.

Health Disparities

Medically Underserved Border Counties, 1998 Underserved Border Counties Entire County Portion Not Underserved Source: HRSA.

Death rates by cause, US border counties, 2000 Source: NCHS/CDC. Rate per 100,000 Note: Rates are age-adjusted to the US 2000 population.

Death rates by cause, US border counties, 2000 Source: NCHS/CDC. Rate per 100,000 Note: Rates are age-adjusted to the US 2000 population.

Communicable Diseases, US border  Disease rates by ethnicity not currently available, but Hispanic excesses have been documented for:  Hepatitis A  Brucellosis  Shigellosis  Tuberculosis  Others

US-Mexico Border Health Commission: Healthy Border/Healthy Gente Program

Healthy Border/Healthy Gente Program Timeline:  1998: First meeting of Design Team and birth of Healthy Gente concept  Jan. 2000: US Section Commissioners appointed  Jan. 2000: HG objectives finalized, presented at launch conference for Healthy People 2010  Nov. 2000: HG workshop, S. Padre Island  Mar. 2001: Second meeting of Commission; US & Mexico agree to Healthy Border Program

Healthy Border/Healthy Gente Program  Program of health education and health promotion  Establishes priority health objectives for the border region  Healthy Gente Program based on U.S. Healthy People 2010 Program  Healthy Border Program combines Healthy Gente objectives with Mexico’s Indicadores de Resultados Program

Healthy Border/Healthy Gente Objectives  Focus attention on key health issues  Improve allocation of health resources  Coordinate public and private action  Inspire ownership of objectives  Achieve objectives through:  coordinated program activities  community projects

Selection Criteria  Key health issues for border  Measurable objectives  Limited number  Compatible with federal and state objectives

Healthy Border/Healthy Gente Program  25 Healthy Gente objectives  20 Healthy Border objectives

Access to Care  25 percent reduction in persons lacking access to primary care provider in underserved areas

Medically Underserved Border Counties Underserved Border Counties Entire County Portion Not Underserved

Cancer  Reduce breast cancer death rate by 20 percent  Reduce cervical cancer death rate by 30 percent

Breast Cancer

Border Breast Cancer Death Rates  20% Healthy Gente Goal

Diabetes  Reduce diabetes death rate by 10 percent  Reduce hospital admissions for diabetes by 25 percent

Diabetes Mortality Source: NCHS, CDC; age-adjusted to US 2000 population

Border Diabetes Death Rate  10% “Healthy Gente” Goal

Environment  All countries will meet or exceed EPA air quality standards  All households will be connected to public sewage systems or septic tanks  Reduce hospitalization for acute pesticide poisoning by 25 percent

Border Counties and EPA Air Quality Standards In Compliance Not in Compliance Compliance Status

HIV  Reduce adolescent and adult HIV cases by 50 percent

Border HIV+ Incidence Rate  50% “Healthy Gente” Goal Source: State Health Departments of Arizona, New Mexico, Texas.

Immunizations and Infectious Diseases  Reduce incidence of hepatitis A and hepatitis B by 50 percent  Reduce incidence of tuberculosis by 50 percent  Raise and maintain immunization coverage rate at 90 percent

Border Hepatitis A and B Rates  50% “Healthy Gente” Goal Source: State Health Departments of Arizona, California, New Mexico, Texas.

Injury/Violence Prevention  Reduce motor vehicle crash deaths by 25 percent  Reduce childhood death rate due to unintentional injuries by 30 percent

Motor Vehicle Crash Deaths Source: NCHS, CDC; rates age-adjusted to US 2000 population

Border Motor Vehicle Death Rate  25% “Healthy Gente” Goal

Maternal and Child Health  Reduce infant mortality rate by 15 percent.  Reduce infant mortality rate due to all birth defects by 30 percent  Raise first trimester prenatal care initiation to 85 percent  Reduce young teen pregnancy rate by 33 percent

Initiation of Prenatal Care in First Trimester, 2000 Source: NCHS, CDC

Border Prenatal Care in First Trimester “Healthy Gente” Goal Source: NCHS/CDC.

Mental Health  Reduce suicide death rate by 15 percent

Suicide Mortality Source: NCHS, CDC; rates are age-adjusted to the US 2000 population.

Border Suicide Death Rate  15% “Healthy Gente” Goal

Nutrition and Overweight  Reduce the proportion of adults who are obese to 15 percent

Proportion Obese, Source: NCHS, CDC Percent

Oral Health  75 percent of population served by flouridated community water systems  75 percent of children and adults use oral health care system each year

Respiratory Diseases  Reduce asthma hospitalization rate by 40 percent

Substance Abuse  Reduce the number of alcohol-related motor vehicle crash deaths by 50 percent  Increase to 89 percent the proportion of teenagers not using alcohol or any illicit drugs in past 30 days

Alcohol-Related Motor Vehicle Crash Deaths, 1998 Source: NHTSA, DOT. BAC 0.01+Alcohol Related

BAC Border Alcohol-Related Motor Vehicle Crash ê50% Percentage “Healthy Gente” Goal Percent

Tobacco Use  Reduce teen and adult tobacco use by one-third

Cigarette Use in Past Month Adolescents Years of Age, USA Source: SAMHSA

Additional Statistical Resources

 Hospitalization/morbidity data:  Asthma, diabetes: Hospital discharge data files from each state  Pesticide poisoning: State poison control centers  Risk factor information (obesity, smoking, drug use, health insurance, dental care):  Border Binational RFSS