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Healthiest Wisconsin 2020 Baseline and Health Disparities Report Hispanics/Latinos. Chapter outline. Chapter Outline. Background Overview of Healthiest Wisconsin 2020 Baseline and Health Disparities Report Key points Data Demographic and socioeconomic data

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chapter outline

Chapter outline

Chapter Outline

Background

  • Overview of Healthiest Wisconsin 2020 Baseline and Health Disparities Report
  • Key points

Data

  • Demographic and socioeconomic data
  • Access to and use of health care services
  • Risk behaviors and health outcomes

References

Links to additional reports and resources

Contacts

report overview

Report overview

Report Overview

This chapter is part of a larger report created by the Wisconsin Department of Health Services to track the progress on objectives of Healthiest Wisconsin 2020 (HW2020) and identify health disparities in the state. The full report is available at: http://www.dhs.wisconsin.gov/publications/P0/p00522.pdf

The report is designed to address the Health Focus Areas in HW2020. Where direct measures exist, data are presented; where direct measures are not available, related information may be included.

Information about populations experiencing health disparities is provided in the Health Focus Area chapters and is summarized in separate chapters devoted to specific populations.

Technical notes are available at: http://www.dhs.wisconsin.gov/publications/P0/p00522y.pdf

report format

Report overview

Report Format

Sample annotated slide

Full Report

  • Format: PDF
  • Intended use: reference document

Chapters

  • Format: Annotated PowerPoint slide set
  • Intended uses: presentations to
    • Decision-makers
    • Service providers
    • Community leaders
    • The public
report outline

Report overview

Report Outline

Executive Summary

Section 1: Introduction

Section 2: Demographic overview

Section 3: Health focus areas

Section 4: Infrastructure focus areas

Section 5: Data summaries by population

Section 6: Technical notes

report outline detail

Report overview

Report Outline: Detail

Section 3: Health focus areas

Section 4: Infrastructure focus areas

report outline detail1

Report overview

Report Outline: Detail

Section 5: Data summaries by population

data notes

Report overview

Data notes

Please refer to the Technical Notes chapter for a more detailed description of limitations and methods: http://www.dhs.wisconsin.gov/publications/P0/p00522y.pdf

The 95% confidence intervals are denoted by error bars. Where

confidence intervals do not overlap, as shown in the example on

the right, differences are statistically significant. Larger confidence

intervals may indicate less reliable estimates that should be

interpreted with caution.

Population estimates that are considered unreliable are excluded.

Misclassification of racial/ethnic groups may affect the accuracy of rates.

Unless otherwise indicated, the Hispanic population may include people of various races; Whites, Blacks, Asians, and American Indians are non-Hispanic.

factors that influence health

Report overview

Factors that influence health

Social determinants of health

Source: University of Wisconsin Population Health Institute. County Health Rankings 2013, http://www.countyhealthrankings.org/our-approach

historical trauma

Report overview

Historical trauma
  • Historical trauma is the cumulative exposure to traumatic events that not only affect the individual exposed, but continue to affect subsequent generations.
  • Descendants of those who experienced the traumatic stressor may still exhibit symptoms.
  • Populations affected by historical trauma include American Indians, African Americans/Blacks, Hispanics/Latinos, Asians, immigrants and refugees, war veterans, and families experiencing intergenerational poverty.
  • Current manifestations may include:
    • Mistrust of health care, legal, and educational systems;
    • Higher rates of risk behaviors such as alcohol and drug abuse, suicide, homicide, and domestic violence; and
    • Higher rates of chronic diseases.
  • Sources: SAMHSA, Fact Sheet: Historical Trauma http://gainscenter.samhsa.gov/cms-assets/documents/93078-842830.historical-trauma.pdf,

Texas Department of Health Services, Trauma Informed Care Training, http://www.dfps.state.tx.us/Training/Trauma_Informed_Care/page35.asp

key points hispanic latino population

Key points

Key Points: Hispanic/Latino population
  • Demographics: The Hispanic/Latino population in Wisconsin is younger than the general population, widely distributed geographically, and growing.
  • Socioeconomic status: Hispanics in Wisconsin are more likely to live in poverty and less likely to have a college degree compared to non-Hispanic Whites.
  • Access to health care: Hispanics have less access to health care compared to other racial/ethnic groups.
key points hispanic latino populatio n

Key points

Key Points: Hispanic/Latino population
  • Key health issues for Hispanic adults include: consequences of lack of exercise, obesity, high blood pressure, diabetes, unintended pregnancies, lack of emotional support, and (among Hispanic men) alcohol and tobacco use.
  • Better data on Hispanics are needed due to small sample sizes, racial/ethnic misclassification, data access issues, and differences between foreign- and U.S. born- Hispanics.
demographic characteristics

Demographic and socioeconomic data

Demographic characteristics

Wisconsin’s Hispanic/Latino population is increasing in numbers, young, and diverse in terms of country of origin. Nearly one-third are foreign born.

  • Wisconsin\'s Hispanic population, 2010: 336,056; 5.9%of state total
  • Change in the Hispanic population, 2000 to 2010: 73%increase
  • Median age, 2010: Hispanic, 23years (Whites, 41.5 years)

The median age is the age at which half the population is older and half is younger.

  • Percent of Hispanics who were foreign-born, 2010: 32% (Total population, 4%)

Sources: http://www.dhs.wisconsin.gov/health/MinorityHealth/Report.htm and U.S. Census Bureau.

socioeconomic data

Demographic and socioeconomic data

Socioeconomic data

Wisconsin’s Hispanic population has a higher poverty rate and less education compared to Whites.

  • Median household income in Wisconsin, 2008-2010: Hispanics, $36,800 (Whites, $53,000)
  • Poverty rate, 2010: Hispanics, 28%(Whites, 10%)

The poverty rate is the percent living below the federal poverty level.

  • Bachelor’s degree or more education (age 25 and older), 2007-2010: Hispanics, 11%(Whites, 27%)
  • Married-couple households as a percent of family households, 2008-2010: Hispanics: 61% (other racial/ethnic groups range from Blacks, 33% to Whites, 82%)

Source: http://www.dhs.wisconsin.gov/health/MinorityHealth/Report.htm and U.S. Census Bureau, American Community Health Survey.

level of urbanization of wisconsin residents by race ethnicity 2007 2011

Demographic and socioeconomic data

Level of urbanization of Wisconsin residents, by race/ethnicity, 2007-2011

Source: American Community Survey, 2007-2011.

.

slide20

Access to health care

Lack of health insurance coverage and Medicaid enrollment among Wisconsin adults, by race/ethnicity, 2008-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.

Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

slide21

Access to heath care

Public health insurance coverage and inadequacy of health insurance among children ages 6-17, by race/ethnicity, Wisconsin, 2011-2012

Source: 2011-2012 National Survey of Children\'s Health.

Note: Wisconsin estimates were only available for White, Black, and Hispanic children.

slide22

Access to health care

Age-adjusted rates of use of and barriers to health care among Wisconsin adults, by race/ethnicity, 2008-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.

Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

slide23

Oral Health

Age-adjusted rates of tooth removal and dental visits in the past year among Wisconsin adults, by race/ethnicity, 2008-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.

Note: Tooth removal question asked in 2008, 2010, and 2011. Dentist visit question asked in 2008 and 2010.

slide24

Access to health care

Lack of routine preventive medical and dental care among children, by race/ethnicity, Wisconsin, 2011-2012

Source: 2011-2012 National Survey of Children\'s Health.

Note: Wisconsin estimates were only available for White, Black, and Hispanic children.

age adjusted indicators of poor health status among wisconsin adults by race ethnicity 2008 2011

Physical health

Age-adjusted indicators of poor health status among Wisconsin adults by race/ethnicity, 2008-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.

Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

age adjusted rate of physical inactivity among wisconsin adults by race ethnicity 2008 2011

Physical Activity

Age-adjusted rate of physical inactivity among Wisconsin adults, by race/ethnicity, 2008-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.

obesity among children ages 2 4 years enrolled in wic by race ethnicity wisconsin 2001 and 2010

Nutrition

Obesity among children (ages 2-4 years) enrolled in WIC, by race/ethnicity, Wisconsin, 2001 and 2010

Source: Centers for Disease Control and Prevention (CDC) Pediatric Nutrition Surveillance Survey, 2010.

Note: Based on >= 95th growth chart percentiles for Body Mass Index for age. WIC is the Supplemental Nutrition Program for Women, Infants, and Children.

age adjusted rate of frequent mental distress among wisconsin adults by race ethnicity 2009 2011

Mental health

Age-adjusted rate of frequent mental distress among Wisconsin adults, by race/ethnicity, 2009-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.

Note: Question asked in 2009-2011. Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

slide30

Mental health

Age-adjusted rate of insufficient sleep and rate of poor emotional support among Wisconsin adults, by race/ethnicity, 2008-2010

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.

Note: Questions were not asked in 2011. Rates of insufficient sleep are age-adjusted; rates of poor emotional support are not age-adjusted. Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

age adjusted rate of smoking among wisconsin adults by race ethnicity 2008 2011

Tobacco use and exposure

Age-adjusted rate of smoking among Wisconsin adults, by race/ethnicity, 2008-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.

Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

unintended pregnancy as a percent of births by race ethnicity wisconsin 2009 2011

Healthy growth and development

Unintended pregnancy as a percent of births, by race/ethnicity, Wisconsin, 2009-2011

Source: Wisconsin Department of Health Services, Division of Public Health, PRAMS, 2009-2011.

slide34

Chronic diseases

Age-adjusted rates of high cholesterol and high blood pressure among Wisconsin adults, by race/ethnicity, 2009 and 2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.

Note: Questions only asked in 2009 and 2011.Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

age adjusted rates of diabetes and prediabetes among wisconsin adults by race ethnicity 2008 2011

Chronic diseases

Age-adjusted rates of diabetes and prediabetes among Wisconsin adults, by race/ethnicity, 2008-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.

Note: Diabetes excludes women who were diagnosed during pregnancy, and does not differentiate between type 1 and type 2 diabetes. Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

slide36

Chronic diseases

Hospitalizations due to long-term complications from diabetes among Wisconsin adults, age-adjusted rate per 10,000, by race/ethnicity, 2010

Source: Wisconsin Inpatient Hospitalization Discharges, 2010.

Note: Hospitalization rates considered unreliable are excluded.

slide37

Chronic diseases

Incidence of end-stage renal disease incidence among Wisconsin adults, by race/ethnicity, age-adjusted rate per 100,000, 2009

Source: United States Renal Data System (USRDS), Renal Data Extraction and Referencing (RenDER) System.

Note: Incidence rates considered unreliable are excluded.

reported cases of hiv ages 15 59 by race and ethnicity rate per 100 000 wisconsin 2007 2011

Reproductive and sexual health

Reported cases of HIV (ages 15-59) by race and ethnicity, rate per 100,000, Wisconsin, 2007-2011

Source: Wisconsin HIV Surveillance System.

Note: Hispanic population may include individuals of various races.

references

References

References

Overview of Race and Hispanic Origin: 2010, 2010. Census Briefs, March 2011. http://www.census.gov/prod/cen2010/briefs/c2010br-02.pdf

University of Wisconsin Population Health Institute. County Health Rankings, 2013. http://www.countyhealthrankings.org/our-approach

Center for Urban Population Health. Milwaukee Health Report, 2011. http://www.cuph.org/mhr/2011-milwaukee-health-report.pdf

LaVeistTA, Gaskin DA, Richard P (2009). The Economic Burden of Health Inequalities in the United States. Joint Center for Political and Economic Studies. http://www.jointcenter.org/sites/default/files/upload/research/files/The%20Economic%20Burden%20of%20Health%20Inequalities%20in%20the%20United%20States.pdf

Thomas JC, Sage M, Dillenberg J, Guillory VJ (2002). A Code of Ethics for Public Health. Am Journal of Public Health. 92(7):1057–1059. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447186/

Wisconsin Department of Health Services (DHS). Healthiest Wisconsin 2020. http://www.dhs.wisconsin.gov/publications/P0/P00187.pdf

Centers for Disease Control and Prevention (CDC). Health Care: See Why Being Insured Matters. http://www.cdc.gov/features/vitalsigns/HealthcareAccess/

Cheung PT, Wiler JL, Lowe RA, GindeAA (2012). National Study of Barriers to Timely Primary Care and Emergency Department Utilization Among Medicaid Beneficiaries. Annals of Emergency Medicine. 60(1). http://www.annemergmed.com/webfiles/images/journals/ymem/FA-PTCheung.pdf

slide40

References

  • Kaiser Commission on Medicaid and the Uninsured. Next Steps in Covering Uninsured Children. Findings from the Kaiser Survey of Children’s Health Coverage. http://kaiserfamilyfoundation.files.wordpress.com/2013/01/7844.pdf
  • CDC. Regular Check-Ups Are Important. http://www.cdc.gov/family/checkup/
  • American Dental Association. American Dental Association Statement on Regular Dental Visits. http://www.ada.org/8700.aspx
  • CDC: Physical Activity. http://www.cdc.gov/physicalactivity/everyone/guidelines/index.html
  • CDC. Obesity Prevalence Among Low-Income, Preschool-Aged Children - United States, 1998-2008. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5828a1.htm
  • CDC. Self-Reported Frequent Mental Distress Among Adults --- United States, 1993—2001. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5341a1.htm
  • CDC. Insufficient sleep is a public health epidemic. http://www.cdc.gov/features/dssleep/
  • CDC. Health-related quality of life: Well-being concepts. http://www.cdc.gov/hrqol/wellbeing.htm#four
  • CDC. PNSS Health Indicators. http://www.cdc.gov/pednss/what_is/pnss_health_indicators.htm#Smoking/Drinking Indicators
slide41

References

  • CDC. Unintended Pregnancy Prevention. http://www.cdc.gov/reproductivehealth/UnintendedPregnancy/
  • CDC. Cholesterol. http://www.cdc.gov/cholesterol/
  • CDC. High Blood Pressure Facts. http://www.cdc.gov/bloodpressure/facts.htm
  • CDC. National diabetes fact sheet: National estimates and general information on diabetes and prediabetes in the United States, 2011. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf
  • Agency for Healthcare Research and Quality. Diabetes mellitus: hospital admission rate for long-term complications. http://www.qualitymeasures.ahrq.gov/content.aspx?id=38559
  • National Institute of Diabetes and Digestive and Kidney Disease. National Diabetes Statistics, 2011. http://diabetes.niddk.nih.gov/dm/pubs/statistics/
  • Ward MM, et al. Access to care and the incidence of end-stage renal disease due to diabetes. http://care.diabetesjournals.org/content/32/6/1032.full.pdf+html
  • CDC. Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5514a1.htm
links to additional reports and resources

Links

Links to additional reports and resources
  • Centers for Disease Control and Prevention, Minority Health, Hispanic or Latino Populations: http://www.cdc.gov/minorityhealth/populations/REMP/hispanic.html
  • Centers for Disease Control and Prevention, Immigrant and Refugee Health: http://www.cdc.gov/immigrantrefugeehealth/
  • U.S. Department of Health and Human Services, Office of Minority Health, Hispanics/Latinos: http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlID=33
  • American Diabetes Association: Información en Español: http://www.diabetes.org/espanol/
  • The National Women’s Health Information Center (en Español): http://es.bodylogicmd.com/enlaces/the-national-womens-health-information-center
  • National Alliance for Hispanic Health: http://www.hispanichealth.org/
  • National Council of La Raza: http://www.nclr.org/
contacts

Contacts

Contacts

Evelyn Cruz, Minority Health Officer

Wisconsin Division of Public Health, Office of Policy and Practice Alignment

E-mail: [email protected]

Karl Pearson, Demographer

Wisconsin Division of Public Health, Office of Health Informatics

E-mail: [email protected]

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