Transcript Slide 1

Latina Women’s
Health
Frances Ashe – Goins, RN, MPH
Deputy Director - Office on Women’s Health
U.S. Department of Health and Human Services
(HHS)
Racial/ethnic categories

2000 Census
Race – African American/Black; Hispanic/Latino; Asian
American; American Indian & Alaskan Native; and Native
Hawaiian & Other Pacific Islander
Ethnicity – Hispanic or Latino or Not Hispanic or Latino
Caucasian/White – majority population
(Note – the data in this presentation is not reflected of the new
racial categories)
U.S. Population



307 million people in the US, 2009 estimate
15.8% are of persons of Hispanic or Latino
origin
50.7% are Hispanic/Latina female
Leading Causes of Death
All women
Hispanic American &
Latina Women
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Heart Disease
All cancers
Stroke
Chronic lower
respiratory diseases
Diabetes
Flu & pneumonia
Alzheimer’s disease
Accidents
Kidney Disease
Septicemia
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Heart Disease
All cancers
Stroke
Diabetes
Accidents
Flu & pneumonia
Chronic lower respiratory
diseases
Perinatal conditions
Chronic liver disease &
cirrhosis
Kidney disease
Health Concerns for
Hispanic/Latina Women
Heart disease
•
137.1 per 100,000; 34.4% of Mexican-American
women have cardiovascular disease.
Stroke death rates
•
36.4 per 100,000
Cancer Mortality Rates per 100,000
•
•
Lung – 13.1
Breast –15.8
Health Concern: Heart Disease,
Cancer, and Stroke
Age-Adjusted Death Rate per 100,000 Persons
325
Heart Disease
300.2
300
Cancer
Stroke
275
250
232.3
233.3
228.2
225
200
190.1
188.5
175
173.2
160.2
150
119.3
125
100
75
127.6
113.5
126.6
74.3
53.5
50
51.4
34.6
45.2
40.5
25
0
All Races
White
African
American
American
Asian/Pacific
Indian/Alaska
Islander
Native
Hispanic
Health Concerns cont.
Maternal Mortality rates - 2000
•
9.0 per 100,000 live births
Infant Mortality
•
5.6 per 1,000 live births
Low birth rate (<5.5 pounds)
•
6.4% (Puerto Rican 9.3% and Mexican 6.1%)
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Infant Mortality Rate per 1,000 Live Births
Health Concern: Infant Mortality Rates per
1,000 Live Births
13.5
8.2
6.8
6.7
5.0
0
Age-Adjusted Death Rate per 100,000 Persons
Health Concern: Sudden Infant Death
Syndrome (SIDS) Rates per 1,000
Live Births
150
122.9
124.2
100
55.5
50.4
50
29.3
15.5
0
All Races
Non-Hispanic
White
African
American
American
Asian/Pacific
Indian/Alaska
Islander
Native
Source: National Vital Statistics Report Nov. 7, 2003, 52(9): 69-77
Hispanic
Health Concerns cont.

HIV/AIDS – Hispanic/Latina women accounts
for 24% of new HIV infections among
Hispanic/Latino in 2006.

Diabetes Mellitus Deaths – 6%
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Tuberculosis Rates – 24%
Age-Adjusted Death Rate per 100,000 Persons
Health Concern: Human
Immunodeficiency Virus (HIV) Disease:
U.S., 2004
25
20.4
20
15
10
5
5.3
4.5
2.9
2.3
0.7
0
All Races
White
African
American
American Asian/Pacific
Indian/Alaska Islander
Native
Hispanic
Age-Adjusted Death Rate per 100,000 Persons
Health Concern: Diabetes Mellitus
48.0
50
45
39.2
40
35
32.1
30
25
24.5
22.3
20
16.6
15
10
5
0
All Races
White
African
American
American Asian/Pacific
Indian/Alaska
Islander
Native
Hispanic
Health Concern: Tuberculosis (TB):
U.S., 2001
Age-Adjusted Cases per 100,000 Persons
35
32.7
30
25
20
13.8
15
11.9
11.0
10
5.6
5
1.6
0
All Races
non-Hispanic
White
non-Hispanic
African
American
American
Indain / Alaska
Native (AI/AN)
Asian/Pacific
Islander
Hispanic
Source: CDC Reported Tuberculosis in the U.S., 2001. Atlanta, GA, U.S. Dept. of Health & Human
Services, CDC, September 2002. Table 13.
http://www.cdc.gov/nchstp/tb/surv/surv2001/pdf/T12and13.pdf
Health Concerns Cont.
Mental Health
 Depression – 11% Hispanic/Latina reported
being depressed.
 Suicide – Hispanic/Latina 1.8/100,000
Violence Against Women
 53% Hispanic/Latina and least likely to be raped
Risk Factors – Hispanic
American, Latina women
•
•
•
•
•
•
High rate of obesity
High rates of breast and cervical cancers due to delayed
diagnoses, lack of preventive screenings
Tobacco use high
Alcohol dependence prevalent
30% of Hispanic/Latina women uninsured though many
employed or live with someone who is employed
Further barriers to health care: language barriers, lack of
transportation, immigration status
Obesity Epidemic

Among Mexican American women,
73 percent are overweight or
obese, as compared to only 61.6
percent of the general female
population.1
 In 2003- 2004 Mexican American
children, between the ages 6-11,
were 1.3 times more likely to be
overweight as Non- Hispanic
White Children.
Source: OWH
http://www.4women.gov/minority/hispanicamerican/obesity.cfm
What Is Obesity?
BMI (Body Mass Index) is a measure of body fat based on height and weight. People
with a BMI of 25 to 29.9 are considered overweight. People with a BMI of 30 or more
are considered obese.
What Are The Health Effects of Being
Overweight or Obese?
Being overweight or obese can increase your risk of:
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Heart disease
Stroke
Type 2 diabetes
High blood pressure
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Breathing problems
Arthritis
Gallbladder disease
Some kinds of cancer
Risk Factors for Disease
1999-2000
Physical Inactivity
 57% immigrants over 18 years are sedentary
Tobacco Use
 12.4 %
Alcohol Use
 49% abstained from using alcohol
Illicit Drug Use
 7.2% drug related deaths
Vaccinations and Screenings
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Pneumococcal and Influenza – among adults 65
and older 30.5% Hispanic/Latina reported no
vaccination.
Influenza – 55.6% Hispanic/Latina no
vaccination in the past 12 months
Cervical cancer – 37% Hispanic/Latina not
screened
Screenings cont.
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Breast cancer – women over 40 years 33% of
Hispanic/Latina women had not been screened
in two years.
Blood pressure –26% Hispanic/Latina women
had not been screened in the past 12 months
Definition of Lupus
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Widespread chronic autoimmune disease
Immune system attacks tissue and organs within
the body
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Joints, kidneys, heart, lungs, brain, blood, and/or
skin
Immune system loses ability to distinguish
between itself and foreign tissue
Who has Lupus?
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There are more than 325,000 Americans
diagnosed with Lupus--90% women
Limited awareness and knowledge of Lupus
Disproportionately affects young women of color
(3 times more than whites);
More prevalent during the years of 15 to 45
Symptoms
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Fatigue, fever, pain, stiffness, swelling, redness
Common symptoms – painful swollen joints,
unexplained fever, extreme fatigue, red rash or
color on the face, chest pain with deep
breathing, pale or purple fingers or toes
Additional – mouth sores, headache, depression,
cognitive dysfunction, scalp hair loss, anemia,
kidney disease
Treatments
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There is no cure
Current therapies
Suppress the entire immune system
 Reduction of inflammation
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Medicines can treat symptoms according to
organ involvement and severity of disease
Treatments are based on the individual patient
Barriers to Engagement
“I don’t have Lupus!”
If I don’t acknowledge it then I
won’t get it.
I’m tired, I ache, I have a
migraine…it’s just stress.
Lupus hits minority women
harder and more often?
I don’t believe it!
I’d rather feed my
family than pay for a
doctor’s visit.
Additional Information:
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Lupus Foundation of America.
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American College of Rheumatology.
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Website: http:///www.rheumatology.org
DHHS/Office on Women’s Health
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Website: http://www.lupus.org
Website: http://www.womenshealth.gov
U.S. National Library of Medicine
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Website:
http://www.nlm.nih.gov/medlineplus/lupus.html
Strategies for the Task Ahead
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Initially connect to women on an an emotional
level
Set up information so that the women can
consume and digest information at the
individuals pace
Give information through many platforms and
touch points
Key Components of Successful
Programs for Minority Women
Internalization of Cultural Sensitivity
• Integrate cultural influences & language
preferences of target community
• Where is minority group located and
concentrated?
• Address issues of stigma
• Hold events in accessible facility
• Address racial/ethnic variations associated with
the incidence, prevalence, morbidity and
mortality of health condition/disease
Key Components of Successful
Programs for Minority Women
Recognition that Disease is not an Isolated
Phenomenon
• Address the societal issues (poverty,
welfare, violence, crime) which affect
community health
• Identify and target behaviors that
contribute to increased incidence and
prevalence of health conditions
Key Components of Successful
Programs for Minority Women
Identification of Disparities between groups
in obtaining health care
• What gaps in services exist?
• What services are needed?
• Do different groups need different
prevention efforts?
• Are resources reaching all in the
community?
Key Components of Successful
Programs for Minority Women
Honest and Frequent Evaluations
• Conduct both impact and process evaluations
• Outline clear and timely objectives to show
achievement and improvement over time
• Produce detailed work plans, quarterly reports,
and final reports
• Obtain input from program participants to
determine participant benefit
Key Components of Successful
Programs for Minority Women
Building of partnerships
• Partner with community organizations, local
government agencies, faith-based organizations,
social organizations, educational institutions,
non-profits, sororities, etc.
• Try to partner with groups that can attract as
many women as possible from the target
population
Key Components of Successful
Programs for Minority Women
Staff who Relate to the Target Community
• This includes staff who have grown up in the
community, look like members of the target
community, or speak the same language as the
target community
• Staff must be knowledgeable about health
condition of the program’s focus
• Staff must have ability to communicate in
culturally and individually sensitive manner
Contact information
DHHS-OWH
200 Independence Avenue, SW
Washington, DC 20021
202-690-7650; fax 202-401-4005
www.womenshealth.gov
1-800-994-9662