Eliminating Barriers: Health Disparities and Solutions for African Americans

Size: px
Start display at page:

Download "Eliminating Barriers: Health Disparities and Solutions for African Americans"

Transcription

1 Eliminating Barriers: Health Disparities and Solutions for African Americans Gregory L. Hall, MD Chairman, Ohio Commission on Minority Health Member, Cuyahoga County Board of Health Ass t Clinical Professor, CWRU School of Medicine Ass t Clinical Professor, NEOMED College of Medicine

2 Health Disparities 1985 Brought to national attention in report in by Margaret Heckler, Secretary of the Department of Health and Human Services under President Reagan. She took note of startling disparities in health status for Blacks and other minorities.

3 Secretary s Task Force on Black and Minority Health The work of the Secretary s Task Force on Black and Minority Health documented the myriad of reasons for these disparities and set forth a number of behavioral, systemic, workforce and resource allocation recommendations to eliminate this historic and persistent problem.

4 Ohio Commission on Minority Health The need for a deliberate, focused effort to address this problem led to the creation of the Ohio Commission on Minority Health in July of Representative Ray Miller convinced the governor of it s importance. It was the first state agency in the nation charged with addressing disparities in the health status between minority and majority populations.

5 Ohio Commission on Minority Health 1987

6 Mission The Ohio Commission on Minority Health is dedicated to eliminating disparities in minority health through: 1. Innovative Strategies and Financial Opportunities 2. Public Health Promotion 3. Legislative Action, Public Policy and Systems Change.

7 Ohio Demographics (2016) Race 13% 4% White African American Hispanic Latino Asian Pacific Islanders American Indian/Alaskan 81%

8 Ohioans with Medicare 6 13 White African American 83 Hispanic Latino

9 Ohioans with Medicaid 1% 3% 28% 67% White African American Hispanic Latino Other

10 The difference is health disparities Ohio Racial Demographics Ohioans with Medicaid 1% White 3% 13% 4% 81% African American Hispanic Latino 28% 67% White African American Hispanic Latino Other

11

12

13

14 Mortality Rate

15

16

17

18

19 Ten Top Causes of Death (US) 1. Heart Disease 2. Cancer 3. Chronic Lower Respiratory Disease 4. Accidents 5. Stroke 6. Alzheimer s Disease 7. Diabetes 8. Influenza / Pneumonia 9. Kidney Disease 10.Suicide

20 Ten Top Causes of Death (US) 1. Heart Disease 2. Cancer 3. Chronic Lower Respiratory Disease 4. Accidents 5. Stroke 6. Alzheimer s Disease 7. Diabetes 8. Influenza / Pneumonia 9. Kidney Disease 10.Suicide

21 The Worst Oxford Dictionary Of the poorest quality or the lowest standard; least good or desirable. Be in the least advantageous position; suffer the most.

22 African American Clinical Care Outcomes Worst death from Cardiovascular disease outcomes: 321 per 100,000 African American 245 per 100,000 European American 188 per 100,000 Hispanic Latino 178 per 100,000 American Indian 137 per 100,000 Asian Pacific Islanders

23 African American Clinical Care Outcomes Worst death from Diabetes outcomes: 50 per 100,000 African American 22 per 100,000 European American 36 per 100,000 Hispanic Latino 45 per 100,000 American Indian 17 per 100,000 Asian Pacific Islanders

24 African American Clinical Care Outcomes in Cancer Worst outcomes in: Lung cancer Breast cancer Ovarian cancer Cervical cancer Colon cancer Prostate cancer Pancreatic cancer Liver cancer Thyroid cancer Head & neck cancers

25 Age-Adjusted Death Rates for Top Five Causes of Cancer Death (CDC)

26 Is it related to insurance?

27 Social Determinants of Health?

28 Social Determinants of Health Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.

29

30

31

32

33

34 ... shocking & inhumane

35

36 Physician-Driven Disparities Lower physician-ordered cholesterol screens Lower physician-ordered diet/nutrition counseling Lower physician-ordered exercise counseling Lower physician-ordered use of Alzheimer disease medications Lower physician-ordered antidepressant medication in the diagnosis of depression

37 Clinician-Driven Disparities Lower physician-ordered cholesterol-lowering medications (statins) after stroke. Lower physician-ordered blood thinners with atrial fibrillation. Lower physician ordered bone marrow transplant (curative treatment) in multiple myeloma. And much more...

38 Poor provider care Poor clinical care by providers Cultural Incompetence Poor medical research application Poor adherence to recommendations

39

40 Cultural Competence In 1998 Jeffrey T. Berger, MD wrote "Culture and Ethnicity in Clinical Care" for the Journal of the American Medical Association and stressed the importance of "physician recognition of the cultural context of patients' illnesses (that) can be essential to a successful therapeutic relationship.

41

42

43

44

45

46

47

48

49

50

51

52 Prostate Cancer

53 Prostate Cancer Mortality Whites: 19 per 100,000 persons Blacks: 44 per 100,000 persons

54 Age-Adjusted Death Rates for Top Five Causes of Cancer Death (CDC)

55 The course of prostate cancer has been shown to be different in African American men prostate cancer volume is greater in African American men and advanced metastatic prostate cancer occurs at a 4:1 ratio.

56 Prostate Cancer The risk of death from prostate cancer in African Americans was consistently higher than in whites in all socioeconomic status strata. Among patients with the same socioeconomic status, cancer screening with a PSA was more common in Whites than African Americans, and cancer detection was earlier in Whites.

57 More watchful waiting % of African Americans were in watchful waiting, compared to only 7.2% of Whites (P<0.001).

58 Prostate Cancer African American patients are more likely to have elevated PSA levels in the presence of prostate cancer. The PSA is better as a prostate cancer screen in African Americans.

59

60 Prostate Cancer Screens All African American men should have an annual PSA drawn.

61 Cardiovascular Differences 2 to 3-fold increased risk for stroke 2-fold increased risk for heart failure 1.5 to 2 fold increased risk for coronary heart disease 1.4 fold increased risk for hypertension 1.7 fold increased risk for diabetes 1.5 fold increased risk for obesity 4 fold increased risk for end stage renal disease

62 Salt Sensitivity African Americans have a salt-sensitive gene that may make hypertension worse.

63 Salt Sensitivity 75% of all African American patients with hypertension are salt sensitive compared to 50% across all races with hypertension. Salt sensitivity increases with age and is more common in patients that are obese, and have renal insufficiency leading to failure... all of which are increased in African Americans. Salt-sensitivity alone is associated with increased mortality, even in salt-sensitive people without hypertension.

64 Salt-Reduction Counseling A modest reduction in salt intake (half normal consumption: 5 to 6 grams) for a month has been shown to make significant and sustained reductions in blood pressure. African Americans showed the most pronounced blood pressure reductions in response to salt restriction with a drop of 8 mm Hg systolic over 4 mm Hg diastolic averaged across as array of studies.

65 Hypertension

66 ALLHAT Trial (42,000 enrollees) Thiazide-type diuretic was better at reducing blood pressure and preventing cardiovascular events than other meds in African Americans.

67

68 ALLHAT Trial (42,000 enrollees) Calcium channel blockers (amlodipine) have also shown greater efficacy in African Americans as first line antihypertensives.

69

70 Hypertension & African Americans Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blocker (ARB) medications are less effective in African Americans for blood pressure control and are associated with worse outcomes.

71 34%

72 Hypertension & African Americans Treatment of hypertension appears to be inconsistent with the prevailing treatment guidelines for nearly one-third of the aged African Americans."

73 Do NOT Stop your Medicine!! Consult your physician!!

74 Stroke

75 Strokes in African Americans Nearly 44% of African American men and 48% of African American women have some form of cardiovascular disease that includes heart disease and stroke. About 2 out of every 5 African American adults have high blood pressure, and less than half of them have it under control. African-Americans are twice as likely to die from stroke as Whites and their rate of first strokes is almost double that of Whites.

76 Ohio Department of Health Burden of Stroke Report 2006

77 Causes of Strokes 1. High Blood Pressure (Hypertension) 2. Tobacco (smoking or chewing) 3. Heart Disease (valves and/or atrial fibrillation) 4. Diabetes 5. Obesity & Lack of Exercise 6. Medications (blood thinners, hormone therapy, BCP & smoking) 7. Family history (strokes or sickle cell)

78 ABCs A - Take aspirin as directed by your health care provider. B - Control your blood pressure. C - Manage your cholesterol. S - Don't smoke.

79 Aspirin Everyone age 50 and older should be on Aspirin 81mg daily unless they have an increased risk for bleeding or cannot tolerate.

80 Blood Pressure Everyone age 50 and older should measure their own blood pressure.

81 Smoking Everyone should stop smoking!!

82 Menthol Cigarettes Studies have also shown a higher propensity among African Americans to smoke mentholated cigarettes (80% vs 5% white) Menthol smokers absorb more nicotine and metabolize it slower. The anesthetizing effect of menthol makes you inhale more deeply and hold smoke in the lungs longer.

83

84 Menthol Cigarettes Higher risk of stroke in menthol smokers. Smoking cessation among menthol cigarette smokers is harder in both African American and Latino smokers, and for those who stopped fewer were able to remain abstinent.

85 Diabetes

86 Racial Differences: Diabetes

87 Racial Differences: Diabetes African Americans with Sickle Cell Trait have much lower HbA1c at any level: HbA1c cannot be trusted in patients with Sickle Cell trait or disease.

88 Racial Differences: Diabetes Compared to non-hispanic whites, HbA1c levels among African Americans typically average 0.4% higher than Whites at similar blood glucose levels. African Americans and Hispanics with normal fasting plasma glucose levels had significantly higher HbA1c values than whites.

89 African Americans should subtract 0.4 from your HbA1c.

90 Diabetes Control Studies have repeatedly shown that: increased diabetes knowledge and understanding have been positively associated with better glucose (sugar) control and increased education leads to elevated confidence in the patient's ability to achieve control.

91 Racial Differences: Colon Cancer Screening Colonoscopies begin at what age? Colonoscopy is indicated at age 45 in African Americans due to earlier onset and faster growing tumors. Sigmoidoscopy...

92

93 Racial Differences: Colon Cancer Colon polyps more often occur on the left side of the colon and can be reached by sigmoidoscopy... Except in African Americans when they occur more often on the right side, out of sight and reach of the sigmoidoscope. Sigmoidoscopy is NOT preferred for African Americans.

94 American College of Gastroenterology

95 African Americans should begin colon screening at age 45 and NEVER have a sigmoidoscopy.

96 Dietary Differences

97 Dietary Differences

98

99

100 Thirsty? Drink water.

101 Racial Differences: Hypertension prevalence and treatment Cardiovascular disease prevalence and treatment Diabetes prevalence and treatment Smoking prevalence and treatment Cancer detection and treatment And much more...

102 Racial & Cultural Differences Exist They impact patient engagement. They impact patient outcomes. They impact patient care quality. They impact patient mortality. To ignore them and treat everyone according to one set of guidelines is completely unadvisable and could be interpreted as a sign of... Clinical incompetence.

103 These poor outcomes cost... Racial health disparities are associated with substantial annual economic losses nationally, including an estimated: $35 billion in excess health care expenditures $10 billion in illness-related lost productivity

104 These poor outcomes cost... Lost hope and aspirations. Lost companionship and leadership. Lost opportunities and accomplishments.

105 Patient-centered care is culturally, racially, and clinically competent care.

106 Thank You

Cancer Disparities in Arkansas: An Uneven Distribution. Prepared by: Martha M. Phillips, PhD, MPH, MBA. For the Arkansas Cancer Coalition

Cancer Disparities in Arkansas: An Uneven Distribution. Prepared by: Martha M. Phillips, PhD, MPH, MBA. For the Arkansas Cancer Coalition Cancer Disparities in Arkansas: An Uneven Distribution Prepared by: Martha M. Phillips, PhD, MPH, MBA For the Arkansas Cancer Coalition Table of Contents Page Burden of Cancer 3 Cancer Disparities 3 Cost

More information

Cancer Facts & Figures for African Americans

Cancer Facts & Figures for African Americans Cancer Facts & Figures for African Americans What is the Impact of Cancer on African Americans in Indiana? Table 12. Burden of Cancer among African Americans Indiana, 2004 2008 Average number of cases

More information

PHACS County Profile Report for Searcy County. Presented by: Arkansas Center for Health Disparities and Arkansas Prevention Research Center

PHACS County Profile Report for Searcy County. Presented by: Arkansas Center for Health Disparities and Arkansas Prevention Research Center PHACS County Profile Report for Searcy County Presented by: Arkansas Center for Health Disparities and Arkansas Prevention Research Center Contents Introduction... Page 2 Demographics...Page 3 Social Environment

More information

Baptist Health Nassau Community Health Needs Assessment Priorities Implementation Plans

Baptist Health Nassau Community Health Needs Assessment Priorities Implementation Plans Baptist Health Nassau Community Health Needs Assessment Priorities Implementation Plans Health Disparities Heart Disease Stroke Hypertension Diabetes Adult Type II Preventive Health Care Smoking and Smokeless

More information

Baptist Health Beaches Community Health Needs Assessment Priorities Implementation Plans

Baptist Health Beaches Community Health Needs Assessment Priorities Implementation Plans Baptist Health Beaches Community Health Needs Assessment Priorities Implementation Plans Health Disparities Heart Disease Stroke Hypertension Diabetes Adult Type II Preventive Health Care Smoking and Smokeless

More information

ELIMINATING HEALTH DISPARITIES IN AN URBAN AREA. VIRGINIA A. CAINE, M.D., DIRECTOR MARION COUNTY HEALTH DEPARTMENT INDIANAPOLIS, INDIANA May 1, 2002

ELIMINATING HEALTH DISPARITIES IN AN URBAN AREA. VIRGINIA A. CAINE, M.D., DIRECTOR MARION COUNTY HEALTH DEPARTMENT INDIANAPOLIS, INDIANA May 1, 2002 ELIMINATING HEALTH DISPARITIES IN AN URBAN AREA VIRGINIA A. CAINE, M.D., DIRECTOR MARION COUNTY HEALTH DEPARTMENT INDIANAPOLIS, INDIANA May 1, 2002 Racial and ethnic disparities in health care are unacceptable

More information

Preventive Services Explained

Preventive Services Explained Preventive Services Explained Medicare covers many preventive care services without charge. Most of these services have been recommended by the U.S. Preventive Services Task Force. However, which beneficiaries

More information

Health Disparities Research. Kyu Rhee, MD, MPP, FAAP, FACP Chief Public Health Officer Health Resources and Services Administration

Health Disparities Research. Kyu Rhee, MD, MPP, FAAP, FACP Chief Public Health Officer Health Resources and Services Administration Health Disparities Research Kyu Rhee, MD, MPP, FAAP, FACP Chief Public Health Officer Health Resources and Services Administration Outline on Health Disparities Research What is a health disparity? (DETECT)

More information

Tuscarawas County Health Department

Tuscarawas County Health Department Tuscarawas County Health Department Community Health Needs Assessment 214 TUSCARAWAS COUNTY HEALTH DEPARTMENT Community Health Needs Assessment 214 Assessment Commissioned by: Dr. James Hubert D.O Health

More information

What is the Impact of Cancer on African Americans in Indiana? Average number of cases per year. Rate per 100,000. Rate per 100,000 people*

What is the Impact of Cancer on African Americans in Indiana? Average number of cases per year. Rate per 100,000. Rate per 100,000 people* What is the Impact of Cancer on African Americans in Indiana? Table 13. Burden of Cancer among African Americans Indiana, 2008 2012 Average number of cases per year Rate per 100,000 people* Number of cases

More information

Clinical Practice Guidelines for Diabetes Management

Clinical Practice Guidelines for Diabetes Management Clinical Practice Guidelines for Diabetes Management Diabetes is a disease in which blood glucose levels are above normal. Over the years, high blood glucose damages nerves and blood vessels, which can

More information

SIGN 149 Risk estimation and the prevention of cardiovascular disease. Quick Reference Guide July Evidence

SIGN 149 Risk estimation and the prevention of cardiovascular disease. Quick Reference Guide July Evidence SIGN 149 Risk estimation and the prevention of cardiovascular disease Quick Reference Guide July 2017 Evidence ESTIMATING CARDIOVASCULAR RISK R Individuals with the following risk factors should be considered

More information

Risk Factors for NCDs

Risk Factors for NCDs Risk Factors for NCDs Objectives: Define selected risk factors such as; tobacco use, diet, nutrition, physical activity, obesity, and overweight Present the epidemiology and significance of the risk factors

More information

Baptist Health Jacksonville Community Health Needs Assessment Implementation Plans. Health Disparities. Preventive Health Care.

Baptist Health Jacksonville Community Health Needs Assessment Implementation Plans. Health Disparities. Preventive Health Care. Baptist Health Jacksonville Community Health Needs Assessment Implementation Plans Health Disparities Infant Mortality Prostate Cancer Heart Disease and Stroke Hypertension Diabetes Behavioral Health Preventive

More information

Hypertension. Hypertension, also referred to as high blood

Hypertension. Hypertension, also referred to as high blood Hypertension Hypertension, also referred to as high blood pressure, is a condition in which the arteries have persistently elevated blood pressure. Every time the human heart beats, it pumps blood to the

More information

ENDING HEALTH DISPARITIES: A Congressional Black Caucus Priority

ENDING HEALTH DISPARITIES: A Congressional Black Caucus Priority ENDING HEALTH DISPARITIES: A Congressional Black Caucus Priority Congresswoman Donna Christensen at the Roundtable on Value and Science-Driven Health Care with the Clinical Effectiveness Research Innovation

More information

RACIAL AND ETHNIC APPROACHES TO COMMUNITY HEALTH. Why REACH Works Overcoming Challenges

RACIAL AND ETHNIC APPROACHES TO COMMUNITY HEALTH. Why REACH Works Overcoming Challenges RACIAL AND ETHNIC APPROACHES TO COMMUNITY HEALTH Why REACH Works Overcoming Challenges Why REACH? Disparities in health care are among the nation s most serious health care problems. Research has extensively

More information

Health Disparities Research

Health Disparities Research Health Disparities Research Kyu Rhee, MD, MPP, FAAP, FACP Chief Public Health Officer Health Resources and Services Administration Outline on Health Disparities Research What is a health disparity? (DETECT)

More information

TOBACCO USE AND ETHNICITY

TOBACCO USE AND ETHNICITY TOBACCO USE AND ETHNICITY Adult and youth tobacco use rates and related smoking-caused death rates vary considerably among different ethnic groups in the United States. Adult Prevalence 15.5 percent of

More information

PRINCIPLES FOR ELIMINATING DISPARITIES THROUGH HEALTH CARE REFORM. John Z. Ayanian, MD, MPP

PRINCIPLES FOR ELIMINATING DISPARITIES THROUGH HEALTH CARE REFORM. John Z. Ayanian, MD, MPP PRINCIPLES FOR ELIMINATING DISPARITIES THROUGH HEALTH CARE REFORM John Z. Ayanian, MD, MPP Harvard Medical School Brigham and Women s Hospital Harvard School of Public Health 8 th Annual National Summit

More information

Pharmacy and Referrals Pharmacy Name, Street Address & Telephone #: Primary Care Physician s Name, Location & Telephone #:

Pharmacy and Referrals Pharmacy Name, Street Address & Telephone #: Primary Care Physician s Name, Location & Telephone #: Patient Registration Please Print Clearly Date: Last Name: First Name: Middle Initial: Sex: Date of Birth: / / Age: Social Security: - - Address: City: State: Zip Code - Circle Preferred Phone Number Home

More information

HEALTH DISPARITIES AMONG ADULTS IN OHIO

HEALTH DISPARITIES AMONG ADULTS IN OHIO OHIO MEDICAID ASSESSMENT SURVEY 2012 Taking the pulse of health in Ohio HEALTH DISPARITIES AMONG ADULTS IN OHIO Amy K. Ferketich, PhD 1 Ling Wang, MPH 1 Timothy R. Sahr, MPH, MA 2 1The Ohio State University

More information

Living Well with Diabetes

Living Well with Diabetes Living Well with Diabetes What is diabetes? Diabetes Overview Diabetes is a disorder of the way the body uses food for growth and energy. Most of the food people eat is broken down into glucose, the form

More information

Hypertension Update Background

Hypertension Update Background Hypertension Update Background Overview Aaron J. Friedberg, MD Assistant Professor, Clinical Division of General Internal Medicine The Ohio State University Wexner Medical Center Management Guideline Comparison

More information

Steps Against Recurrent Stroke (STARS)

Steps Against Recurrent Stroke (STARS) Steps Against Recurrent Stroke (STARS) Take steps against recurrent stroke by making the necessary changes in your life Your Guide to Ischemic What Happened to Me? You had a stroke. The stroke you had

More information

Diversity and HTN: Approaches to optimal BP control in AfricanAmericans

Diversity and HTN: Approaches to optimal BP control in AfricanAmericans Diversity and HTN: Approaches to optimal BP control in AfricanAmericans Quinn Capers, IV, MD, FACC, FSCAI Assistant Professor of Medicine Associate Dean for Admissions Do Racial Differences Really Exist

More information

Burden of Cancer in California

Burden of Cancer in California Burden of Cancer in California California Cancer Reporting and Epidemiologic Surveillance Institute for Population Health Improvement UC Davis Health August 22, 2018 Outline 1. Incidence and Mortality

More information

Steps Against Recurrent Stroke (STARS)

Steps Against Recurrent Stroke (STARS) Steps Against Recurrent Stroke (STARS) Take steps against recurrent stroke by making the necessary changes in your life. Your Guide to Ischemic Stroke What happened to me? You had a stroke. The stroke

More information

HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION PROGRAM OREGON STATE OF THE HEART AND STROKE REPORT 2001 PREPARED BY.

HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION PROGRAM OREGON STATE OF THE HEART AND STROKE REPORT 2001 PREPARED BY. OREGON STATE OF THE HEART AND STROKE REPORT 2001 PREPARED BY THE OREGON DEPARTMENT OF HUMAN SERVICES HEALTH SERVICES HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION PROGRAM www.healthoregon.org/hpcdp Contents

More information

TOBACCO USE AMONG AFRICAN AMERICANS

TOBACCO USE AMONG AFRICAN AMERICANS TOBACCO USE AMONG AFRICAN AMERICANS Each year, approximately 45,000 African Americans die from smoking-related disease. 1 Smoking-related illnesses are the number one cause of death in the African-American

More information

TOBACCO-RELATED DISPARITIES IN WASHINGTON STATE

TOBACCO-RELATED DISPARITIES IN WASHINGTON STATE TOBACCO-RELATED DISPARITIES IN WASHINGTON STATE Tobacco is a Health Equity Problem Tobacco use remains a leading cause of preventable death and disease in Washington State. It is associated with more than

More information

Health Promotion, Screening, & Early Detection

Health Promotion, Screening, & Early Detection OCN Test Content Outline 2018 Health Promotion, Screening, & Early Detection Kelley Blake MSN, RN, AOCNS, OCN UW Medicine/Valley Medical Center I. Care Continuum 19% A. Health promotion & disease prevention

More information

NAME DATE Page 1. Other. Kidney Removed (Right, Left) Bladder Removed. Ovaries Removed for Endometriosis Breast Biopsy

NAME DATE Page 1. Other. Kidney Removed (Right, Left) Bladder Removed. Ovaries Removed for Endometriosis Breast Biopsy NAME DATE Page 1 Past Medical History: (please circle ALL that apply) Anxiety Hepatitis Arthritis Hypertension Artificial joints HIV/AIDS Asthma Hypercholesterolemia Atrial fibrillation Hyperthyroidism

More information

Texas Chronic Disease Burden Report. April Publication #E

Texas Chronic Disease Burden Report. April Publication #E Texas Chronic Disease Burden Report April 2010 Publication #E81-11194 Direction and Support Lauri Kalanges, MD, MPH Medical Director Health Promotion and Chronic Disease Prevention Section, Texas Department

More information

Factual Information Contained in this Report: PURPOSE. Health Perceptions. Health Insurance Coverage. Health Care Access. Preventive Health Care

Factual Information Contained in this Report: PURPOSE. Health Perceptions. Health Insurance Coverage. Health Care Access. Preventive Health Care Factual Information Contained in this Report: Health Perceptions Health Insurance Coverage Health Care Access Preventive Health Care Maternal and Child Health Alcohol, Tobacco, and Other Drug Use PURPOSE

More information

Colorado Health Disparities Profiles

Colorado Health Disparities Profiles Health Disparities Profiles includes: Larimer County Population Total Population Source: CDC/NCHS 2007-based, bridged-race population estimates, 2007. Social Determinants of Health 287,574 248,312 26,629

More information

Hypertension Update. Aaron J. Friedberg, MD

Hypertension Update. Aaron J. Friedberg, MD Hypertension Update Aaron J. Friedberg, MD Assistant Professor, Clinical Division of General Internal Medicine The Ohio State University Wexner Medical Center Background Diagnosis Management Overview Guideline

More information

Cancer Health Disparities in Tarrant County

Cancer Health Disparities in Tarrant County Cancer Health Disparities in Tarrant County A presentation to the Tarrant County Cancer Disparities Coalition May 3, 07 Marcela Gutierrez, LMSW Assistant Professor in Practice UTA School of Social Work

More information

Know Your Number Aggregate Report Single Analysis Compared to National Averages

Know Your Number Aggregate Report Single Analysis Compared to National Averages Know Your Number Aggregate Report Single Analysis Compared to National s Client: Study Population: 2242 Population: 3,000 Date Range: 04/20/07-08/08/07 Version of Report: V6.2 Page 2 Study Population Demographics

More information

Heart Disease and Stroke in New Mexico. Facts and Figures: At-A-Glance

Heart Disease and Stroke in New Mexico. Facts and Figures: At-A-Glance Heart Disease and Stroke in New Mexico Facts and Figures: At-A-Glance December H e a r t D i s e a s e a n d S t r o k e Heart disease and stroke are the two most common conditions that fall under the

More information

The Burden Report: Cardiovascular Disease & Stroke in Texas

The Burden Report: Cardiovascular Disease & Stroke in Texas The Burden Report: Cardiovascular Disease & Stroke in Texas Texas Cardiovascular Health and Wellness Program www.dshs.state.tx.us/wellness Texas Council on Cardiovascular Disease and Stroke www.texascvdcouncil.org

More information

Colorado Health Disparities Profiles

Colorado Health Disparities Profiles Health Disparities Profiles County includes: Jackson, Moffat, Rio Blanco, and Counties Population Total Population 22,382 43,638 4,861,515 21,015 39,473 3,508,736 904 3,224 909,833 140 263 228,718 210

More information

National Strategy. for Control and Prevention of Non - communicable Diseases in Kingdom of Bahrain

National Strategy. for Control and Prevention of Non - communicable Diseases in Kingdom of Bahrain Kingdom of Bahrain Ministry of Health National Strategy for Control and Prevention of Non - communicable Diseases in Kingdom of Bahrain 2014 2025 Behavioural Risk Factors Tobacco Use Unhealthy Diets Physical

More information

Pharmacy and Referrals Pharmacy Name, Street Address & Telephone #: Primary Care Physician s Name, Location & Telephone #:

Pharmacy and Referrals Pharmacy Name, Street Address & Telephone #: Primary Care Physician s Name, Location & Telephone #: Patient Registration Please Print Clearly Date: Last Name: First Name: Middle Initial: Sex: Date of Birth: / / Age: Social Security: - - Address: City: State: Zip Code - Home Phone #: Work Phone #: Cell

More information

Page down (pdf converstion error)

Page down (pdf converstion error) 1 of 6 2/10/2005 7:57 PM Weekly August6, 1999 / 48(30);649-656 2 of 6 2/10/2005 7:57 PM Achievements in Public Health, 1900-1999: Decline in Deaths from Heart Disease and Stroke -- United States, 1900-1999

More information

650, Our Failure to Deliver

650, Our Failure to Deliver 650, Our Failure to Deliver, Director UAB Comprehensive Cancer Center Professor of Gynecologic Oncology Evalina B. Spencer Chair in Oncology President, American Cancer Society All Sites Mortality Rates

More information

Long-Term Care Updates

Long-Term Care Updates Long-Term Care Updates August 2015 By Darren Hein, PharmD Hypertension is a clinical condition in which the force of blood pushing on the arteries is higher than normal. This increases the risk for heart

More information

2015 Disparities in Care. Aiming for Health Equity in Washington State.

2015 Disparities in Care. Aiming for Health Equity in Washington State. 2015 Disparities in Care Aiming for Health Equity in Washington State www.wacommunitycheckup.org Disparities in care 2015 report Table of Contents Background 3 Key findings 5 Accessing care 5 Health screenings

More information

In Pursuit of Health Equity. A panel discussion

In Pursuit of Health Equity. A panel discussion In Pursuit of Health Equity A panel discussion MNCM Annual Seminar 2017 There is variation in quality results by race, ethnicity, language and country of origin 2016 Health Equity of Care Report, page

More information

2017 USRDS ANNUAL DATA REPORT KIDNEY DISEASE IN THE UNITED STATES S611

2017 USRDS ANNUAL DATA REPORT KIDNEY DISEASE IN THE UNITED STATES S611 Healthy People 2020 In this chapter, we examine data for 11 Healthy People 2020 (HP2020) objectives 10 for CKD and one for diabetes spanning 20 total indicators for which the USRDS serves as the official

More information

The Burden of Cardiovascular Disease in North Carolina. Justus-Warren Heart Disease and Stroke Prevention Task Force April 11, 2018

The Burden of Cardiovascular Disease in North Carolina. Justus-Warren Heart Disease and Stroke Prevention Task Force April 11, 2018 The Burden of Cardiovascular Disease in North Carolina Justus-Warren Heart Disease and Stroke Prevention Task Force April 11, 2018 Purpose 1. To detail the burden of heart disease and stroke in North Carolina

More information

CHRONIC DISEASE PREVALENCE AMONG ADULTS IN OHIO

CHRONIC DISEASE PREVALENCE AMONG ADULTS IN OHIO OHIO MEDICAID ASSESSMENT SURVEY 2012 Taking the pulse of health in Ohio CHRONIC DISEASE PREVALENCE AMONG ADULTS IN OHIO Amy Ferketich, PhD Ling Wang, MPH The Ohio State University College of Public Health

More information

proposed set to a required subset of 3 to 5 measures based on the availability of electronic

proposed set to a required subset of 3 to 5 measures based on the availability of electronic CMS-0033-P 143 proposed set to a required subset of 3 to 5 measures based on the availability of electronic measure specifications and comments received. We propose to require for 2011 and 2012 that EP's

More information

Health Disparities and Community Colleges:

Health Disparities and Community Colleges: Health Disparities and Community Colleges: Being Part of the Solution Elmer R. Freeman, MSW Annual Convention of the American Association of Community Colleges Monday, April 11, 2005 Mission The mission

More information

Health Disparities Matter!

Health Disparities Matter! /KirwanInstitute www.kirwaninstitute.osu.edu Health Disparities Matter! Kierra Barnett, Research Assistant Alex Mainor, Research Assistant Jason Reece, Director of Research Health disparities are defined

More information

Will Equity Be Achieved Through Health Care Reform?

Will Equity Be Achieved Through Health Care Reform? Will Equity Be Achieved Through Health Care Reform? John Z. Ayanian, MD, MPP Director & Alice Hamilton Professor of Medicine Mass Medical Society Public Health Leadership Forum April 4, 214 OBJECTIVES

More information

Disclosure. I have no relevant financial relationships with commercial interests to disclose American Medical Association. All rights reserved.

Disclosure. I have no relevant financial relationships with commercial interests to disclose American Medical Association. All rights reserved. Disclosure I have no relevant financial relationships with commercial interests to disclose. 2 Objectives Describe the trends in type 2 diabetes and implications for clinical practice Review the evidence

More information

Multnomah County: Leading Causes of Death

Multnomah County: Leading Causes of Death Leading causes of death are presented in this report by gender and race/ethnicity. Mortality data is based on the Death Certificate statistical file provided by the Center for Health Statistics, Oregon

More information

Region VI. Health Initiative Overview

Region VI. Health Initiative Overview Region VI Health Initiative Overview National Health Committee Region VI Health and Wellness Coordinators Chapters Objectives Health Awareness Health Disparities Education Prevention Health Focus of the

More information

Hypertension and Heart Disease. Weldon James, MD, Mercy Clinic Family Medicine, Union

Hypertension and Heart Disease. Weldon James, MD, Mercy Clinic Family Medicine, Union Hypertension and Heart Disease Weldon James, MD, Mercy Clinic Family Medicine, Union The Silent Killer High blood pressure, also known as HBP or hypertension, is a widely misunderstood medical condition

More information

Populations of Color in Minnesota

Populations of Color in Minnesota Populations of Color in Minnesota Health Status Report Update Summary Fall 2002 Center for Health Statistics Minnesota Department of Health Table of Contents Part I: Birth Related Indicators...1 Low Birthweight...1

More information

III. Health Status and Disparities

III. Health Status and Disparities Mid-America Regional Council and REACH Healthcare Foundation Regional Health Assessment March 2015 www.marc.org/healthassessment III. Health Status and Disparities Community health outcomes are often a

More information

Diabetes Care Begins With Diabetes Prevention

Diabetes Care Begins With Diabetes Prevention Diabetes Care Begins With Diabetes Prevention Noah Nesin, M.D., FAAFP June 28, 2018 12-1pm Webinar Logistics for Zoom Audio lines for non-presenters are currently muted Please use the Q & A function for

More information

Impact of Poor Healthcare Services

Impact of Poor Healthcare Services Competency 3 Impact of Poor Healthcare Services Updated June 2014 Presented by: Lewis Foxhall, MD VP for Health Policy Professor, Clinical Cancer Prevention UT MD Anderson Cancer Center Competency 3 Objectives

More information

Indian CHRNA (Community Health Resources and Needs Assessment)

Indian CHRNA (Community Health Resources and Needs Assessment) (Community Health Resources and Needs Assessment) Between 2014 and 2015, the Center for the Study of Asian American Health collected 113 surveys in the Indian community in NYC in partnership with community

More information

Prevention What It s All About

Prevention What It s All About Prevention What It s All About Dr James Schuppert Director, January 14, 2015 Information Security This presentation contains Corning Restricted information and is intended solely for those with a need

More information

Community Engagement to Improve Health Outcomes Adventist HealthCare Center for Health Equity & Wellness

Community Engagement to Improve Health Outcomes Adventist HealthCare Center for Health Equity & Wellness Community Engagement to Improve Health Outcomes 2017 Adventist HealthCare Center for Health Equity & Wellness Adventist HealthCare: 2017 Mission We extend God s care through the ministry of physical, mental

More information

Otis W. Brawley, MD, FACP, FASCO

Otis W. Brawley, MD, FACP, FASCO Otis W. Brawley, MD, FACP, FASCO Chief Medical and Scientific Officer American Cancer Society Professor of Hematology, Medical Oncology, Medicine and Epidemiology Emory University Prostate Cancer and

More information

Prioritizing Disease Prevention. Man and women, young and old, black and white, gay and straight, rich and poor,

Prioritizing Disease Prevention. Man and women, young and old, black and white, gay and straight, rich and poor, El-Magbri 1 Prioritizing Disease Prevention Man and women, young and old, black and white, gay and straight, rich and poor, all are susceptible. Over 35 million are inflicted and the lives of far too many

More information

Clinical Recommendations: Patients with Periodontitis

Clinical Recommendations: Patients with Periodontitis The American Journal of Cardiology and Journal of Periodontology Editors' Consensus: Periodontitis and Atherosclerotic Cardiovascular Disease. Friedewald VE, Kornman KS, Beck JD, et al. J Periodontol 2009;

More information

HEALTH HISTORY FORM. Student PID Number Date of Birth Legal Sex Preferred Pronouns Relationship Status (ie. he/him, she/her, they/their)

HEALTH HISTORY FORM. Student PID Number Date of Birth Legal Sex Preferred Pronouns Relationship Status (ie. he/him, she/her, they/their) 2 Health Center Drive Athens, OH 45701 Tel: (740)593.1660 Fax: (740)593.0179 HEALTH HISTORY FORM Legal Name Last First Middle Initial Preferred Name Student PID Number Date of Birth Legal Sex Preferred

More information

2010 Community Health Needs Assessment Final Report

2010 Community Health Needs Assessment Final Report 2010 Community Health Needs Assessment Final Report April 2011 TABLE OF CONTENTS A. BACKGROUND 3 B. DEMOGRAPHICS 4 C. GENERAL HEALTH STATUS 10 D. ACCESS TO CARE 11 E. DIABETES 12 F. HYPERTENSION AWARENESS

More information

Tobacco Use Percent (%)

Tobacco Use Percent (%) Tobacco Use 1 8 6 2 23 25 27 Lifetime cigarette use 64.8 62. 59.9 Current cigarette smoker 3.2 25.7 24.2 Current cigar smoker 19.4 21.3 18.9 First cigarette before age 13 24.7 2. 18. Current spit tobacco

More information

Executive Summary To access the report in its entirety, visit

Executive Summary To access the report in its entirety, visit Executive Summary To access the report in its entirety, visit http://www.hpcswf.com/health-planning/health-planningprojects/. Demographic and Socioeconomic Characteristics Population Demographics has a

More information

JNC Evidence-Based Guidelines for the Management of High Blood Pressure in Adults

JNC Evidence-Based Guidelines for the Management of High Blood Pressure in Adults JNC 8 2014 Evidence-Based Guidelines for the Management of High Blood Pressure in Adults Table of Contents Why Do We Treat Hypertension? Blood Pressure Treatment Goals Initial Therapy Strength of Recommendation

More information

*

* Introduction Cancer is complex, can have many possible causes, and is increasingly common. For the U.S. population, 1 in 2 males and 1 in 3 females is at risk of developing cancer in their lifetime. The

More information

You have already begun to reduce your risk for heart attack and stroke just by reading this workbook. Instructions:

You have already begun to reduce your risk for heart attack and stroke just by reading this workbook. Instructions: You have already begun to reduce your risk for heart attack and stroke just by reading this workbook. You are in charge and can lead your team (your nurses, therapists, doctors, and family) in helping

More information

Washington, D.C Washington, D.C

Washington, D.C Washington, D.C May 24, 2018 The Honorable Roy Blunt The Honorable Patty Murray Chairman Ranking Member United States Senate United States Senate Washington, D.C. 20510 Washington, D.C. 20510 Dear Chairman Blunt and Ranking

More information

Supplementary Online Content

Supplementary Online Content Supplementary Online Content Inohara T, Xian Y, Liang L, et al. Association of intracerebral hemorrhage among patients taking non vitamin K antagonist vs vitamin K antagonist oral anticoagulants with in-hospital

More information

The clinical and economic benefits of better treatment of adult Medicaid beneficiaries with diabetes

The clinical and economic benefits of better treatment of adult Medicaid beneficiaries with diabetes The clinical and economic benefits of better treatment of adult Medicaid beneficiaries with diabetes September, 2017 White paper Life Sciences IHS Markit Introduction Diabetes is one of the most prevalent

More information

CANCER SCREENING IN MINORITY AND UNDERSERVED POPULATIONS

CANCER SCREENING IN MINORITY AND UNDERSERVED POPULATIONS CANCER SCREENING IN MINORITY AND UNDERSERVED POPULATIONS Gina Villani, MD, MPH CEO and Medical Director Healthfirst 2016 Fall Symposium Prevention as a Priority in Value-Based Healthcare Part II Disparities

More information

Demographics and Health Data

Demographics and Health Data Demographics and Health Data Information for Local Planners City of Lakewood, WA Demographic Characteristics Environmental Health Division 3629 South D Street, Tacoma, WA 98418 (253) 798-6470 Table 1 presents

More information

Cancer Prevention: the gap between what we know and what we do

Cancer Prevention: the gap between what we know and what we do Cancer Prevention: the gap between what we know and what we do John D Potter MBBS PhD Public Health Sciences Division Fred Hutchinson Cancer Research Center Global Trends Global Trends Increasing population

More information

JUSTUS WARREN TASK FORCE MEETING DECEMBER 05, 2012

JUSTUS WARREN TASK FORCE MEETING DECEMBER 05, 2012 SAMUEL TCHWENKO, MD, MPH Epidemiologist, Heart Disease & Stroke Prevention Branch Chronic Disease & Injury Section; Division of Public Health NC Department of Health & Human Services JUSTUS WARREN TASK

More information

DIABETES AND CHRONIC KIDNEY DISEASE

DIABETES AND CHRONIC KIDNEY DISEASE DIABETES AND CHRONIC KIDNEY DISEASE Stages 1 4 www.kidney.org National Kidney Foundation's Kidney Disease Outcomes Quality Initiative Did you know that the National Kidney Foundation's Kidney Disease Outcomes

More information

Changes to the Guideline: update to mammogram screening ages (possible benefit to screen in age if high risk)

Changes to the Guideline: update to mammogram screening ages (possible benefit to screen in age if high risk) Adult Preventive Clinical Guideline (21 & over) Line of Business: DE Medicaid Summary: The Adult Preventive Clinical Guideline is meant to provide guidance for preventive care for the general, adult population.

More information

THE HEALTH OF CHINESE AMERICANS: 1970 TO TODAY PRESENTED BY KATHY KO CHIN, PRESIDENT AND CEO ASIAN & PACIFIC ISLANDER AMERICAN HEALTH FORUM

THE HEALTH OF CHINESE AMERICANS: 1970 TO TODAY PRESENTED BY KATHY KO CHIN, PRESIDENT AND CEO ASIAN & PACIFIC ISLANDER AMERICAN HEALTH FORUM THE HEALTH OF CHINESE AMERICANS: 1970 TO TODAY PRESENTED BY KATHY KO CHIN, PRESIDENT AND CEO ASIAN & PACIFIC ISLANDER AMERICAN HEALTH FORUM OUR MISSION The Asian & Pacific Islander American Health Forum

More information

FACT SHEET % 15.0% Percent 10.0%

FACT SHEET % 15.0% Percent 10.0% FACT SHEET The Branch addresses the impact of diabetes in Alabama by developing, policies, recommendations, and programs about the disease and related issues. The program is funded through a five-year

More information

Chapter III: Summary of Data for Specific Cancers

Chapter III: Summary of Data for Specific Cancers Chapter III: Summary of Data for Specific Cancers [This page left intentionally blank.] Chapter III Chapter III: Summary of Data for Specific Cancers This chapter provides detailed information on the most

More information

Healthy People 2010 Leading Health Indicators: California, 2000

Healthy People 2010 Leading Health Indicators: California, 2000 January 4 DATA SUMMARY No. DS4- Healthy People Leading Health Indicators: California, By Jim Sutocky This report focuses on the Healthy People Leading Health Indicators (LHIs). H i g h l i g h t s As of

More information

Almost 1 in 10 adults have been diagnosed with diabetes. Alabama is ranked fifth in prevalence of diabetes in the United States and its territories.

Almost 1 in 10 adults have been diagnosed with diabetes. Alabama is ranked fifth in prevalence of diabetes in the United States and its territories. 2008 FACT SHEET The Diabetes Branch addresses the impact of diabetes in Alabama by developing policies, recommendations, and programs about the disease and related issues. The program is funded through

More information

PREVENTIVE GUIDELINES

PREVENTIVE GUIDELINES PREVENTIVE GUIDELINES for Patients & Providers Nov. 2016 Preventive Care for All Adults (Men and Women) Preventive Service 19-39 Years 45-64 Years I Age 65 and Older Daily Aspirin Colon Cancer Screening

More information

Our Healthy Community Partnership. and the Brown/Black Coalition are. pleased to release the Douglas County Health and

Our Healthy Community Partnership. and the Brown/Black Coalition are. pleased to release the Douglas County Health and Our Healthy Community Partnership and the Brown/Black Coalition are pleased to release the 2007 Douglas County Health and Disparities Report Card. This report provides a snapshot of local disparities in

More information

Chronic Disease Challenges and Solutions

Chronic Disease Challenges and Solutions Chronic Disease Challenges and Solutions Janet Collins, PhD Director, Division of Nutrition, Physical Activity and Obesity, CDC Council of State Governments Kansas City, MO September 18, 2013 Centers for

More information

Behavioral Risk Factors in Adults

Behavioral Risk Factors in Adults Behavioral Risk Factors in Adults Behavioral risk factors are behaviors that increase the possibility of disease, such as smoking, alcohol use, bad eating habits, and not getting enough exercise. Because

More information

Primary and Secondary Prevention of Cardiovascular Disease. Frank J. Green, M.D., F.A.C.C. St. Vincent Medical Group

Primary and Secondary Prevention of Cardiovascular Disease. Frank J. Green, M.D., F.A.C.C. St. Vincent Medical Group Primary and Secondary Prevention of Cardiovascular Disease Frank J. Green, M.D., F.A.C.C. St. Vincent Medical Group AHA Diet and Lifestyle Recommendations Balance calorie intake and physical activity to

More information

Shaping our future: a call to action to tackle the diabetes epidemic and reduce its economic impact

Shaping our future: a call to action to tackle the diabetes epidemic and reduce its economic impact Shaping our future: a call to action to tackle the diabetes epidemic and reduce its economic impact Task Force for the National Conference on Diabetes: The Task Force is comprised of Taking Control of

More information

A Closer Look at Leading Causes of Death in Guilford County

A Closer Look at Leading Causes of Death in Guilford County 2015 GCDHHS Division of Public Health Data Brief A Closer Look at Leading Causes of Death in Guilford County Highlights Heart disease mortality rates declined 43% from 244.8 deaths per 100,000 in 1995

More information

Using the New Hypertension Guidelines

Using the New Hypertension Guidelines Using the New Hypertension Guidelines Kamal Henderson, MD Department of Cardiology, Preventive Medicine, University of North Carolina School of Medicine Kotchen TA. Historical trends and milestones in

More information

Condition/Procedure Measure Compliance Criteria Reference Attribution Method

Condition/Procedure Measure Compliance Criteria Reference Attribution Method Premium Specialty: Cardiology Credentialed Specialties include: Cardiac Diagnostic, Cardiology, Cardiovascular Disease, Clinical Cardiac Electrophysiology, and Interventional Cardiology This document is

More information