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THE HISPANIC COMMUNITY OF MIAMI DADE COUNTY Grand Canyon University: NRS-427VN Instructor: Alma

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Celaya Aug 12, 2018 Lorena Hernandez, Idongesit Akazue, Jennifer Thomas, Ace Rodriguez, Maria Salas. Introduction • The Hispanic community refer to the Spanish speaking group of people in America. • The community comprise of Hispanic Americans and Latino Americans. • The community holds the second fastest growing community in the U.S. • The communities live in places like California, Arizona, and Nevada. Community And Community Boundaries • The community boundaries comprise some parts of the original Republic of Mexico in 1821. • The Hispanic community comprises 16.7% of the American population. • More than 50% of the community lives in the Southwest region of the U.S. • Community includes Mexicans, Puerto Ricans, Dominicans, Salvadorans, and Cubans. The Geographic And Geopolitical Nature Of The People • The Hispanic community is a young community in the U.S. • Huge populations in the country immigrate to the U.S. with university degrees. • The Hispanic community has contributes to demographic changes in America. • The community is increasing its political power in the U.S. The Financial & Education Level Of The Hispanic People • The U.S. born among the community recorded increased financial literacy as compared to the immigrants. • Low levels of understanding of financial concepts among the community. • The community is making large attempts to increase its college enrollment rate. • The dropout rate of the communnity is dropping significantly. The Ethnic And Phenomenological Features Of The Community • The Hispanic community comes from different backgrounds. • The major religion of the community is Christianity. • The cuisine of the community is famous across the country. • The community is growing its consciousness levels in the U.S. Types Of Social Interactions, Common Goals, And Interests Of The Community. • Most of the community members are very diverse from one another. • The community has limited common goals. • The community holds a lot of interest in the family unit. • Most of the community support their families in their countries through remittances. Barriers And Challenges Faced By The Community. • • • • Immigration. Low SES and education. Acculturation Language Conclusion • The Hispanic community’s growth keeps expanding exponentially. • The community comprises many diverse groups. • The community’s political power is increasing. • Challenges like language and education remain unsolved for the community. Interview with Angie Ngoc B. L. Interview performed on July 28th, 2018, by Lorena Hernandez • Doctor of Medicine (M. D.), Internal Medicine Larkin Community Hospital • Main role / responsibilities of interviewee : advice and diagnosis for patients, follow-up and monitoring of treatment adherence, regular check-ups, emergencies. => Mostly secondary and tertiary prevention. Population and Diseases of Interest • – Profile of patients: Children (5-17 years) Emergencies (including those in need of surgery) Elderly (check-ups and treatment adherence) • – Most frequent medical conditions : Diabetes (obesity, unhealthy lifestyles) Liver disease (excessive drinking, sometimes addiction) HIV (increasing prevalence, transmission mostly through sexual intercourse) Challenges in the local/state healthcare system • Understaffing in hospitals and clinics • Prohibitive cost of treatment (poverty, raise of healthcare costs, insurance insufficient / absent) • Also problem for hospitals’ finances (unpaid bills) => Heavily burdened medical care delivery system Health Assessment • High prevalence of obesity and diabetes, esp. among the Hispanic community (Davis, Taitel et al, 2017). • Explained by unhealthy lifestyle habits • Poor diet combined with heavy drinking (since young age) also explaining high prevalence of liver diseases. • Inaccessibility of treatment bec. of lack of insurance (Qato, Wilder, et al, 2017). In Miami-Dade County, the uninsured rate in 2017 is 67.7%(“FLHealthCHARTS Data Viewer”, 2017) Lifestyle habits – Data for Miami Dade County (Florida Department of Health, 2007) (CDC, 2007) Miami-Dade County adults are much less physically active than Americans overall. Lack of Insurance • In places like South Florida’s (Dade County) the immigrant population likely contributes to the high uninsured rate. • Some don’t make enough money to quality for tax-subsidized Affordable Care Act polices. • Many are accustomed to going to emergency rooms or public health clinics when they get sick • It’s not part of their culture to have health insurance • When they do obtain insurance, they do not understand how to use is or even how to make an appointment. Diabetes • Unhealth lifestyles (high fats and high carb (“Latino Health Disparities”, n.d.) • Hispanic youth population consumes a total 40 % of their calories from solid fats and added sugar (“Latino Health Disparities”, n.d.) • Low income neighborhoods have limited access to healthy foods and an abundance of fast food and low cost convenience store. (“Latino Health Disparities”, n.d.) • In Miami-Dade County the 2017 Death Rate for Diabetes was 19.7% for the Hispanic population. This is compared to the entire Florida population that was at 20.7%. (“FLHealthCHARTS Data Viewer”, 2017) Liver Disease • Chronic liver disease is the leading cause of death in Hispanic communities • In Miami-Dade County the 2017 Death Rate for Chronic Liver Disease and Cirrhosis was 5.8% for the Hispanic population. This is compared to the entire Florida population that was at 11.4%.(“FLHealthCHARTS Data Viewer”, 2017) HIV • HIV (increasing prevalence, transmission mostly through sexual intercourse) • In Miami-Dade County the 2017 Death Rate HIV/AIDS was 2.1% for the Hispanic population. This is compared to the entire Florida population that was at 3.2%.(“FLHealthCHARTS Data Viewer”, 2017) Recommendations on Improvement Opportunities • Lack of Insurance • Provide help in filling out forms and explaining benefits • Diabetes • Provided educational cooking classes for alternative Hispanic meals • Liver Disease • Providing AA groups tailored to the Hispanic population • Hosting “dry” social events to increase awareness and demonstrate that fun can be had with the use of ETOH • HIV • Education tailored to the Hispanic population • Distributing free condoms at social gatherings Existing Health Initiatives and Partnerships in Miami Dade County • RX4HEALTH PROGRAM (HTTP://WWW.MIAMIDADE.GOV/PARKS/RX4HEALTH.ASP) – Public: Adult, Youth, Children • Main objectives : live longer and healthier, prevent heart diseases, high blood pressure, prevent type 2 diabetes, prevent weight gain. – Activities: Walk for Life, Enhance Fitness, Yoga, Zumba, Pilates, Tai Chi, Water Aerobics – Walk with Ease : program aimed at teaching how to incorporate physical activity in everyday life. Possibility to participate in a sixweek group program led by a trained leader. – Developed by the Miami-Dade County Parks, Recreation and Open Spaces Department Initiatives funded by United Way of Miami-Dade (2018) • Family Christian Association of America [FCAA] “Healthy Kids Miami”: education and awareness activities + physical assessment to create lifelong healthy eating and wellness habits in children. Funding: $99,502 • Open Door Health Center Health Promotion, Disease Prevention Program: medical services + selfmanagement education & support groups for uninsured people with diabetes & other chronic health conditions. Funding: $29,851 Promotion of healthy eating and cooking programs for children in school settings Grants’ total value: $25,000. References (1) • Daviglus, M. L., Pirzada, A., Durazo‐Arvizu, R., Chen, J., Allison, M., Avilés‐Santa, L., … & Sorlie, P. D. (2016). Prevalence of low cardiovascular risk profile among diverse Hispanic/Latino adults in the United States by age, sex, and level of acculturation: The Hispanic Community Health Study/Study of Latinos. Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, 5(8). • CDC (2007). Nutrition, Physical Activity, and Obesity: Data, Trends and Maps- Nutrition. Retrieved from : https://nccd.cdc.gov/dnpao_dtm/rdPage.aspx?rdReport=DNPAO_DTM.Expl oreByLocation&rdRequestForwarding=Form • Davis, A. M., Taitel, M. S., Jiang, J., Qato, D. M., Peek, M. E., Chou, C. H., & Huang, E. S. (2017). A national assessment of medication adherence to statins by the racial composition of neighborhoods. Journal of racial and ethnic health disparities, 4(3), 462471. References (2) • FLHealthCHARTS Data Viewer. (2017). Retrieved from http://www.flhealthcharts.com/charts/DataViewer/DeathVie wer/DeathViewer.aspx?indNumber=0091 • Florida Department of Health (2007). . Retrieved from: http://www.floridacharts.com/charts/mapp_report.aspx • Hurtibise, R. (2016). Sun Sentinel – We are currently unavailable in your region. Retrieved from http://www.sunsentinel.com/business/consumer/fl-uninsured-rate-falls-20160913story.html • Patel, S. R., Sotres-Alvarez, D., Castañeda, S. F., Dudley, K. A., Gallo, L. C., Hernandez, R., … & Redline, S. (2015). Social and health correlates of sleep duration in a US Hispanic population: results from the Hispanic Community Health Study/Study of Latinos. Sleep, 38(10), 1515-1522. References (3) • Qato, D. M., Wilder, J., Zenk, S., Davis, A., Makelarski, J., & Lindau, S. T. (2017). Pharmacy accessibility and costrelated underuse of prescription medications in lowincome Black and Hispanic urban communities. Journal of the American Pharmacists Association, 57(2), 162-169. • United Way of Miami-Dade (2018). Health Programs. Retrieved from: https://unitedwaymiami.org/what-wedo/our-work-in-health/health-programs/
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