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

Transcription

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

2 Why REACH? Disparities in health care are among the nation s most serious health care problems. Research has extensively documented the pervasiveness of racial and ethnic disparities. Institute of Medicine, 2002

3 We must endeavor to eliminate, so far as possible, the problem elements which make a difference in health among people W.E.B Dubois, 1899 The Philadelphia Negro

4 Alarming Facts Heart disease death rates 30% higher for African-Americans Americans than whites; stroke death rates 41% higher. Diabetes higher among American Indians and Alaska Natives (2.3 times), African Americans (1.6 times), and Hispanics (1.5 times.) Vietnamese American women have a higher cervical cancer rate than any other ethnic group (55 times non-hispanic white women.) African American infants are 2.5 times more likely to die before their first birthday.

5 REACH Partners Office of Minority Health Office of Public Health Science Office of the Assistant Secretary for Program Planning and Evaluation Office of Minority Health and Health Disparities, NIH Administration on Aging California Endowment

6 What Are REACH Communities Doing? Empowering community members to seek better health Bridging gaps between the health care system and community Changing social and physical environments to overcome barriers to good health Implementing strategies that fit unique social, political, economic, and cultural circumstances Moving beyond individuals to community and systems change

7 #1 Lesson Learned: Health disparities are not insurmountable, and CAN be overcome.

8 Producing Results: Health Outcomes South Carolina REACH Communities: 36% and 44% reduction in amputations among African-American American men; 21% gap in blood sugar testing virtually eliminated. Lawrence, Massachusetts Latino Health Project Participants: Improvements in blood sugar (8.7%,) systolic blood pressure (17.5%) and diastolic blood pressure (14.4%.)

9 Producing Results: Risk Factor Improvements Atlanta, GA; Portland, OR; and others.

10 Consumption of Five Fruits and Vegetables per Day Charlotte, NC REACH (REACH Risk Factor Survey) *African Americans only

11 Cholesterol Screening Among Hispanics REACH Risk Factor Survey, Percent Year REACH Hispanics Nation - All Nation - Hispanics *CVD/DM communities only

12 Cholesterol Screening Among African Americans REACH Risk Factor Survey, Percent REACH African American Nation - All Nation - African Americans Year *CVD/DM communities only

13 American Indians Currently on Medication for High Blood Pressure, REACH 2010 Risk Factor Survey* Percent (%) Nation REACH AI Nation AI * Data from REACH 2010 communities that focus on Cardiovascular Disease/Diabetes = Behavioral Risk Factor Surveillance System

14 Smoking Prevalence Among Asian Men REACH Risk Factor Survey, REACH Asian Men 40 Percent Nation - All Year *CVD/DM communities only

15 Challenges Time Matching federal and community priorities Community, academic, and governmental partnerships Ownership Power Resources/sustainability

16 Why REACH Works: Theme #1: Community- Driven Programs and Policy- Development

17 Why REACH Works: Community-Driven Programs and Policy-Development EMPOWERMENT of individuals I ve learned to be ready for the doctor when I go to the doctor s office and I go into the exam room, I take off my shoes and socks. I don t wait for him to tell me. On the counter I lay my monitor book with all my blood pressures and all my sugars. So it is there so he don t have to walk out and come back. I m getting every bit of the minutes he s supposed to be giving me. Participant, REACH Seattle-King County, WA

18 Why REACH Works: Community-Driven Programs and Policy-Development EMPOWERMENT of communities New York Success: Bronx Health REACH

19 Why REACH Works: Theme #2: Community, Academic, and Governmental Partnerships

20 Why REACH Works: Theme #3: Community Expertise

21 Why REACH Works: Theme #4: Investment in Communities

22 Why REACH Works: Investment in Communities HOPE

23 HOPE If it hadn t been for these people, I don t think I d be alive anymore. I think I d be dead by now. [La] Vida is beautiful and that s what it is. Life is beautiful. New Mexico, La Vida REACH

24 REACH-ing Further Centers of Excellence expert consultation, mentorship, dissemination to more communities Action Communities implementation and evaluation of established and innovative interventions

25 REACH U.S. Communities Action Communities CEED Communities African-American/ Blacks American Indian/ Alaska Native Asian Guam Native Hawaiian/ Other Pacific Islanders Hispanic/Latinos Multi-Ethnic

26 Closing Remarks