que sera sera n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Que Sera? Sera? PowerPoint Presentation
Download Presentation
Que Sera? Sera?

Loading in 2 Seconds...

play fullscreen
1 / 88

Que Sera? Sera? - PowerPoint PPT Presentation


  • 148 Views
  • Uploaded on

Que Sera? Sera?. Elizabeth Lee-Rey, MD Luz Towns-Miranda, PhD Hispanic Center of Excellence Albert Einstein College of Medicine. Que Sera? Sera?. OBJECTIVES To obtain an overview of demographic representation of Latinos nationally and locally in NYC and the Bronx.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Que Sera? Sera?' - ulric-harrington


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
que sera sera

Que Sera? Sera?

Elizabeth Lee-Rey, MD

Luz Towns-Miranda, PhD

Hispanic Center of Excellence

Albert Einstein College of Medicine

que sera sera1
Que Sera? Sera?
  • OBJECTIVES
  • To obtain an overview of demographic representation of Latinos nationally and locally in NYC and the Bronx.
  • To gain knowledge regarding key health issues facing Latinos/as.
que sera sera2
Que Sera? Sera?
  • OBJECTIVES
  • To increase awareness regarding significant parameters that impact the health care of Latinos.
  • To gain greater understanding of the differences that distinguish the predominant Latino groups in the Bronx.
name all 11 countries in south america
Peru

Ecuador

Bolivia

Chile

Colombia

Venezuela

the Guyana

Brazil

Uruguay

Paraguay

Argentina

Name all 11 countries in South America.
name all 8 countries in central america
Name all 8 countries in Central America.
  • Panama
  • Costa Rica
  • Guatemala
  • Nicaragua
  • Salvador
  • Honduras
  • Belize
what are the 3 countries of hispanic origin found in the caribbean
What are the 3 countries of Hispanic origin found in the Caribbean?
  • Cuba
  • Dominican Republic
  • Puerto Rico
what are some of the barriers to health care for hispanics
What are some of the barriers to health care for Hispanics?
  • Poverty
  • Less education
  • Unemployment rates
  • Poor access to adequate health care
  • Discrimination
  • Socioeconomic status
  • Lack of health insurance
tortillas are a staple food of which ethnic group
Tortillas are a staple food of which ethnic group?
  • Puerto Ricans
  • Mexicans
  • Salvadorians
  • Dominicans
the largest ethnic parade held in nyc is celebrated by which latino group
The largest ethnic parade held in NYC is celebrated by which Latino group?
  • Mexicans
  • Dominicans
  • Cubans
  • Puerto Ricans
mangu is a breakfast food for which latino group
Mangu is a breakfast food for which Latino group?
  • Mexicans
  • Cubans
  • Puerto Ricans
  • Dominicans
which group is less likely to have a regular physician
Which group is less likely to have a regular physician?
  • Asian Seniors
  • Hispanic Male Adolescents
  • African American Newborns
  • Middle-age Women
minority boys are less likely to have a regular physician
Minority Boys Are Less Likely to Have a Regular Physician

Percent of boys with no regular MD

The Commonwealth Fund Survey of the Health of Adolescent Girls, 1997 Louis Harris and Associates, Inc

who was the first female puerto rican congresswoman
Who was the first female Puerto Rican Congresswoman?
  • Iris Chacon
  • Nydia Velazquez
  • Marife Hernandez
  • Celia Cruz
who was the first nyc dominican councilman
Who was the first NYC Dominican Councilman?
  • Guillermo Linares
  • Victor Marisete
  • Adriano Espaillat
  • Tito Puente
what percentage of latino babies are born into poverty1
What percentage of Latino Babies are born into poverty?
  • ¾ of Latino babies are born into poverty
  • Almost 2/3 of all Latino children live below the poverty line
  • 73% of Hispanic children are living in “distressed neighborhoods.”
hispanic women make up what percentage of the total nyc female population1
Hispanic women make up what percentage of the total NYC female population?
  • Latinas represent 29% of the total female population in NYC
  • Latinas comprise approx. 51% of the Hispanic pop in NYC
  • Their median age is lower than for all other racial and ethnic groups

Source:NYC Depart of Planning

Presentation by NYC Major’s Off of Health Service

latinas nationally are how likely to have diabetes as compared to the general population
Latinas nationally are how likely to have diabetes as compared to the general population
  • As likely
  • Less likely
  • Twice as likely
  • Three times as likely
latinas and diabetes
Latinas and Diabetes
  • While NYC statistics are not available be ethnicity, data from neighborhoods where Hispanics comprise more than 60% of the population indicate that the incidence of DM hospitalizations far exceeds the average.
  • Latinas nationally are twice as likely as the general population to have diabetes.
  • The average incidence of DM hospitalizations in NYC is 7.4 per 1000. In Bushwich, where the Hispanic population is 67%, the rate is 20.8 per 1000.

Presentation by the NYC Mayor’s Office of Health Services

latina s biggest cancer risk is
Latina’s biggest cancer risk is
  • Colon
  • Lung
  • Breast
  • Cervical
cancer facts
Cancer Facts
  • Latinas are somewhat under-represented in the total cancer statistics. This may due to the relatively younger age of Latinas
  • Latina’s biggest cancer risk is Breast Cancer. As a whole, the rate of Latina deaths due to Breast Ca is 1.7 per 100,000. This compares to less than .5 for all other forms of cancer to the reproductive health organs.

Presented by the NYC Mayor’s Office of Health Services

the leading cause of death for hispanic females from birth to 49 is
The leading cause of death for Hispanic females from birth to 49 is
  • Cancer
  • Heart Disease
  • AIDS
  • Diabetes
the leading cause of death for hispanic males age 1 to 59 is
The leading cause of death for Hispanic Males age 1 to 59 is

a) Homicide

b) Heart Disease

c) AIDS

d) Cancer

the leading cause of death for hispanics in nyc
The Leading Cause of Death for Hispanics in NYC
  • In NYC, according to 1995 data, AIDS was the leading cause of death for Hispanic males from ages 1 yr old to 59 yrs old. It was the leading cause of death for Hispanic females from birth to 49 yrs old.

Source: The seventh Annual Hispanic Federation Annual Survey

Hispanic New Yorkers on Nueva York

Report 4:Latinos and HIV/AIDS

who are the uninsured
Who are the Uninsured?
  • Live in families with incomes higher than the federal poverty level.
  • Poor, unemployed and belong to a racial ethnic group.
  • Seniors over the age of 65.
  • Children.
who are the uninsured1
Who Are The Uninsured?
  • Many Americans stereotype the uninsured as poor, unemployed, and minorities. While these groups run a greater risk, they do not represent the majority of Americans without health coverage.
who are the uninsured2
Who Are The Uninsured?

In fact, most of the 44 million uninsured Americans:

  • live in families with incomes higher than federal poverty level.
  • Are from working families with at least one full time worker.
  • Are adults under the age of 65.
  • Work in medium size/large businesses with more than 25 employees.
  • Are not from America’s racial and ethnic minority groups.
what is the distribution of the hispanic nonelderly uninsured when compared by race and ethnicity
What is the distribution of the Hispanic nonelderly uninsured when compared by race and ethnicity?
  • 50%
  • 25%
  • 5%
  • 17%
which group is at most risk of being uninsured
Which group is at most risk of being uninsured?
  • White (non-Hispanic)
  • Black
  • Native American
  • Hispanic
which group is at most risk of being uninsured1
Which group is at most risk of being uninsured?

SOURCE: Hall, Collins, and Glied, 1999

The Commonwealth Fund

Collins, Hall, and Neuhaus, U.S. Minority Health: A Chart Book, 1999

slide47
Which Hispanic group report the worst health status and the highest incidence of acute medical conditions?
  • Colombians
  • Ecuadorians
  • Puerto Ricans
  • Mexicans
slide48
Which Hispanic group report the worst health status and the highest incidence of acute medical conditions ?

Source:Therrien & Ramirez 2000 The Hispanic population in the US:3/2000 US Bureau of Census for Labor Statistics 3/99

slide50
When was the category Hispanics first included in national data systems such as US census and birth/death certificates?
  • 5 years ago
  • In the last 2 decades
  • Never an issue
  • 100 years ago
slide51
What is the projected growth of the Hispanic population of the US population within the next 50 years?
  • Nearly 25%
  • Half
  • No growth anticipated
  • Not significant
projected resident population by race and ethnicity of us 2001 2050
Projected Resident Population by Race and Ethnicity of US 2001- 2050

AFRICAN AMERICAN

HISPANIC

80

% 0 25

Source: Day,J.C. 1996 Population projection for the US by age,sex,race,and Hispanic origin:1995-2050

Source Data for 2005:Population projections program, US census

which group has had the most emerging presence in us population
Which group has had the most emerging presence in US population?
  • Central and South America
  • Puerto Rican
  • Mexican
  • Cuban
characteristics of the hispanic population in the us 2000
Characteristics of the Hispanic Population in the US,2000

Source:Project HOPE Center for Health Affairs-Dec 2000 Current Population Survey

emerging latino populations
Emerging Latino Populations
  • The Latino population is by all accounts growing dramatically and in the year 2000 became the country’s largest “minority” group.
  • Immigration from the Caribbean and South America is making significant contributions to the growth of the Latino population. Relatively new Latino subgroups- Salvadorians, Dominicans, and Mexicans.
  • Between 1980-2000 the size of the Central and South American pop doubled from 7% to 14.5%.
latinos in the united states
Latinos In The United States

Source:Therrien, M.,& Ramirez,RR 2000. The Hispanic Population in the US: March 2000

national origin of latinos in new york city est 2000 census
National Origin of Latinos in New York City: Est 2000 Census

SOURCE: NYC Depart of Planning

Presented by the NYC Mayor’s Office of Health Service

vignette
Vignette
  • You are seeing for the first time a 56 yo Latina woman who comes in because she is “ feeling that her blood pressure is high”. She has a past medical history significant for Diabetes, Hypertension, Hyperlipidemia, and a family history of Breast Cancer. She volunteers to you that she had been listening to a doctor over the Spanish radio who was talking about herbal teas and concoctions (“preparaciones”) for her blood pressure which might be helpful to her symptoms. She is considering ordering a sampler package. She also wants her cholesterol checked because she also feels it is high.
vignette1
Vignette
  • Her 19 yo daughter who comes to the appointment her, reports that she is concerned about a breast lump that her mother found on herself about 3 months ago but had not sought medical attention for it. Patient had last mammogram 3 years ago. Results were not known.
physical exam findings
PHYSICAL EXAM FINDINGS

History offered by patient and daughter.

Exam revealed an Overweight, Hispanic woman who appeared much older than her stated age.

VSS- T98.7 BP 170/100, repeat 168/ 90 HR 70

HEENT- Fundi cotton wool spots noted and changes consistent with HTN retinopathy

PERRLA- fair dentition with upper dentures

Neck- Supple, No neck masses, No bruits noted

Lungs- Mild upper airway rhonchi, no rales or wheezes noted. Adequate inspiratory effort noted

Cor- Distant heart sounds, mild 2/6 systolic ejection murmur at apex.

physical exam findings1
PHYSICAL EXAM FINDINGS

Breast Firm, discrete, irregular 2x4 cm, nontender mass palpated in LUQ Left breast.

Left Axillary node palpated-mildly tender

Abd Obese, nontender with no HSM or masses noted No abd bruits noted

Ext Limited ROM with crepitus of knees noted when getting on and off exam table, 1+ edema with

varicosities bilaterally. Without skin breakdown or fissue

Of evidence of infection. UE arthritic changes noted bilaterally

Neuro Cranial nerves intact. Monofilament testing revealed sensory deficits bilaterally

vignette2
Vignette

Medications: Allergies- NONE

Atenolol 50 mg po qd Tobacco 30 yr/pack

HCTZ 25 mg po qd Quit 10 years ago

Zocor 100mg po qd

Metformin 500mg po qd

ASA 81mg po qd

Premarin 4months/d/c’ed

Una de gato

Shark cartilage

Hoja de Tilo

Hoja de naranja Agria

Flores de Coco Indio

Anis de Estrella

vignette3
Vignette

Questions:

  • What are are some challenges presented to the physician in this encounter?

Given what what you have just learned about Latino health:

  • What are some possible health needs to be addressed with this patient?
  • What are some factors that can facilitate or hinder the doctor-patient relationship to be considered?
  • What issues seem important to this patient?
outcome
Outcome

Patient went for mammogram, which indeed revealed breast mass as palpated by patient and confirmed by MD. Subsequently, needed special views, ultrasound of the area and an excisional biopsy was ordered. Pathology revealed a fibroadenoma. No evidence of malignancy. Annual mammograms with monthly SBE were recommended. Pt with positive family history will require surveillance. Diabetes and Arthritis no active issues. Remain stable and are monitored on following visits.

outcome1
Outcome

After several visits patient revealed that she had believed that a mass found in her breast meant cancer and that meant death. It was in” la manos de dios” and so had not needed attention. Patient had met with the local cuidrandero and had been going for banos. Patient starts to come to her visits unaccompanied by daughter. Daughter schedules appointment with provider.

to feel heard and understood is perhaps the most precious gift of life

“To Feel Heard and Understood is Perhaps the Most Precious Gift of Life”

Arthur Frank,

Just Listening,1988

which latino group has the highest rate of poverty
Which Latino group has the highest rate of poverty?
  • Salvadorians
  • Mexicans
  • Ecuadorians
  • Puerto Ricans
who was the first puerto rican congressman
Who was the first Puerto Rican Congressman?
  • Ramon Velez
  • Bobby Garcia
  • Herman Badillo
  • Luis Munoz Marin
thanks to
Thanks to:

Technical Support

  • Carol Whitaker
  • Maria Pasa
  • Wilma Burgos
  • Taneka Banks