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Health Needs Assessment for the Latino Population of Nevada

Health Needs Assessment for the Latino Population of Nevada. Sherry Liao, MPH Candidate University of Nevada, Reno April 17 , 2014. citizenship.honeywell.com.

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Health Needs Assessment for the Latino Population of Nevada

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  1. Health Needs Assessment for the Latino Population of Nevada Sherry Liao, MPH Candidate University of Nevada, Reno April 17, 2014

  2. citizenship.honeywell.com As diversity in the United States continues to increase, a variety of outreach methods are needed to reach all segments of the population.

  3. Health Disparities Faced by Latinos • Obesity1 • Hypertension2 • Diabetes3 • HIV/AIDS4 • Breast cancer detection, treatment, and follow-up5 • Colorectal cancer screening6 • Mental health7 growthhormonecanada.ca

  4. Lack of Access to Care • Language Barrier8 • Lack of cultural competence9 • Mistrust9 • Low Educational Attainment8 • Unable to navigate system9 • Immigration status8 www.alphasandesh.com

  5. 47% of Hispanics in Nevada lack access to care.8 myfertilitychoices.com

  6. From 2000 to 2011, the Latino population in the United States grew 47.5%.10 During that same time period, the Latino population in Nevada grew 66.0%.10 bionutritionalresearch.olhblogspace.com

  7. Nevada presents unique challenges in accessing healthcare. pubs.usgs.gov

  8. Community Health Worker Program CHW Program

  9. Methods • Latino Health Needs Assessment (LHNA) Survey • 76 questions • Topics • General demographics • Access to healthcare • Chronic diseases • Health screenings • Health behaviors • Reproductive health • Mental health • Community factors • Development mexicoinstitute.wordpress.com mexicoinstitute.wordpress.com

  10. Methods • Latino Health Needs Assessment • Data collection: July 2013 – November 2013 • Formats • Paper and Electronic • English and Spanish (72.8% Spanish) • Incentives ($25 gift cards) • Participant Recruitment • Inclusion Criteria mexicoinstitute.wordpress.com

  11. Methods • Data Analysis • Data cleaning • 3 excluded due to age • 3 excluded due to ethnicity • Invalid and out-of-state zip code excluded from county analysis • Final sample: N = 933 • Combining free response answers • Ex. Please specify your type of employment.

  12. Demographics

  13. Demographics

  14. Over a quarter of respondents (26.8%) reported an annual household income of less than $10,000 and well over half (62.3%) reported one of less than $30,000. http://eofdreams.com/photo/money/11/ N = 855

  15. Only 22.2% and 19.0% of respondents reported receiving benefits from WIC and SNAP, respectively, in the past year. N = 864

  16. Only about one in four respondents had healthcare coverage of any kind. N = 890

  17. Healthcare Coverage by County

  18. Of respondents who have children, 93.6% reported that all their children were up to date on their immunizations. N = 484 www.smchealth.org

  19. Most respondents (61.9%) reported that they had a place to go if sick or needed health advice. www.negotiationlawblog.com N = 872

  20. Reasons for Lack of Regular Physician or Dental Visits

  21. Have you ever felt discriminated against by a healthcare provider due to any of the following?

  22. Physical and Mental Health N = 907 & 854, respectively

  23. Calculated versus Self-Reported BMI Classifications N = 865 & 688, respectively

  24. About half of respondents (50.35%) reported participating in physical activity in the past month outside of their job. www.ymcanyc.org N = 850

  25. Availability of Fresh Fruits and Vegetables N = 857

  26. Over a third (36.7%) of respondents had cut the size of their or their family’s meals because there was not enough food. N = 842 www.sodahead.com

  27. About a quarter of respondents (25.4%) said it was difficult for them to eat healthy foods. (N = 839) sathiyam.tv Over a third of respondents (36.0%) said it was difficult for them to exercise.(N = 850) www.thehealthytrucker.net

  28. What makes it Difficult for you to Exercise?

  29. What makes it difficult for you to eat healthy foods?

  30. Prevalence of Chronic Disease

  31. Breast Cancer Screenings

  32. Breast Cancer Screenings * Women over age 40

  33. Colorectal Screenings * All respondents over age 50

  34. Colorectal Screenings * All respondents over age 50

  35. More than two out of five (44.2%) of respondents knew where to go to get an HIV test. N = 877

  36. Tobacco products were currently used by 19.3% of respondents on at least some days. N = 844 jagopunjabjagoindia.com

  37. Of respondents who drank alcohol in the past 30 days, 65.1% had two or more drinks on average on the days they drank and 35.7% had five or more drinks in two hours on one or more days. www.cancercouncil.com.au N = 243 & 249, respectively

  38. Of women with children, 77.2% reported they had initiated breastfeeding, even for a short time. N = 872 (WIC, 2012)

  39. Community Factors • Safety (N = 864) • Safe or Very safe: 62.5% • Empowerment (N = 846) • Empowered or Very empowered: 34.1% • Top sources of health information • Television: 12.9% • Healthcare provider: 12.3% • Family: 12.0% • Friends: 12.0%

  40. Perceived Community Problems

  41. Discussion • Areas of greatest need • Healthcare costs too much for a lot of people • WIC and SNAP utilization could possibly be improved • There is a need for culturally-competent and language-specific healthcare and health resources • Cancer screening rates are very low • Heavy and binge drinking is a problem that needs to be addressed in the community

  42. Survey Limitations • Sampling method • Venues • Word-of-mouth • Over-representation • Survey length • Paper versus electronic • Possible solutions • Dedicated training for survey administrators • Expand recruitment venues • More rigorous data collection and sampling

  43. Recommendations Public Policy Society (cultural values, norms) Community (schools, neighborhoods) Interpersonal (peers, partners, family) Individual (behaviors, knowledge, attitudes)

  44. Thank You! Questions or Comments?

  45. Contact Information Sherry Liao CHW Program Evaluation Intern Chronic disease prevention and health promotion Division of public and behavioral health sliao@health.nv.gov (775) 684-4122 Melanie Flores Community health worker Program manager Chronic disease prevention and health promotion Division of public and behavioral health mflores@health.nv.gov (775) 687-7509 Eliane Fuentes Community health worker Program Coordinator Chronic disease prevention and health promotion Division of public and behavioral health eefuentes@health.nv.gov (775) 684-4083

  46. References • Taveras, E. M., Gillman, M. W., Kleinman, K. P., Rich-Edwards, J. W., & Rifas-Shiman, S. L. (2013). Reducing racial/ethnic disparities in childhood obesity: the role of early life risk factors. JAMA pediatrics, 167(8), 731–8. doi:10.1001/jamapediatrics.2013.85 • Sánchez, V., Cacari Stone, L., Moffett, M. L., Nguyen, P., Muhammad, M., Bruna-Lewis, S., & Urias-Chauvin, R. (2014). Process Evaluation of a Promotora de Salud Intervention for Improving Hypertension Outcomes for Latinos Living in a Rural U.S.-Mexico Border Region. Health promotion practice. doi:10.1177/1524839913516343 • Spanakis, E. K., & Golden, S. H. (2013). Race/ethnic difference in diabetes and diabetic complications. Current diabetes reports, 13(6), 814–23. doi:10.1007/s11892-013-0421-9 • Grossman, C. I., Purcell, D. W., Rotheram-Borus, M. J., & Veniegas, R. (n.d.). Opportunities for HIV combination prevention to reduce racial and ethnic health disparities. The American psychologist, 68(4), 237–46. doi:10.1037/a0032711 • Molina, Y., Thompson, B., Espinoza, N., & Ceballos, R. (2013). Breast cancer interventions serving US-based Latinas: current approaches and directions. Women’s health (London, England), 9(4), 335–48; quiz 349–50. doi:10.2217/whe.13.30

  47. References • Liss, D. T. & Baker, D. W. (2014). Understanding Current Racial/Ethnic Disparities in Colorectal Cancer Screening in the United States: The Contribution of Socioeconomic Status and Access to Care. American Journal of Preventive Medicine, 46(3), 228-236. http://dx.doi.org/10.1016/j.amepre.2013.10.023 • Molina, Y., Thompson, B., Espinoza, N., & Ceballos, R. (2013). Breast cancer interventions serving US-based Latinas: current approaches and directions. Women’s health (London, England), 9(4), 335–48; quiz 349–50. doi:10.2217/whe.13.30 • Livingston, G., Minushkin, S., & Cohn, D. (2009). Hispanics and health care in the United States: access, information, knowledge. Pew Hispanic Center, Robert Wood Johnson Foundation. http://pewhispanic.org/files/reports/91.pdf • Juckett, G. (2013). Caring for Latino patients. American family physician, 87(1), 48–54. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/24326471 • Pew Hispanic Center. (2013). Statistical Portrait of Hispanics in the United States, 2011. http://www.pewhispanic.org/2013/02/15/statistical-portrait-of-hispanics-in-the-united-states-2011/#2

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