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Health Issues Brief
Minority Health Summit includes local partners and John Agwunobi, M.D.

August 2002

As a local coalition continues its work on eliminating health disparities, Florida Secretary of Health John Agwunobi, M.D., will be the keynote speaker at a community Minority Health Summit to be held August 22 in Orlando.

The Summit has evolved from the efforts of a local collaboration which recognizes that - in spite of great advances in the nation's health status - race, gender and economic status continue to directly influence people's health status in central Florida and across the nation. The group also knows that central Florida already has an extremely diverse population - with major growth continuing over the next several years.

Defining Health Disparities

An Institute of Medicine (IOM) study released in March 2002 showed that racial and ethnic populations have higher death rates from cancer, heart disease, diabetes and HIV infection. The IOM study also suggested that minorities continue to receive lower quality health care and fewer diagnostic tests and services - even when their income, insurance and medical conditions are the same.

In central Florida, a 1999 Community Health Assessment* showed that that there are high incidences and death rates from diabetes, tuberculosis, depression, HIV and AIDs among African-Americans and Hispanics versus white populations. Another critical finding of the study is how barriers such as cost, poor transportation, lack of insurance, physician and appointment availability as well as inconvenient office hours affect low-income and minority residents.

Both studies reinforce the 100% Access, 0% Disparity campaign initiated by the federal Health Resources & Services Administration (HRSA). "HRSA" believes that eliminating the disproportionate burden of ill health among racial and ethnic populations would not only enhance health and life expectancy, but also reduce the costs of treating chronic diseases. Health disparities are defined as population-specific differences in disease, health outcomes or access to care. They present in several categories:

• Only 7% African-American and 2% of Hispanic children are prescribed routine asthma medications - vs. 21% of white children.
• College-educated African-American women have more low-birthweight babies than white teenagers.
• 10.2% of Hispanics have diabetes - vs. 7.8 percent of whites.
• Women are more likely to die than men from heart attacks - even though heart attacks are more frequent in men.
• African-American men typically develop congestive heart failure 15 years earlier than white males - but many go undiagnosed.
• The great majority of Hispanic women never have a mammogram.
• African-Americans have a 35% higher mortality rate from cancer than whites.

• 46% of Hispanics, 22% of African-Americans and 14% of Asian-Americans were among those most likely to be uninsured during the past year versus 12% of whites.
• 30% of Hispanics and 20% of African-Americans lack a usual source of health care - vs. 16% of whites.
• 33% of Hispanics, 27% of Asian-Americans and 23% of African-Americans report difficulty communicating with their physicians - compared to 16% of whites.

• In an English factory, the line employees who smoked had much higher rates of lung cancer than the managers who smoked.
• Low-income people are less likely to have regular checkups, and have more complications from chronic diseases.

What's behind health disparities?

Although the reasons for disparities in health and healthcare are not completely known, studies suggest they are related to:

• Socioeconomic factors
• Poverty
• Lack of education
• Lack of insurance
• Lack of access to primary care
• Difficulty finding a physician
• Lack of transportation
• Difficulty getting an appointment
• Inconvenient office hours
• Language and cultural barriers
• Difficulty communicating with doctors about health issues
• The perception that their physician isn't listening to them
• Having questions but do not feel comfortable asking them due to cultural beliefs
• Diagnosis and treatment decisions
• Health professional bias
• Stereotyping of minorities
• Mistrust
• Shortage of culturally and linguistically competent services and professionals
• Lack of in-depth data and research

The Minority Health Summit - partners in action

Finding ways to eliminate local health disparities will be the focus of a Minority Health Summit set for August 22 at the downtown Marriott.

The Summit has evolved from months of effort by multiple community groups already working on the issue. Partners include:

• Central Florida Pharmacy Council
• Florida Hospital
• Hebni Nutrition Consultants Inc.
• Hispanic Health Initiatives
• Osceola County Health Department
• Orange County Health Department
• Partnership for Minority Health and Education Initiative
• Seminole County Health Department
• The Center for Multicultural Wellness and Prevention Inc.
• University of Central Florida's Women's Resource Center

The Florida Department of Health, represented by Melvin L. Herring, director of the Office of Equal Opportunity and Minority Affairs, has also been active in the partnership.

The effort leading to the Minority Health Summit has been facilitated by Creating New Access (CNA), which granted no-cost technical assistance to this and seven other projects nationwide. CNA grant criteria revolved around community need and the readiness of community partnerships. Since January, CNA has helped the local partners establish an initial work team, set the initial vision and design the Summit; they will also help with long-term governance.

At the Summit, CNA facilitators will lead participants through a discussion around the (potential) formation of a Minority Health Institute that could:

• Offer expanded opportunities for community collaboration, education and research
• Help identify sources of funding for existing and expanded minority health initiatives
• Identify and disseminate best practices in minority health
• Help collaborative partners publish their findings and successes
• Influence public policy
• Work with government and agency partners to enhance health services access for minorities
• Partner in and facilitate the implementation of disease-specific health programs

"Our local partners are doing such good work already," said Andria Martin, R.N., M.S., and manager of minority health for Florida Hospital. "However, our racial and ethnic populations are growing so fast, and we all want to build on that work. We are hoping that a united effort like a community-based Minority Health Institute could help us leverage even more grants and resources to help eliminate health disparities in our community," she added. "We want to reach that 100% Access, 0% Disparity goal."

Florida Hospital's Minority Health effort is part of the hospital's Primary Care Initiative, which partners with other community groups to improve access to healthcare in central Florida.

*The Community Health Assessment was funded by the Winter Park Health Foundation and the Community Health Improvement Council of Florida Hospital.

 Sources:

1. Agency for Healthcare Research and Quality
2. Astra Sachs Database
3. Institute of Medicine study, "Unequal Treatment: Confronting Racial & Ethnic Disparities in Health Care," March 2002
4. Knight Ridder Newspapers, "Study finds race is a factor in health-care disparities," 3/20/02
5. Palm Beach Post, "Boost doctor diversity," 3/27/02
6. Race Relations.com - Race and Health - Examining racial disparities in health care
7. The Commonwealth Fund 2001 Health Care Quality Study
8. The Florida Department of Health
9. WPHF/CHIC study

This Health Issues release is located on the Internet at: http://www.floridahospital.org/

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