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Healthcare Disparities for Hispanic Immigrants: Challenges and Solutions in North Carolina

Explore the impact of population changes on Latino immigrants in North Carolina, focusing on health issues, insurance disparities, and patient care. The data reveals the need for tailored healthcare solutions to address the unique needs of Hispanic communities.

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Healthcare Disparities for Hispanic Immigrants: Challenges and Solutions in North Carolina

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  1. Health Issues for Latino Immigrants

  2. Net Population Change in North Carolina by Race and Hispanic or Latino Origin, 1990-2004* Census Data * Source: US Census Bureau

  3. Mecklenburg County, 1990 – 2004* Census Data * Source: US Census Bureau

  4. Hispanic Breakdown by EthnicityMecklenburg County 2000 Census Data

  5. “The Browning of America” • 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

  6. America’s Color Adjustment Source: James H. Johnson, Jr., UNC Chapel Hill, 2003

  7. Uninsured Population by Race / Ethnicity in US

  8. Insurance Status of Latinos in the United States • 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

  9. Unique Hispanic / Latino Patients 2005 • 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

  10. Patients by Race / EthnicityMecklenburg County Health Department 2005

  11. Public Health DepartmentHispanics as a % of Total Patients * Source: Mecklenburg County Health Dept.

  12. Patients by Race / EthnicityCMC Ambulatory Clinics - 2005

  13. CMC Ambulatory Care Clinics Hispanic/Latino Primary Care Growth CMC North Park, CMC Myers Park, CMC Biddle Point & CMC Eastland * Source: Carolinas HealthCare System

  14. 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

  15. CMC Ambulatory Care Clinics Hispanic/Latino Primary Care Growth * Source: Carolinas HealthCare System

  16. 41% Increase in CMC NorthPark Visits

  17. 40% Growth in OB Visits at all CMC Clinics

  18. 41% Growth in Pediatric Visits at all CMC Clinics

  19. Patients by Race / Ethnicity on CMC Sliding Scale vs Total Clinic Population - 2005 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.

  20. Importance of Bilingual Staff • 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.

  21. CMC Clinics 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 Non-English Speaking Patients

  22. CMC Initiatives to recruit Bilingual Staff • 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

  23. CMC Initiatives to Meet the Needs of Spanish Speaking Patients • 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”

  24. 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)

  25. 1st Trimester Prenatal Care & Outcomes • 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

  26. Hispanic Birth Indicators 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)

  27. Barriers to Health Care • 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

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