Health Issues for Latino Immigrants - PowerPoint PPT Presentation

Health Issues for

Latino Immigrants

* Source: US Census Bureau

* Source: US Census Bureau

Hispanic Breakdown by EthnicityMecklenburg County 2000 Census Data

• 20 years ago, demographers predicted that the US population would flatten
• Demographic projection revised due to
• Age of immigrants
• Fertility indicators
• Foreign born Hispanic = 112.3 live births per 1,000 women
• US born non-Hispanic = 59.9 live births per 1,000 women

Source: James H. Johnson, Jr., UNC Chapel Hill, 2003

• 37% of Latinos are uninsured in the U.S.
• 54% of all Latino adults in North Carolina are uninsured, compared to 11% Non-Latino Whites, and 22% African Americans.
• Latinos are more likely to work for employers who do not provide health care coverage, and Latinos are less likely to qualify for federally and state-funded insurance.

Source: NC Latino Health, 2003

• Mecklenburg County Health Department – 17,500 Latino patients
• 16,620 Latino patients have a medical home
• CMC Clinics – 15,000 Latino patients
• CW Williams Community Health Center – 820 Latino patients
• Physicians Reach Out – 350 Latino patients
• Charlotte Community Health Clinic – 450 Latino patients

Public Health DepartmentHispanics as a % of Total Patients

* Source: Mecklenburg County Health Dept.

CMC Ambulatory Care Clinics Hispanic/Latino Primary Care Growth

CMC North Park, CMC Myers Park, CMC Biddle Point & CMC Eastland

* Source: Carolinas HealthCare System

CMC Ambulatory Care DivisionVolume of Spanish Speaking Patients

61,000 visits provided to Spanish speaking patients in the CMC Ambulatory Care Division in 2005

• 34,000 visits at CMC NorthPark
• 11,000 visits at CMC Myers Park Pediatrics
• 11,500 visits at CMC Myers Park OB Gyn
• 2,000 visits at CMC Myers Park Orthopaedics & Surgery
• 1,000 visits at CMC Myers Park Internal Medicine
• 1,000 visits at CMC Biddle Point
• 500 visits at CMC Eastland

CMC Ambulatory Care Clinics Hispanic/Latino Primary Care Growth

* Source: Carolinas HealthCare System

Sliding Scale

Ambulatory Clinics

30% of patients seen in the CMC clinics are Hispanic.

11% of the patients on sliding scale are Hispanic.

Many Hispanic/Latinos do not qualify for Governmental (Federal, State or County) programs.

• For non-bilingual staff, caring for a Spanish speaking patient takes 17.65% longer than caring for an English speaking patient.
• Compensating a bilingual staff member is 9 times more cost effective than paying an internal interpreter and 30 times more cost effective than paying an outside agency interpreter.
• 33% of the employees at CMC NorthPark and 25% of the employees at CMC Myers Park are bilingual.

The CMC Clinics employ 11 interpreters at an annual cost of $440,000

Bilingual staff provided an additional 15,500 hours of interpretation at a cost of $23,000 above base pay

Mecklenburg County HD

MCHD employs 6 full-time interpreters at an annual cost of $300,000

Bilingual staff are paid an additional $25,000 above base pay for their bilingual skills

• Bilingual Incentive Pay Program: per hour compensation incentive for time staff spend using their language skill
• Bilingual Referral Bonus: referral bonus for CHS employees who refer a bilingual new hire to high need areas
• Advertising Campaign: culturally appropriate advertisement to recruit bilingual staff placed in Charlotte Observer and La Noticia

• All interpreters & bilingual staff must pass competency test
• Bilingual staff and interpreters on site in areas where > 5% or population speaks Spanish; on-call in other areas
• Bilingual English / Spanish signage & telephone prompts
• Patient information brochures and education materials widely available in Spanish
• Prescription bottles printed in Spanish. CMC Outpatient Pharmacies filled 75,000 prescriptions in Spanish in 2005.
• Spanish and bilingual books given to children at their well child checks (Reach Out and Read Program)
• In 2003 and 2005, CMC participated in the Latino Health Coalition’s immersion experience to Mexico
• Physician continuing education on Cultural Competency for care of Latinos
• AHEC classes on “Spanish for the Healthcare Provider”

Some Latino Health Issues

• Mexican Paradox: Generally healthy, but worsen as acculturate
• In US, highest prevalence of childhood dental caries (43%)(Healthy people 2010)
• In US, higher rates of diabetes than average (66/1000) (1999 NC OMHHD/SCHS)
• In NC, highest prevalence of childhood obesity (17%) (2003 NC OMHHD/SCHS)
• In NC, increasing rates of STDs
• Chlamydia (+478% from 1991-1995) (1999 NC OMHHD/SCHS)

• Hispanics are twice as likely as African Americans to receive no 1st trimester prenatal care.
• Hispanics rates of prematurity and low birth weight, however, are significantly lower.
• Early prenatal care does not have a strong, independent correlation with birth outcomes or infant mortality.

*Mecklenburg County Residents, 2004

Selected Characteristic Hispanic % Total %

< 12 yrs education 57.7 16.2 (lower education level)

1st trimester care 80.1 89.4 (less early prenatal care)

No Care 1.9 1.1 (more w/ no care)

Adequate Care 77.0 86.0 (more with inadequate care)

Outcomes Hispanic % Total %

Low birth weight 5.8 9.3 (fewer low birth weight)

< 37 weeks gestation 6.8 11.5 (fewer premature babies)

• Understanding of important Latino Cultural Beliefs
• Use of Folk Medicine
• Inability to pay for medical care
• Lack of interpreter services
• Lack of knowledge of available resources