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

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

3. 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)

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

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

7. Population trends in U.S.-Mexico border 1970-2020 Population in millions Projections

8. *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

11. 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

13. Source: Census 2000 Summary File 1, U.S.Bureau of the Census. American Indian/Alaskan Native population, 1990 and 2000 2000 AIAN Or Combination 19902000 AIAN alone Number in millions (+25%) (+ 110%)

14. Socioeconomic Differentials

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

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

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

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

19. Health Disparities

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

21. 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.

22. 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.

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

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

25. 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

26. 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

27. 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

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

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

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

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

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

33. Breast Cancer 1998-2000

34. Border Breast Cancer Death Rates  20% Healthy Gente Goal

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

36. Diabetes Mortality 1998-2000 Source: NCHS, CDC; age-adjusted to US 2000 population

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

38. 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

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

40. HIV  Reduce adolescent and adult HIV cases by 50 percent

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

42. 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

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

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

45. Motor Vehicle Crash Deaths 1998-2000 Source: NCHS, CDC; rates age-adjusted to US 2000 population

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

47. 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

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

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

50. Mental Health  Reduce suicide death rate by 15 percent

51. Suicide Mortality 1998-2000 Source: NCHS, CDC; rates are age-adjusted to the US 2000 population.

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

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

54. Proportion Obese, 1988-94 Source: NCHS, CDC Percent

55. 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

56. Respiratory Diseases  Reduce asthma hospitalization rate by 40 percent

57. 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

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

59. BAC 0.01+ Border Alcohol-Related Motor Vehicle Crash ê50% Percentage “Healthy Gente” Goal Percent

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

61. Cigarette Use in Past Month Adolescents 12-17 Years of Age, USA Source: SAMHSA

62. Additional Statistical Resources

63.  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 - 2005