Hispanic Health Initiative

1. Hispanic Health Initiative Partnership Empowerment Education

2. 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

3. Hispanic Growth 2000 - 2010

5. 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

6. Introduction • Applied for AAPGrant 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

7. 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

8. Focus Group Questions • 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?

9. Language • “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.”

10. “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

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

12. Transportation • “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.”

13. Cultural Differences • 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.”

14. Hispanic Health Access Barriers Language Financial Restraints/Lack of Insurance Legal Status Perceived Discrimination Transportation Cultural Issues

15. HISPANIC HEALTH INITIATIVE Partnership Empowerment Education

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

17. Florida Department of Health in Duval County Jacksonville’s Hispanic Health Council Partnership Board for Children’s Health Nemours Children’s Clinic University of Florida College of Medicine in Jacksonville Wolfson Children’s Hospital Florida Blue AmeriCorps/North Florida Health Corps Northeast Florida Pediatric Society

18. Empowerment Development of culturally effective tools and initiatives to empower the Hispanic/Latino community. Hispanic Resource Guide Community Outreach Programs

20. Education Develop healthcare provider cultural competency training modules to improve health outcomes Education of our cohorts: Cultural Competency Event in April of 2012 Incorporate cultural competency into residency training

21. 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

23. 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 DIFFICULTIESimpede accessing the health system.

24. Hispanic Population and the Obesity Epidemic

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

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

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

29. 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.

30. 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.

31. In 2007, The American Journal of Public Health published an article Called 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 butbreastfeeding for at least six months significantly decreased the odds of obesity

32. Interventions at Beaches Family Health Center Breastfeeding Project In 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

43. Representative Mia Jones 316 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.

44. 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