REDUCING HEALTH INEQUITIES THROUGH THE IMPROVEMENT OF BIRTH OUTCOMES 9/13/2004
PRESENTOR SHIRLEY SHELTON CALIFORNIA BLACK INFANT HEALTH PROGRAM COORDINATOR
INSIGHTS CRITICAL KNOWLEDGE
PROGRESS w Life has improved for most racial and ethnic groups in California over the last 30 years, but not for all or on all dimensions. w Despite real progress in social, political, and economic equity, deep disparities persist. w On the whole, Whites and Asians are healthier, more educated, economically better off, and less likely to be victims of violent crime than AA’s and Hispanics.
POPULATION w California = 34 million people w California’s population is one of the world’s most diverse. n n n 50. 0% Female 50. 3% non-Hispanic 30. 8% Hispanic 11. 5% Asian and P/I 6. 8% African-American 0. 6% American Indian
EDUCATION w The education gap between AA’s and Whites diminishing. w College initiation and completion rates remain lower for AA’s than for Whites. w U. S. born Hispanics have lower high school and college completion rates than do AA’s, Asians, and Whites.
ECONOMIC STATUS w Asian and White family incomes are substantially higher than those for AA’s and Hispanics. Lower income translates into higher poverty and public assistance rates for AA’s and Hispanics.
CRIME w African-Americans in California continue to experience the highest risk of arrest and incarcerations. African-Americans are also more likely than others to be victims of violence. w African-Americans along with Hispanics are more likely to be killed than Whites.
POVERTY w Poverty w Wealth w The pursuit of Happiness
HEALTH STATUS w Chronic health conditions increase with age. w African-Americans fare worse than other racial and ethnic groups in California. w Life expectancy for White males and females was 74 and 80 years respectively; 79 and 86 years for Hispanic; 80 and 86 years for Asian/Pacific Islander, and 67 and 74 years for Black males and females respectively.
HEALTH STATUS CONT. w Life expectancy is related to family income and having the means to adequately provide for and respond to the needs of the household. w People with lower income die younger. w Children from higher income families are more likely to have health insurance coverage.
PROBLEM STATEMENT w It’s a familiar but a disheartening story. Black women are not well and die younger and faster than their peers. w Likewise, African-American babies are twice or more likely to die during infancy as other babies. w African-American women experience the highest level of maternal mortality.
TROUBLING TRENDS w Obesity a nationwide epidemic with disproportionate rates in the African. American community. w Diabetes, the sixth leading cause of death and constitutes over 18 million cases in American and 2 million in California. w HIV/AIDS
TROUBLING TREND (cont. ) w Preventive Health Behaviors/Poor Health Practices n n n Mammography Pap Smear General Health Check-up
BARRIERS w Acknowledge and address barriers n Barriers include more than lack of coverage l l l l l Making end meet/survival (priorities) Different realities (the press of family issues) Transportation and child care Transience Lack of support (lack of partner or family support) Lack of knowledge/awareness of symptoms Trust Cultural inefficiencies (lack of reflective/like personnel and differential treatment) Discrimination
PATHWAYS w Initial steps n n n Recognition Understanding Throne abandonment Seek real partnership w/target community Respect, Value, & Honor
PATHWAYS CONT. w Cultural Advisors expertise (what’s their thinking, what do they know that you need to know, what would they do) w Standardized state-of-the-art strategies n n Community awareness Linkage to appropriate and quality services Follow-up Other interventions l (Social Support/Empowerment, Role of Men) w Assessment/Evaluation/Re-evaluation w Cultural Advisors buy-in
PROGRAM IMPROVEMENTS w Political/public will w Cultural and professional competence w Committed resources w Standardized strategies w Stabilized time investment w 33 percent infant mortality decline
EQUITY w Respect, Value, and honor is vital! n n Willing! Doing!! Going!!! Acting!!!!
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