health disparities

Health Risk - American Indians and Alaska Natives: Incidence of diabetes is more than _______ that of the general population AND they die of the disease at a rate of ______ higher than the general population Life expectancy of ______ years less than general population Die at a rate of _____ per every 1000 live births as compared to 6.8 per 1000 Increased incidence of tuberculosis, alcoholism (depression), motor vehicle accidents, unintentional injuries, homicide and suicide

twice 189% 2.4 8.5

Hispanic-Americans and Health Risk: _______ the risk of developing diabetes AND _______ as likely to die from the disease Hispanic-American ♀ highest incidence of _________ cancer Increased risk of cardiovascular disease

twice twice cervical

African Americans & Health Risk: Cancer incidence rate - ____ higher Cancer mortality rate ____ higher African-American ♀ - higher mortality rates from breast cancer **despite the fact that whites experience higher incidence rates** ______ the risk of developing diabetes Increased risk of cardiovascular disease AND highest rate of mortality from CVD

10% 35% Twice

"Health disparities are differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the United States."

2002 IOM (Inst. of Med.)

more than ____ of health care providers do not know how to obtain interpreters Providers must establish a patient's ability to understand ALL components of the health care encounter.

40%

Asian Descent and Health Risk: Vietnamese ♀ - Cervical cancer rates _____ times higher Asians and Pacific Islanders - much higher rates of hepatitis and tuberculosis Increased risk of cardiovascular disease

5x

United States racial and ethnic minorities represent _____ of all reported AIDS cases _____ of reported gonorrhea cases HIV/AIDS - leading cause of death for African-Americans

71% 80%

Ethnic population % in the US: Whites Black/African American Predictions for 2050 White population will decrease by 19% Hispanic/Latino population - double Asian population - double Black/African American population - will increase Underrepresented minority groups will increase

72.4% 16.3% 12.6%

A disabled person is someone with a physical or mental impairment that substantially limits one or more major life activities (as well as someone with a history of such an impairment or someone regarded as such) This includes people with obvious, visible disabilities, as well as the majority of people with disabilities who have hidden conditions such as arthritis, diabetes, or hearing impairment.

Americans with Disabilities Act (ADA

"Health disparities are differences that occur by gender, race, and ethnicity, education, and income, disability, living in rural localities, and sexual orientation."

Healthy people 2000

"...differences in the incidence, prevalence, mortality, and burden of diseases, and other adverse health conditions that exist with specific population groups in the U.S Research on health disparities related to socioeconomic status is encompassed in the definition."

National Institutes of Health

to render a message from one written language to another

Translator

An educational model to assist healthcare workers to increase communication skills and cultural awareness in providing medical care. Improve understanding of cultural practices including cultural practices that may interfere with medical care or treatment

The LEARN Model

First adopted by the American Hospital Association in 1973, latest revision 1992 #___ - "Patient's have the right to an interpreter when language presents a barrier between the patient and the practitioner"

The Patient's Bill of Rights 6

patients with Limited English Proficiency (LEP) have language assistance by: Certified interpreter - AT&T interpretive services Health care system provided interpreters Written translation services

Title VI of the Civil Rights Act of 1964

generalizations may be a helpful starting point such as dress, language, eye contact, personal space, tone/cadence of voice.

cultural cues (clues)

Patients may have different behaviors, beliefs, fears, languages and attitudes relevant to the delivery of health care.

cultural variances

The behaviors and beliefs characteristic of a particular social, ethnic, or age group. the quality in a person or society that arises from a concern for what is regarded as excellent. Social "norms" within a group. a learned behavior established in home, community or influenced by a large social network.

culture.

lack of similarity; inequality; difference

disparity

requirements for core professionalism instruction and core cultural competencies in physician assistant education

explicit curriculum

Population-specific differences in the presence of disease, health outcomes, or access to health care.

health disparity

the ability of an individual to assess, understand, and use health-related information and services to make appropriate health decisions.

health literacy

student observation of provider-patient and peer encounters in the health care environment (going to see professional and unprofessional conduct; learn from good behavior)

hidden curriculum

someone who is fluent in two or more languages and renders messages from one spoken or signed language into another spoken or signed language. role is to convey information NOT to explain things.

interpreter