Multicultural Health Summit December 2006

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Multicultural Health SummitDecember 2006

• The Facts
• Diabetes Cardiovascular Disease

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Multicultural Health Summit

• Disparities in healthcare
• Cultural competency
• Statistical Data
• Conclusion

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Disparities in Healthcare

• Definition
• Significant differences between one population
  and another
• Difference in the overall rate of disease
  incidents, prevalence, morbidity,mortality or
  survival rates.

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Disparities in Healthcare

• Who is affected?
• Persons of racial and ethnic minorities,
  residents of rural areas, women, children,
  elderly and persons with disabilities

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Cultural Competency

• Cultural and linguistic competence is a set of
  congruent behaviors, attitudes and policies that
  come together in a system, agency or among
  professionals that enables effective work in
  cross-cultural situations.

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Cultural Competency

• How might disparities in healthcare be addressed?
• A family physicians practical guide to
  Culturally Competent Care
• Cultural, language services and organizational
  issues using case studies and real feedback from
  providers in health care settings.
• Designed to equip family physicians with
  awareness, knowledge and skills to better treat
  the increasingly diverse U.S. population.
• http//cccm/thinkculturalhealth.org

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Culture and Language May Influence

• Health, healing and wellness belief systems
• How illness, disease and their causes are
  perceived both by the patient and caregiver
• The behaviors of patients and the delivery of
  services by providers who look at the world
  through his/her own set of values, which can
  compromise access or patient from other cultures.

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Statistical DataThe Good, The Bad, The Ugly

• Total prevalence of people with diabetes aged 20
  or older (2005)
• 9.6 of all people 20 or older
• 20.9 of all people 60 or older
• Men 10.5 of all men 20 or older
• Women 8.8 of all women 20 or older

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Total Prevalence by Race/Ethnicity age 20 or Older

• Non-Hispanic Whites 8.7
• Hispanic/Latino Americans 9.5
• Native American/Alaskan Native 12.8
• Non-Hispanic Blacks 13.3
• Asian Americans/Pacific Islanders numbers not
  available.

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Heart Disease Stroke

• Accounts for 65 of deaths in people with
  diabetes
• Death rates 2-4 times higher if you have diabetes
• Stroke risk is 2-4 times higher if you have
  diabetes

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Hypertension

• 73 of adults with diabetes have blood pressure
  greater than 130/80 or
• use prescription drugs for hypertension

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More Statistics

• Diabetes is the leading cause of new cases of
  blindness among adults 20 74 years.
• Gum disease is more common with diabetes Double
  risk for gum disease with diabetes
• 1/3 of people with diabetes have severe gum
  disease.

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More Statistics

• Poorly controlled diabetes before conception and
  during first trimester can cause major birth
  defects in 5 - 10 of pregnancies and
  spontaneous abortion in 15-20.
• Poorly controlled diabetes during 2nd - 3rd
  trimester can result in excessively large babies,
  posing a risk for both mother and child.
• These statistics may become more prevalent as
  younger women are diagnosed with diabetes

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More Statistics

• Diabetes is the leading cause of kidney failure
  (44 of new cases in 2002).
• 60 70 of people with diabetes have mild to
  severe forms of nervous system damage
• Impaired sensation or pain (hands or feet)
• Decreased digestion
• Carpal tunnel syndrome

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More Statistics

• Diabetics account for 60 of lower limb
  amputations
• Uncontrolled diabetes can lead to diabetic
  ketoacidosis and hyperosmolar (non-ketotic) coma
• Diabetics are more susceptible to many other
  illnesses often with a worse prognosis than
  non-diabetics.

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More Statistics

• Blood pressure control reduces the risk of heart
  disease and stroke among persons with diabetes by
  33 to 50
• Blood pressure control reduces the risk of micro
  vascular complications (eye, kidney, nerve
  disease) by approx. 33
• Control of cholesterol (HDL, LDL, triglycerides)
  can reduce cardiovascular complications by
  20 - 50
• Blood pressure control and cholesterol control
  can help control the complications of diabetes!

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Deaths Among People With Diabetes (2002)

• 73,249 death certificates showing diabetes as
  cause of death
• 224,092 deaths with diabetes as a causative
  factor
• 10-15 of death certificates may show diabetes as
  an underlying cause of death

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More Statistics

• Estimated diabetes costs in the U.S. 2002
• Total Cost 132 billion
• Direct Cost 92 billion
• Indirect Cost 40 billion (disability, work
  loss,
• premature mortality).

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The Good

• There are patients who are committed to becoming
  proactive about their health
• Healthcare providers committed to cultural
  competency
• Individuals in this room dedicated to being
  change agents in the changing face of healthcare
  in the U.S.

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ConclusionTo Do List (all in a days work!)

• Eliminate disparities in healthcare
• Empower the disempowered patient
• Patients must educate their healthcare providers
  about what is important to them
• Create ways to initiate cultural competency
• HMOs, PPOs, etc.
• Begin in medical and nursing schools
• Private practice

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TO DO LIST (continued)

• Call our healthcare system into accountability
  regarding the shameful disparities
• Be the squeaky wheel
• Tell everyone about the option of cultural
  competency training
• Be the change that you want to see happening
• Expect Change

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THANK YOU