Hispanic Health Initiative

PartnershipEmpowerment

Education

Why the Need?

• The Hispanic population is the fastest growing community in Jacksonville : est. pop: 66,062

• Over the past ten years the Hispanic population has doubled: 7.6% of population

• Approximately 40% of pediatric patients served at Beaches Family Health center are Hispanic

COUNTY NAME   POPULATION, 2010   POPULATION, 2000   POPULATION CHANGE, 2000 TO 2010

    Total Non-Hispanic HispanicHispanic Share of

Total  Total Non-

Hispanic HispanicHispanic Share of

Total  Total

ChangeTotal

Change (%)

Hispanic Change

Hispanic Change

(%)

Florida   18,801,310 14,577,504 4,223,806 22%   15,982,378 13,299,663 2,682,715 17%   2,818,932 18% 1,541,091 57%

Baker County   27,115 26,595 520 2%   22,259 21,840 419 2%   4,856 22% 101 24%

Clay County   190,865 176,256 14,609 8%   140,814 134,755 6,059 4%   50,051 36% 8,550 141%

Duval County   864,263 798,865 65,398 8%   778,879 746,933 31,946 4%   85,384 11% 33,452 105%

Flagler County   95,696 87,445 8,251 9%   49,832 47,295 2,537 5%   45,864 92% 5,714 225%

Nassau County   73,314 70,934 2,380 3%   57,663 56,790 873 2%   15,651 27% 1,507 173%

Putnam County   74,364 67,658 6,706 9%   70,423 66,255 4,168 6%   3,941 6% 2,538 61%

St. Johns County   190,039 180,067 9,972 5%   123,135 119,891 3,244 3%   66,904 54% 6,728 207%

Hispanic Growth 2000 - 2010

Estimates of US Population 2000 to 2050(U.S. Census Bureau)

13.1 13.5 13.9 14.3 14.6

3.8 4.6 5.4 6.2 7.1 8.02.5 3.0 3.5 4.1 4.7 5.312.615.5

17.820.1

22.324.4

69.4 65.1 61.3 57.5 53.7 50.1

12.7

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2000 2010 2020 2030 2040 2050

Year

Per

cent

of P

opul

atio

n

.White alone, not Hispanic

.Hispanic (of any race)

.All other races

.Asian Alone

.Black alone

By the year 2020, an estimated 1 in 5 children in the US will be Latino

Changing America: Indicators of Social and Economic Well-Being by Race and Hispanic

Origin; Council of Economic Advisors for the President’s Initiative on Race, 1998

Introduction

• Applied for AAP Grant in Fall 2008

• Awarded $11,708 in March 2009

• Partnered with DCHD’s Hispanic Advisory Council to develop a better understanding of issues affecting the Hispanic community

Project Design

• Performed 13 Key Informant Interviews of Hispanic Leaders in the community

• Developed Focus Group Questions from the interviews

• Interviewed 37 Hispanic Families through four focus group sessions

• Identified Hispanic Health Barriers

• Think about a time when your child was ill. Tell me what you did from beginning to end.

• What were your experiences with the doctor, if you went to one?

• What has led you to the ER and what happened at the ER, if you went to one?

Focus Group Questions

“I try and communicate in English when I call but the staff laughs or they say they don’t understand and just hang-up.”

“I have called before to get an appointment and did not get one because I was Hispanic.”

Language

“My husband took out his own stitches so he would not have to pay again in the Emergency Room.”

“Cost is so high that I feel, I rather die at home.”

Financial Restraints

“Hispanics don’t go to the doctor because they are afraid they will be deported. The biggest obstacle is the immigrant status.”

Legal Status

“My wife has to wait until I get home from work to go to the doctors because we only have one car for the family to use.”

“If I call a taxi that can mean a whole month’s salary.”

Transportation

In my country, I can go straight to the pharmacist and get the appropriate antibiotic without ever seeing a doctor.”

“In my country, you can visit the ER as often as you want…you don’t necessarily have a primary doctor.”

Cultural Differences

Hispanic Health Access Barriers

LanguageFinancial Restraints/Lack of Insurance

Legal StatusPerceived Discrimination

TransportationCultural Issues

HISPANIC HEALTH INITIATIVE

Partnership

Empowerment

Education

Partnership

Establish partnerships amongst key stakeholders to bring awareness about the health disparities faced by the Hispanic/Latino population

Florida Department of Health in Duval CountyJacksonville’s Hispanic Health CouncilPartnership Board for Children’s HealthNemours Children’s ClinicUniversity of Florida College of Medicine in JacksonvilleWolfson Children’s HospitalFlorida BlueAmeriCorps/North Florida Health CorpsNortheast Florida Pediatric Society

Empowerment

Development of culturally effective tools and initiatives to empower the Hispanic/Latino community.

Hispanic Resource Guide Community Outreach Programs

Education

Develop healthcare provider cultural competency training modules to improve health outcomes

Education of our cohorts: Cultural Competency Event in April of 2012Incorporate cultural competency into residency training

Provider Education

Invited a nationally-renowned leader in cultural competence, Dr. Denise Cora-Bramble• Gave Grand Rounds at WCH• Lead a working dinner meeting• Facilitated a key stakeholder

INSURANCE: 69.9 % of Hispanics have health insurance versus 88.1 % of all Duval County residents

PHYSICIAN ACCESS: 20.5% of Hispanics could not see a doctor at least yearly due to cost versus 15.4 % for all Duval County residents

TRANSPORTATION and LANGUAGE DIFFICULTIES impede accessing the health system.

Hispanic Population and the Obesity

Epidemic

Obesity epidemic is one of the greatest public health, social, and economic challenges of the 21st century.

In 2010, more than one third of children and adolescents were overweight or obese.

There are significant racial and ethnic disparities in obesity prevalence among U.S. children and

adolescents.

In 2007—2008, Hispanic boys, aged 2 to 19 years were significantly more likely to be obese than non-Hispanic white boys

In 2007—2008, non-Hispanic black girls and Hispanic girls were more likely to be obese than non-Hispanic white girls.

The prevalence of obesity was rising faster among African American and Hispanic children,

according to an analysis of data from the National Longitudinal Survey of Youth.

Over 10 years, obesity increased more than 120% among African American and Hispanics

while increasing by about 50% in whites.

Hispanic and African American children are significantly less likely than caucasian children to be involved in

organized physical activity outside the school.

About 25% of Hispanic and African American children aged 9 to13 are involved in organized physical activity

outside the school as compared to 50% of caucasian as noted by the National Collaborative on Childhood

Obesity Research.

In 2007, The American Journal of Public Health published an articleCalled the Racial and Ethnic Differentials in Overweight and Obesity Among Three Year Old Children.

A national sample of 3-year-olds from urban, low-income families and assessed possible determinants of differences

Hispanic children were twice as likely as either African American Or Caucasian children to be overweight or obese by age 3

Taking a bottle to bed nearly doubled the odds of obesity but breastfeeding for at least six months significantlydecreased the odds of obesity

Interventions at Beaches Family Health Center

Breastfeeding ProjectIn Partnership with UNF using low-literacy material

Free Family Centered Bilingual Nutrition classes In Partnership with AmeriCorps and Winn Dixie

Bilingual Educational Material regarding healthy eating and cholesterol levels

Supported legislature that promoted a healthier community

Representative Mia Jones316 The Capitol 402 South Monroe Street Tallahassee, FL 32399-1300 Re: Support for HB 1301, Healthy Beverages in Child Care Dear Representative Mia Jones, I am writing to endorse House Bill 1301, Healthy Beverages in Child Care. Please add our name to the list of organizations standing up for some of the youngest members of our society by defending their right to live a healthy life and prevent them from becoming another statistic in the obesity epidemic. The Healthy Beverages in Child Care legislation responds to the public health problem of childhood obesity by limiting SSBs at young ages and creating healthy, lifelong habits for kids that will help them maintain a healthy weight and generate positive oral health benefits as well.

CONCLUSION

Obesity is an epidemic and is more pronounced in the Hispanic population

The Hispanic population has unique health access barriers

Design community outreach programs through the schools and the health department clinics

These programs need to be culturally and linguistically sensitive to our Hispanic community