The Impact of Health Disparities…. Why Does it Still Have Power Today?

1. Forsyth County Health Summit 2008 Winston-Salem, NC Tuesday, January 15, 2008 The Impact of Health Disparities….Why Does it Still Have Power Today? Ava Barbry-Crawford, Research Associate Barbara Pullen-Smith,Director Office of Minority Health and Health Disparities (OMHHD) North Carolina Department of Health and Human Services

2. Diversity in Health: National Institutes of Health Defines Disparities as… “The difference in the incidence, prevalence, mortality, and burden of disease and other adverse health conditions that exists among specific population groups in the United States”* *National Institutes of Health, Addressing Health disparities: The NIH program of Action. What are disparities. Available at http:healthdisparities.nih.gov/whatare.html.

3. Diversity in Health: NC Office of Minority Health and Health Disparities Defines Health Disparities as… “Significant differences or inequalities in health that exist between whites and racial/ethnic minorities.” Source: NC Office of Minority Health and Health Disparities

4. North Carolina Population, U.S. Census, 2000

5. “Statistics are People With The Tears Washed Off” Victor Sidel ~~~~~~~~~~~~~~~~~~~~~~~~~~ For Every Statistic There is a Face…

6. Racial and Ethnic Health Disparities in North Carolina REPORT CARD 2006 Office of Minority Health and Health Disparities And State Center for Health Statistics North Carolina Department of Health and Human Services

7. Health Disparities Report CardDisparity Ratio and Grades Guidelines Used to Assign Grades: • 0.0 - 0.5 = A • 0.6 - 1.0 = B • 1.1 - 1.9 = C • 2.0 - 2.9 = D • 3.0 or Greater = F Source: NC Division Public Health Epidemiology Team; NC OMHHD Research Associate; NC State Center for Health Statistics

8. Social and economic well-being Maternal and Infant Health Adult Health Communicable Diseases Violence and Injuries Child and Adolescent Health Risk Behaviors and Health Promotion Health Disparities Report Card “2006 Update” Focus Areas

9. Any Rate Ratios that are >1.0 indicate that African Americans are more likely to die at a higher rate than Whites. Ove Grade F Grade F Grade D Grade C Grade D Grade C Data Source: SCHS/OMHHD Report Card

10. Although, improvement has occurred for some areas, the death disparity gap consistently remains negatively greater between American Indians & Whites in NC Grade F Any Rate Ratios that are >1.0 indicate that American Indians are more likely to die at a higher rate than Whites. Grade F Grade D Grade D Grade D Grade C Grade C Grade C Grade C Grade C Grade C Grade C Data Source: SCHS/OMHHD Report Card

11. The Disparity Grades have maintained over the 7 yrs, but the actual disparity gap is slowly increasing for each area. The gaps for Homicide & HIV/AIDS Deaths are greatest. Grade D Grade D Grade D Any Rate Ratios that are >1.0 indicate that Hispanic/Latinos are more likely to die at a higher rate than Whites. Grade D Grade C Grade C Grade B Grade B Data Source: SCHS/OMHHD Report Card

12. 3 out of 4 racial/ethnic groups have children that live in poverty at least 2.6 times more often than the majority white population. AA Grade F H/L Grade F AA Grade D H/L Grade D AI Grade D AI Grade D The % of N.C. African American and Hispanic/Latino families are living in poverty at a much higher rate than whites A/PI Grade B A/PI Grade B % Children < 18yrs Living Below Poverty % of families Living Below Poverty

13. “Of all the forms of inequality, injustice in health is the most shocking and the most inhumane” Dr. Martin Luther King, Jr.

14. The Impact of Health Disparities…Why does it still have power today? • Bridging the Gap…. • Closing the Gap…. • Health Disparities…. • Health Inequality….

15. Contributing Factors to the Disparity in Health Status … • Lifestyle Behaviors • Socio-Cultural • System Influences

16. Systems Change is The Key Based on: Integration Investment Accountability

17. NC Office of Minority Health and Health DisparitiesCall To Action ModelState & Community Level Created & Owned by: NC Office of Minority Health and Health Disparities Equip Staff/ Stakeholders Source: NC Office of Minority Health and Health Disparities

18. OMHHD Community Focused Eliminating Health Disparities Initiative (CFEHDI) $2million – 2005 General Assembly Promoting Healthy Lifestyles: Diabetes, HIV/AIDS, Infant Mortality Homicide, Cancer, Motor Vehicle FBOs, CBOs, Tribes, LHDs Partnerships, Capacity Building Reduce Access Barriers Community Level Capacity Building

19. Populations Engaged in CFEHDI

20. CBO CBO 2006-2007: N=59 Grantees CBO 2005-2006: N=61 Grantees 2007-2008 N=42 Grantees LHD LHD LHD FBO FBO FBO TRIBE TRIBE TRIBE A Barbry-Crawford, Research Associate/OMHHD

21. Community Level Capacity BuildingOMHHDCommunity Focused Eliminating Health Disparities Initiative: Community Health Ambassador Program Major Components… • Curriculum = 20 Classroom Hours • Approved for 2.0 CEU s • Focus Areas = Diabetes, Cancer • Team Identifier= Vest • Partnerships = Success Dynamics, ONSMS, NC Community Colleges, UNC Greensboro (Nursing Program), Community Leaders

22. NC DHHS Eliminating Health Disparities Call To ActionA State Level Comprehensive Plan 2003 9 Key Recommendations • Increased Awareness • Document/Champion Best Practices • Community Capacity Building • Monitor Progress • Services that Meet the Needs • Increase Resources/Investments • Workforce Diversity • Policy Development • Accountability/Ownership for Health Outcomes

23. NC DHHS Call to Action State Level Capacity BuildingThe NC DHHS Eliminating Health Disparities Steering Committee of 14 Divisions/Offices Focus = Access, Services, Health Disparities Eliminating Health Disparities = Increasing Access To: • Prevention • Screening/Early Detection • Healthcare Services

24. “Knowing what to do is not enough, People need support to be healthy.” Barbara Pullen-Smith, Director NC OMHHD ~ Social Support Networks ~

25. On Behalf of the OMHHD Thank You for Being a Partner in the Fight to Eliminate Health Disparities! Every One Matters. Healthy Communities. Office of Minority Health and Health DisparitiesNC Department of Health and Human Services 1110 Navaho Drive 1906 Mail Service Center Raleigh, NC 27699-1906 (919) 431-1613 www.ncminorityhealth.org