Preparing for the Next Generation Latino Health in California Verónica Montoya, Policy Director...
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Transcript of Preparing for the Next Generation Latino Health in California Verónica Montoya, Policy Director...
Preparing for the Next Generation
Latino Health in California
Verónica Montoya, Policy DirectorLatino Coalition for a Healthy California
California’s Healthcare : Measuring the Need
Background
Demographics
LCHC
Areas of Priority
Current Issues
Recommendations
Summary
Total population in California expected to increase- - Expected to add 10 million residents by 2020 - Brings the total state population to 46 million
Californians are getting older – A 73% expected increase in this population between 2000 - 2020
Our income is declining – Lower average pay in currently growing industries
Income and job gap in California is expected to widen – A quarter of California’s jobs pay $10 or less per hour
Background:
Source: California Budget Project, Paving the Way
Majority of California’s low-wage workers are adults and/or full-time workers -- - 84% of all workers are between the ages of 25 - 64 - Of those, nearly 60% are low-wage workers
Most workers depend on employer-based health care coverage –Nearly 18 million California residents receive health insurance coverage through their employer
Employer-provided coverage is declining -- In 2000, nearly 60% of all those with healthcare coverage received it through their employer. Only four years later (2004), this had declined to 54%
Approx. 6.5 million Californians are uninsured --More than one out every six people is uninsured
California’s Healthcare : Measuring the Need
Background
Demographics
LCHC
Areas of Priority
Current Issues
Recommendations
Summary
Source: California Budget Project, Paving the Way
Latino Health and Healthcare Coverage
Background
Demographics
LCHC
Areas of Priority
Current Issues
Recommendations
Summary
Demographics:
Nationally:• 13% of the US population is Latino• 1/3 of nation’s Latinos live in California • By 2050, 1/4 of the nation’s population will be Latino
Statewide:• 33% of Californians are Latino (11 million)• By 2040, half of the state’s population will be Latino (majority of new population growth will be within the Latino community)• One of every two children born in California is Latino
Source: 2000 U.S. Census
Latino Health and Healthcare Coverage
Background
Demographics
LCHC
Areas of Priority
Current Issues
Recommendations
Summary
Latinos tend to be younger -- The Californian median age is 34 versus 25 for Latinos
Latinos tend to have higher workforce participation rates but lower wages – Latinos continue to have one of the highest, but continue to comprise the largest population of low-wage earners – making up 57% of the current 59% of all workers who are low-wage earners
Latinos tend to be of the working age but have lower rates of employer-provided coverage –Only 43% of Latinos have employer provided coverage compared to 76% for Whites
Latinos are often uninsured –- Latinos continue to be the majority of those over-represented- Currently, 54% of the uninsured are Latino
Source: U.S. 2000 Census, U.S. Dept. of Labor, California Budget Project
Source: Institute of Medicine, Unequal Treatment
Latino Health and Healthcare Coverage
Latinos continue to increasing health disparities - Have higher incidence rates in chronic and LT
illnesses - Nearly one out of every five Latino adults over the age of 50 report they have diabetes, twice the rate for their White counterparts- Most recent data indicates that gap is getting worse with 59% of disparity measures widening for Latinos (Agency for Healthcare Research & Quality)
Latinos continue to be under-represented in health and medical professions- Despite being a third of California’s population, less than 5% of all practicing physicians, nurses and dentists are Latino- Continuing decline in medical school enrollment
Latinos physicians more likely to practice in underserved areas Minority physicians are more likely to provide care to minority population, practice in under-served areas and serve uninsured patients.
Background
Demographics
LCHC
Areas of Priority
Current Issues
Recommendations
Summary
Background
Demographics
LCHC
Areas of Priority
Current Issues
Recommendations
Summary
Access to Healthcare
Priorities in Latino Health
Community Health
Health Disparities
1
2
3
Issue: Latinos are the majority of California’s uninsured. Focus: Strategies that work to increase access to high quality, culturally and linguistically appropriate care in a timely manner
Issue: Less than 5% of all actively practicing physicians in California are Latino. Focus: Work to develop a diverse, culturally and linguistically competent health care work force
Issue: Nearly one in five Latino adults over the age of 50 report that they are diabetic, twice the rate of Whites Focus: Need to build healthy communities through collaborative, multi-sect approaches to prevent disease
Overcoming Health Disparities: Latinos in the Health Professions
Background
Demographics
LCHC
Areas of Priority
Current Issues
Recommendations
Summary
2
Economic and Workforce NeedAllied health accounts for 60% of the healthcare workforce
Continued projections on healthcare workforce ‘shortages’
Top 30 fastest growing jobs through 2010 in the U.S. expected to be in allied health jobs
Combining supply with demandAging population will place new demands on long-term careOpportunity to match (and educate) next generation of Latinos with demand
Impacting increasing cost in healthcare Patients’ perceived treatment (“concordance”) may positively impact
and reduce ongoing healthcare disparities in treatment & outcomes
Goal: to curb or decrease skyrocketing healthcare cost; Decreased cost(s) could enable more to be covered
Source: Commonwealth Fund, Disparities in Patient
Experiences
Source: UCSF Center for Health Professions
Overcoming Health Disparities: Latinos in the Health Professions
Background
Demographics
LCHC
Areas of Priority
Current Issues
Recommendations
Summary
CA Pop
Nurses MD DDS
Latino 31% 4% 4% 6%
Af. Am. 7% 4% 3% 2%
Nat. Am.
0.9% >1% >1% 0.2%
API 12% 13% 21% 41%
White 49% 79% 72% 52%
Source: U.S. Census 2000,
Overcoming Health Disparities: Latinos & Allied Health
Background
Demographics
LCHC
Areas of Priority
Current Issues
Recommendations
Summary
Source: U.S. Census 2000, UCSF Center for Health Professions
Estimated 200 different allied health professions – complicates data collection
Estimated 11 million workers
Latinos = Approx. 6-8%
Facts:
Projected Shortages:Per 100,000 U.S. CAMedical Asst. 233 217EMTs/Paramedics 63 46Respiratory Care Practitioners 29 26Clinical laboratory workers 102 76
What’s Been Done With Building Latinos in Healthcare?
Background
Demographics
LCHC
Areas of Priority
Current Issues
Recommendations
Summary
AB 2394 (Firebaugh)
Review of Policy:
Established the Task Force on Culturally and Linguistically Competent Physicians and Dentists to develop recommendations for a continuing education program for physicians and dentists. Also established sub-committee to study feasibility of establishing a pilot program to allow Mexican & Caribbean-licensed physicians and dentists to practice in non-profit community health centers in CA’s medically under-served communities.
1999
AB 1045 (Firebaugh)As follow up to AB 2394, AB 1045 created a pilot program for licensed physicians to practice medicine and dentistry in CA for 3 years. Also required a training program to be created by visiting clinicians. To date, program remains unfunded.
2002
What’s Been Done With Building Latinos in Healthcare?
Background
Demographics
LCHC
Areas of Priority
Current Issues
Recommendations
Summary
AB 938 (Yee)Creates Licensed Mental Health Service Provider Education program that provides loan assumption for mental health professionals.
2003
2003AB 982 (Firebaugh) LCHC sponsoredCreates the California Medical and Dental Student Loan Repayment program (later named the Stephen L. Thompson Loan Repayment plan) to provide loan repayment to doctors and dentists who agree to practice in under-served areas.2005
SB 63 (Committee on Budget & Fiscal Review)Creates SNAPLE (State Nursing Assumption Program ofLoans for Education) that allows loan forgiveness for those going into the teaching profession for nursing or nursing programs.
What’s Been Done With Building Latinos in Healthcare?
Background
Demographics
LCHC
Areas of Priority
Current Issues
Recommendations
Summary
Would have requested that the UC Regents take further information into consideration regarding the admissions process.
2005
2005AB 327 (De La Torre)Creates voluntary assessment of an additional $50 per application fee to be diverted specifically into the Medically Underserved Account that provides financial incentives to physicians and surgeons practicing in a medically underserved community.
2006
SB 1309 (Scott)Makes changes to the State Nursing Assumption Program ofLoans for Education program from full time to part time.Status: Before the Governor.
SB 780 (Ortiz) -- VETOED
Other Current Issues
Background
Demographics
LCHC
Areas of Priority
Current Issues
Recommendations
Summary
AB 2283 (Oropeza) LCHC sponsoredWould report data of physician cultural
ethnicity and languagePublic reporting annuallyOpportunity to begin public planningStatus: Before the Governor
Proposition 86: Stephen L. Thompson Loan Repayment Plan Issue of cost -- funding
Portion expected to continue funding programOpportunity to use as mirror programStatus: On November ’06 ballot
Recommendations: Thoughts for the Future
Background
Demographics
LCHC
Areas of Priority
Current Issues
Recommendations
Summary
Latinos
K-12 High School
CollegeHealth
Profession School
Inadequate educational programs
Drop Out No Applications
Academic Difficulty
Rejection
Health professionals
Financial difficulty
Source: Developing the CA Health Care Workforce of Tomorrow, CA Wellness Found.
Recommendations: Thoughts for the Future
Background
Demographics
LCHC
Areas of Priority
Current Issues
Recommendations
Summary
Need to continue collecting workforce data
Need to continue collecting patient data
Need to develop overall long-term, mid-range, and short-term strategy
Need to develop directed policy goals and objectives that will begin meeting the needs of the workforce (expected shortages)
Review of alternative non-policy strategies
Your Role Conclusion
Background
Demographics
LCHC
Areas of Priority
Current Issues
Recommendations
Summary
Opportunities to Collaborate:
Participate in HELhP (Health Enhanced by Latinos in health Professions)
Constructing strategies
Demand data
Keep updated on policy issues
See Yourself
Here.
For More Information
Latino Coalition for a Healthy California
1225 Eighth Street, Suite 500
Sacramento, CA 95814
Ph: 916.448.3234
Fax: 916.448.3248
www.lchc.orgStaff:
Lupe Alonzo Diaz, Executive Director
Verónica Montoya, Policy Director
Vanessa Cajina, Regional Networks Coordinator
Liz Dominguez, Administrative Assistant