1. HEALTH (CANCER) RISK ASSESSMENT: TELESCOPING THROUGH THE CULTURAL EYES
CITY OF PORTLAND, MAINE
Health and Human Services Department, Public Health Division
Minority Health Program
HEALTH (CANCER) RISK ASSESSMENT:
TELESCOPING THROUGH THE CULTURAL EYES
Presentation by
Kolawole A. Bankole, M.D., M.S.

2. Let’s celebrate diversity

3. Contents Project Aim / Goal Background/Demographic paradigm
Diversity in Maine
Methodology and Approach
Results and Outcome analyses
Clinical / Public health implications
Minority Health Program’s interventions
Conclusion

4. Project Aims / Goals
Reduce health disparities among Portland, Maine’s racial/ethnic minority through computerized health risk assessments, counseling and referral for quality and affordable services.

5. Background/Demographic paradigm
Changes in the diversity of Portland, Maine demographics with > 57 different ethnic language groups
Increase in primary & secondary immigrants
Largest 11 ethnic/language groups: Khmer, Arabic, Spanish, Acholi, Somali, Serbian/Croatian, Vietnamese, Nuer, French, Chinese, and, Russian.

6. Diversity in Maine In 2005: 20,000 Hispanics 19,000 Asians
8,000 African Americans
7,000 Native Americans
Source:
National Center for Cultural Competence, 2004
ACS: American Community Survey

7. City Fact sheet: Portland, Maine
Summary City Data (and Source)
Population (2003 CB est.): 63,635
Population (2000 Census): 64,249
Foreign-born Population (2000 Census):4,895 Share Foreign Born (2000): 7.6%
Population Projection 2025 (FAIR*): 64,000
*FAIR: Federation for American Immigration Reform

8. Journey to “Well-Being” Link between migration & resettlement health burden:
Pre-migration: exposure to infectious & parasitic diseases, physical & psychic trauma
During migration: malnutrition, exposure to the elements, physical & psychic trauma
Post-migration: increasing susceptibility to chronic diseases, problems of resettlement (racism, unemployment, ESL, crime, etc.)

9. Methodology and Approach
Exploratory, outreach/research Project ~ Aug. ‘05 – June, ’06.
Sample size: 202 individuals across 6 racial/ethnic groups
Africans~A/Americans: Somali, Sudanese, Great Lakes of Africa/French
Asians: Cambodian, Vietnamese
Caucasians: Russian
Eleven community meetings and outreach educational sessions held.
Confidential individualized health risk assessment (HRA) survey implemented
Survey results with computer software analyses (TRALE, Inc. software)

10. Cancer / health risk variables assessed
Demography: Gender, Age, and Ethnicity
Tobacco smoking status and Alcohol
Nutrition and physical activity
Stress and depression
Current health status & medical care status
Family history
Women and Men’s health statuses
Vehicle safety
Readiness to change
Biometric measures ~ height, weight, blood pressure

11. Results and Outcomes analyses
Overall wellness score was 67.
A score below 80 indicates elevated likelihood of developing certain medical conditions
Individual variable scores below

12. Overall Wellness: Score 67

13. Risk Areas

14. Demographic: Gender

15. Demographic: Age

16. Demographic: Ethnicity

17. Cancer Risks
Controllable cancer risks: Weight, Nutrition, and Tobacco use
Uncontrollable cancer risks: Family history, age, race, and sex
Overall cancer score: 68

18. Direct Cancer Risk effects
Overall Score: 68
Some cancers directly affected 3% of the groups' population
Runs in families:
Breast cancer 2%
Ovarian cancer 24.8%
Colon or Rectal cancers 11.4%

19. Cancer Risk Factors

20. Men’s Health

21. Self-Testicular Exam

22. Women’s Health

23. Women’s Health 106 female participants
59.4% ~ Pap smear within past 3yrs
26.5% ~ Digital rectal exam within past 2yrs
61.2% ~ Mammogram within past 2yrs (aged >40yrs)
2.8% ~ Have at least one immediate relative who had breast cancer

24. Tobacco

25. Cigarette Smoking

26. Physical Activity: Score 49

28. Body Mass Index: Average Women~18.2; Men~17.2

29. Weight Management

30. Mental Wellness: Score 69

31. Stress and Depression

32. Nutrition: Score 51

33. Nutrition Risk

34. Alcohol: Score 94

35. Blood Pressure: Score 51

36. Diabetes: Score 61

37. Self-reported Blood Sugar

38. Heart Health

39. Motor Vehicle Safety: Score 84

41. Clinical / Public health implications
Qualitative health status information for public health interventions
Counseling and referrals for needed services
Improved racial/ethnic data collections
Attempts to reflect goals & objectives of Maine Comprehensive Cancer Control Plan/ ME CDC & Prevention

42. Clinical / Public health implications
Improving awareness and understanding of health care services
Strengthening health care providers’ capacities to better understand risk areas and create infrastructure to meet health needs of communities
Acknowledge value of holistic approaches in health healing within ethnic minority communities

43. Minority Health Program’s Interventions
“Latinos Exercise for Health and Love” event:
737 participants
85 screened for diabetes & HPTn; 4 alarm values
67 without PCPs; 41 now connected with PCPs
“3rd Annual Latino Soccer Tournament” 6 teams; 577 attended
“2nd Annual Festival of Nations’ Soccer Tournament”; 8 teams; ~655 attended
“Somali/Sudanese Walk for Life” event 65 participants

44. Minority Health Program’s Interventions
“BRISK”/ breast cancer prevention project
Diabetes prevention & healthy nutrition
DM prevention & mgt educational series
“Let’s Go” Healthy Weight Initiative
“Somali/Sudanese Exercise for Health and Love” event: May 19, 2007

46. Contact info.
Kolawole A. Bankole, M.D., M.S.
Minority Health Program Coordinator /
Access Project Director
Public Health Division
Health & Human Services Department
City of Portland, Maine
389 Congress St., Portland, ME
Tel , Fax
Web site: