Hispanics & Health Disparities Summit Series Recommendations

1. Hispanics & Health Disparities Summit Series Recommendations National Hispanic Medical Association U.S. Department of Health and Human Services Office of Minority Health 2008

2. NHMA – Who are We? • Established in 1994 in DC, non-profit 501c6 association representing 36,000 Hispanic physicians in the U.S. • Mission: to improve the health of Hispanics and other underserved • NHMA Board of Directors • Established its foundation, National Hispanic Health Foundation, 501c3, for research and education activities – affiliated with NYU Wagner Graduate School of Public Service

3. Ciro Sumaya, MD, Chair Dean, Rural Health Public Health School, Texas A&M Elena Rios, MD, Pres & CEO Kathy Flores, MD, Sec Dir, UCSF-Fresno Latino Research Ctr, CA AHEC Yolanda Partida, DrPH, Treas Hablamos Juntos/RWJF Carol Brosgart, MD Gilead Sciences Emilio Carrillo, MD President, NY-Presbyterian Health Plan Rogelio Lopez, MD VP, Presbyterian Hospital, CA Jaime Rivera, MD Dir, Public Health, Delaware Angel Seda, MD Treasurer, Wyeth Pharmaceuticals Reed Tuckson, MD VP, United HealthCare Alfonso Vargas, MD Chair, NHMA Council of Medical Societies Advisory Council: Richard Carmona, MD, 17th Surgeon General Henry Cisneros, CEO, CityView Ivelisse Estrada, VP, UNIVISION Linda Griego, Pres, Griego Enterprizes NHMA Board of Directors

4. NHMA Networks • NHMA Council of Medical Societies • NHMA Council of Residents • Medical Student members • Hispanic Health Professional Leadership Network – all national Hispanic health professional associations

5. American Latinos & Health Care • Largest ethnic group now and in new America • 2050: America will be a nation >50% bicultural groups • Most uninsured (over one-third of all Hispanics) • Most problems with disparities in health care according to US DHHS 2006 Disparities Report • Need for cultural, language, education services • System lacks Hispanic researchers, providers and leaders in public/private agencies

6. Think Future: how to prepare for a New America? • The new America will consist of populations who face severe lack of access to health care, lack of trust and knowledge, and are low-income, poorly educated with strong cultural and family values, limited English proficiency, mainly living in urban areas, suffering from high rates of obesity, diabetes, infectious and chronic diseases, and demanding health care reform. • THE FUTURE IS NOW… YOU ARE THE ANSWER

7. Planning • 3 Regional Summits – • New York Academy of Medicine, New York • Sacramento, California • Austin, Texas • November 2007 – March 2008 • Planning Committee of OMH hdqts/regional offices and NHMA • Announce Recommendations at NHMA Annual Conference, April 18th, DC to the Health Policy Advisors of Obama, Clinton, McCain

8. Clinics/Community agencies Hospitals Medical Schools Foundations Pharma Cos. Insurance Cos. Government Business – Corp + Media Unions Hispanic Chambers of Commerce Physicians Consultants Associations K-12 Stakeholder Participants

9. Access – Recommendations1. Financing • Universal and affordable health insurance coverage • Expand eligibility for public programs – families, undocumented, legal doc, FPL level • Comprehensive benefits - preventive, mental health, dental, educational services • Individual mandates, automatic for all • Portable, quality measures, accountable

10. Access – Recommendations1. Financing • Public-Private partnerships with community demonstrations for low cost care delivery (eg. Mobile clinics)– with understanding of poverty, social determinants of health, outcomes for increasing health equity, preventive services that are culturally/linguistically appropriate, mid-level providers, promotoras

11. Access – Recommendations2. Health Care System • Enforce standards for Culturally and Linguistically Appropriate Services (JACHO) • Promote cultural competency provider training (incentives, performance payments, Federal clearinghouse) • Language services – interpreters, pooling of resources, federal laws on access to services • Race/ethnicity/Language data --mandatory • Support providers in underserved communities • Strengthen DSH payment system to private practice • Expand NHSC or similar program

12. Access Recommendations2. Health Care System • Invest in a diverse workforce • Fully fund HCOP, COE • Emphasize diversity throughout the pipeline • Medical Home = CHCs for all + increase referral systems to tertiary care • Patient centered care

13. Access – Recommendations3. Education/Marketing • Promote Awareness • Standard health education in K-12 • Use promotoras for community education • National Media Campaigns • Incentives/reimbursement for patient education

14. Prevention – Recommendations1. Education and Awareness • Schools • Standardize K-12 wellness programs • Provide healthy foods in schools • Community/parents • Support community coalitions • Increase green market penetration • Cooking skills, food pyramid • Clinics – increase diabetes and obesity focus • Policymakers – find our champions

15. Prevention – Recommendations2. Marketing • Expand Social Marketing • Public/private partnership to promote healthy lifestyles • Major Hispanic marketing campaign about public health • Industry to ban marketing of unhealthy foods to kids

16. Prevention – Recommendations3. Nutrition Policy • Federal policy for healthy foods • Provide USDA subsidies for healthier foods • Make WIC and food stamp programs healthier • Regulate unhealthy food marketing, labeling, and sales • Strengthen nutrition education • Standardize evidence-based health education in schools • Redefine traditional Hispanic foods as healthy • Schools • Ban vending of junk food/sodas • Report cards/incentives to good schools/state standards

17. Prevention – Recommendations4. Promote Physical Activity • Build a healthier environment to live in • More and safer parks, sidewalks, and gyms in minority areas • Increase availability of exercise programs • in and after school, community • at worksites & elsewhere - supported by employers

18. Prevention Recommendations5. Health Care System • Reimbursement/cpt codes for prevention (CMS to increase focus on diabetes and obesity) • Redesign for obese pts • Low cost interventions (CDC, NIH) • Healthy food in hospitals • CME/cultural competence training • Research – community-based • Multidisc teams – include nutritionists, educators

19. Hispanics in the Health Professions Recommendations • BUILD POLITICAL WILL • Strengthen Educational Pipeline • Improve K-12 education in minority communities • Target funds to low income school districts, increase counseling and faculty awareness • Health career tracks in high schools –magnets, tutoring • Provide more Hispanic mentors & role models in health professions at all educational levels • Support Hispanic students in higher education • Provide more scholarships & loan repayment options

20. Hispanics in Health ProfessionsRecommendations • Outreach to students/parents in low income neighborhoods about health careers in a new program • Develop value of education; funding • Link to clinics, libraries, science museums • Media/marketing about health careers • Public-Private partnerships in regions • HSIs linkage in regional efforts

21. Hispanics in the Health Professions Recommendations • Changes in Health Profession Schools • Fund COE and HCOP & expand focus • Change admissions – increase focus on background, leadership, underserved interest vs #s • Improve minority representation – admissions (include community), faculty, leadership • Link recruitment to professionals, alumni

22. Obama Administration • CHIP Bill • Economic Stimulus Bill – H-IT, Medicaid, Medicare, Cobra, Workforce, Clinics, Comparative Effectiveness Research • Health Care Reform – Health Disparities • Title VII reauthorization • HHS Leadership & Hispanics • OMH Leadership Summit – Feb. 26th

23. What We Do - NHHF • Affiliated with the Robert F. Wagner Graduate School of Public Service, New York University • Education Programs • NHMA Leadership Fellowship • Childhood Obesity Education Program • Hispanic Health Portal www.hispanichealth.info • Research and Research Training on Hispanic Health • Hispanic Health Professional Student Scholarship

24. What We Do - NHMA • Advocacy – health of Hispanics • Leadership development of Hispanic physicians and health professionals • Policy forums – Summit Series • 13th Annual Conference – Mar. 19-22nd • NY Marriott at the Brooklyn Bridge • www.nhmamd.org