• Welcome to NHMA

    Established in 1994 in Washington, DC, the National Hispanic Medical Association is a non-profit association representing the interests of 50,000 licensed Hispanic physicians in the United States. NHMA is dedicated to empowering Hispanic physicians to be leaders who will help eliminate health disparities and improve the health of Hispanics. NHMA's vision is to be the national leader to improve the health of Hispanic populations.
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  • NHMA 22nd Annual Conference

    Gaylord National Harbor Hotel, Washington, DC area - May 4-7, 2017: We also invite government agencies, health industry, corporate and non profit health experts to becoming a Sponsor and to provide a Career Exhibit for our health professionals and students and medical residents.
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  • National Hispanic Health Foundation

    The National Hispanic Health Foundation (NHHF), a 501c3 organization, was established in 1994 as the philanthropic branch of the National Hispanic Medical Association. The mission of NHHF is to improve the health of Hispanics and other underserved.
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  • NHMA Featured

NEWSLETTER

Monthly NHMA Newsletter submitted by Dr. Elena Rios

22nd ANNUAL CONFERENCE

Join us and register today!              

MEMBERSHIP

Have a Voice. Make an Impact. We Invite you to become a member.

Help Victims in Puerto Rico and  Mexico

Hurricane Maria and Earthquake have brought devastating destruction to Puerto Rico and Mexico. As an organization based on helping the Hispanic community, we ask that our members look at some of the following ways to help the victims of these tragedies. 

EVENTS

 

October 2017
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PUBLICATIONS

Consensus Summit on Building Diversity in Medicine and Research Report

As a part of an ongoing commitment to promote health care equity and quality, the National Hispanic Medical Association (NHMA) convened a meeting of national experts to the Consensus Summit on Building Diversity in Medicine and Research, on January 29, 2015 at the National Institutes of Health (NIH) in Bethesda, Maryland.  National leaders for underrepresented populations in science and medicine discussed their best ideas and practices for improving representation; established recommendations, and formulated a direction and consensus statements, with the aim to build diversity in medicine and research in the U.S. not sure about the wording:  Link here to the Summit Final Report.

Read Full Report

NHMA White Paper: NHMA Produced a white paper entitled: “An Examination of Minority Populations and the Dental Service Organization Model in the US," which examines dental access among minority & low -income populations.

Read full report.

For More Publications: Click Here

PARTNERS

                                        

 

 

          

 

WHAT'S NEW AT NHMA

Introducing the NHMA Endorsed Employee Benefits Program: NHMA is excited to respond to the needs of its member physicians and supporters by offering our new NHMA Endorsed Employee Benefits Program.  The program offers access to quality health plans and valuable supplemental insurance and business products for NHMA physicians, members and their staff. Click here for more information. 

NHMA's "CALL TO ACTION" against GOP Health Care Bill to Repeal  : This week, the Graham-Cassidy-Heller-Johnson Bill was introduced in the Senate as a last effort to Repeal the ACA this year. NHMA is not in favor of this bill.  NHMA advocates for health reform that includes access to affordable healthcare insurance for all and Medicaid expansion and subsidies and cost sharing for insurance plans. We must move forward to improve health reform policy that includes Essential Beneifits, health care professional diversity, leadership development and the support for the Offices of Minority Health at the US HHS agencies. Go to Government Affairs for Call to Action for more details and to Call your Senator TODAY.

NHMA Conference - Mar. 22-25, 2018, Washington, DC  - We are seeking Speakers Abstracts - till Sept. 30th; Sponsors; Exhibitors to Share Career Opportunities for physicians and health professionals; and Loan Repayment programs, Masters programs for policy, public health, business for medical students; Financial planning and Technology for physicians and medical students.  See Conference page on this website.

Research Training Programs - NHHF PCORI Program - seeking Jr Faculty Mentees and Sr Faculty Mentors - includes webinars and 2 day training at NHMA Conference on Mar. 21-22

                                                    NIDDK Program seeking Residents for one day training at NHMA Conference on Mar. 22

NHMA College Scholars Program - Conferences for College PreHealth Students - Los Angeles (TBD), San Antonio (TBD), Washington, DC (Mar. 24, 2018) - We are seeking Mentors - medical, nursing, public health, dental students who will meet at least once per month with a college student.

NHMA Medical School Liaison Program - We are seeking NHMA members to meet with medical students 3 times during the academic year.

For programs above - send an email to NHMA@NHMAmd.org

TWITTER

A Report on Health Disparities and Hispanics Leadership Summit Series

Partners:
National Hispanic Medical Association
and the
U.S. Department of Health and Human Services
Office of Minority Health
Spring 2009
INTRODUCTION
Health care spending is expected to consume 17.6 percent of Gross Domestic Product (GDP) in 2009, and it is projected to rise to 20.3 percent by 2018 if current trends continue.  Since 2000, health care premiums have grown four times faster than wages.  The U.S. spends twice as much per person for health care as any other country in the world, and yet continues to lag behind other countries in terms of coverage and quality.  There are nearly 46 million uninsured people in America, and millions more have inadequate coverage. The U.S. has lower life expectancy rates than most of the other industrialized countries of the world.
According to the U.S. Census, Hispanics are 15 million or 15 percent of the U.S. population and by 2042 will be one out of four Americans. Hispanics are the subpopulation with the highest rate of uninsured as well as the highest rate of health care disparities. Hispanics are the ethnic group with this highest proportion who are uninsured and over one-third of Hispanics do not have health insurance. Without changes in policy, a growing number of Hispanics will become uninsured.
According to the U.S. Department of Health and Human Services National Health Disparities Reports, since published in 2006, Hispanics have consistently had the worst record with access to health care and the highest gaps in health disparities, compared to the non-Hispanic population groups.
Hispanics face severe lack of access to health care, lack of trust and knowledge, and are low-income, poorly educated with strong cultural and family values, limited English proficiency, mainly living in urban areas. Due to immigration and media, Hispanics have a strong identity.
Hispanics suffer from high rates of obesity, diabetes, infectious and chronic diseases with a strong need for cultural competence, language and education services from the health care providers.
In order for health care reform policies to develop enrollment and awareness for insurance plans and primary care and prevention services, there is a critical need for cultural competence training of physicians, health providers and the general healthcare workforce; and language services including interpreters of oral communication and translators for written communication.
Moreover, should health reform be passed, there will be an increased support for disease prevention and health promotion, primary care services as well as a new public health infrastructure at the Federal and State level. However, the current healthcare workforce lacks Hispanic researchers, providers and leaders in public/private agencies who can provide strategies and solutions to reaching and including Hispanics in health care programs.
Thus, we need to approach thinking about the future and how to prepare for a New America? The new America will consist of populations who face severe lack of access to health care, lack of trust and knowledge, and are low-income, poorly educated with strong cultural and family values, limited English proficiency, mainly living in urban areas, suffering from high rates of obesity, diabetes, infectious and chronic diseases, and demanding health care reform.
THE FUTURE IS NOW… AND THE PARTICIPANTS OF THE SUMMITS ARE THE ANSWER.
The purpose of the NHMA and US DHHS OMH Health Disparities and Hispanics Leadership Summit Series was to
1) discuss the barriers of current programs that impact on the health of Hispanics*;
2) discuss strategies needed for future health care programs; and
3) build consensus on the Federal programs and policies that can be developed or enhanced to improve the quality of health care delivery to Hispanics in the United States over the next five years.
* Programs that decrease health disparities of Hispanics are those which are strongly linked to the community and have been shown to enhance one of the following: access to health care; prevention of obesity and/or diabetes; and increase diversity in the health professions.
One hundred participants were invited to three regional summits who were representatives from Federal, State and local governments, health insurance and pharmaceutical companies, hospitals, clinics, and other health providers, foundations, insurance and pharmaceutical companies, business, unions, media, academic health centers, K-16 education, and community agencies with experience in programs impacting the health of Hispanics.
The NHMA and OMH established a planning committee including members of NHMA and key staff from the national and regional offices of OMH. The planning committee agreed to the protocols and to the focus on three areas for discussion: How to Improve Access to Health Care for Hispanics? How to Increase Prevention of Obesity and Diabetes for Hispanics? How to Increase Hispanics in the Health Professions?
The participants were nominated by planning committee, federal and state elected officials, and government and private sector leaders. The NHMA Fellows were tasked with serving as facilitators at the working tables of ten participants with a balance of stakeholder “type”. A facilitator consultant was contracted to train the fellows and to guide the participants through the consensus development sessions.
The Summits were convened as follows:
November 26, 2007 -New York Academy of Medicine, New York City, New York
January 22, 2008 – Sheraton Grand Hotel, Sacramento, California
March 6, 2008 – Texas State Capitol Building, Austin, Texas
The recommendations were ranked by the participants and at the end of the three meetings, all the recommendations were incorporated, by ranking, into the top tier of recommendations.
The outcome of the project was to disseminate the recommendations to Federal policymakers. NHMA presented the recommendations to the 2008 Presidential campaign health care advisors at the NHMA Annual Conference in Washington, DC, in a policy briefing at the New York Academy of Medicine, and at the national democratic and republican conventions, and to Senate and the Congress staff writing health care reform legislation.
NHMA announced these recommendations in April 2008 at the 12th NHMA Annual Conference in Washington, DC to the health advisors of the Obama, McCain and Clinton presidential campaigns and the presidents of the American Medical Association, the National Medical Association. All commented on the need to consider these health disparities recommendations for the impending national health care reform debate.
NHMA shared the recommendations with the delegates of both the democratic and republican national conventions and with the national minority coalitions that NHMA works with on health care advocacy. Starting in August, 2008 with Senator Kennedy briefing from medical associations, NHMA has shared the recommendations with the Senate and Congress staff in all the major health reform committees as well as the Congressional Hispanic Caucus and Congressional Black Caucus and President Obama’s White House advisors. For the past year, NHMA has also educated national groups on these priorities so that they too gain an understanding on how to improve health for Hispanics/Latinos and for all Americans.
Finally, the purpose of this report is to disseminate the key issues and recommendations to improve Hispanic health that came from the three summits held jointly between the National Hispanic Medical Association (NHMA) and the Office of Minority Health of the U.S. Department of Health and Human Services (US DHHS OMH) to policymakers and other healthcare leaders, so that they begin to incorporate these thoughts in their work to improve the health of all Americans.

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U.S. Department of Health & Human Services
Office of Minority Health
The mission of the Office of Minority Health (OMH) is to improve and protect the health of racial and ethnic minority populations through the development of health policies and programs that will eliminate health disparities.
OMH was established in 1986 by the U.S. Department of Health and Human Services (HHS). It advises the Secretary and the Office of Public Health and Science (OPHS) on public health program activities affecting American Indians and Alaska Natives, Asian Americans, Blacks/African Americans, Hispanics/Latinos, Native Hawaiians, and other Pacific Islanders.
OMH advises the Department on health policy issues affecting health status and access to care among minority populations. It coordinates programs to help HHS implement minority initiatives, including the HHS Disparities Initiative, the White House Initiative on Historically Black Colleges and Universities, the White House Initiative on Educational Excellence for Hispanic Americans, the White House Initiative on Tribal Colleges and Universities, and the HHS Minority HIV/AIDS Initiative.
OMH works with HHS operating divisions and other Federal departments to improve collection and analysis of data on the health of racial and ethnic minority populations. It monitors efforts to achieve Healthy People 2010 goals for minority health.
OMH develops and implements health campaigns to increase awareness of health disparities and promote prevention. Campaigns encourage communities, individuals, health providers, businesses, and national, state, community and faith-based organizations to get involved in eliminating health disparities.
OMH was proud to sponsor the 11th Annual National Hispanic Medical Association Conference March 22-25, 2007, in San Antonio, TX to bring together experts from across the nation to share their experience in eliminating health disparities for Hispanics.
In October 2004, OMH sponsored the First National Child Health and Child Welfare Conference to help address the health and welfare disparities of racial/ethnic minority children, bridge the health and human services systems, and achieve positive outcomes for racial/ethnic minority children.
OMH also sponsored the first National Leadership Summit on Eliminating Racial and Ethnic Disparities in Health, which drew 2,200 community representatives to Washington, D.C., in July 2002, for strategy and skills-building sessions.
National Hispanic Medical Association
Established in 1994 in Washington, DC, the NHMA represents 45,000 licensed Hispanic physicians in the U.S. Its mission is to improve the health of Hispanics and other underserved. The Association has recently established a Foundation—the National Hispanic Health Foundation to compliment the work of the Association. Based in New York City, its specific role is to develop educational activities and health policy research to improve the health of Hispanics. It is affiliated with The Robert F, Wagner Graduate School of Public Service at New York University.
The NHMA was developed as a result of a meeting of Presidents of Hispanic medical societies. During the meeting it was decided an organization was needed to fill a void in Washington, DC – the need for a voice for Hispanic/Latino physicians as advocates for Hispanic health with the Federal government. This decision grew from a history of organizing efforts dating back to the 1960s when Hispanic medical students formed regional associations and local societies focused on social and charitable activities. In 1982, Rios established the California Chicano/Latino Medical Student Association and in 1985, the Supernetwork Program to link CMSA with 25 undergraduate Chicano premed clubs. In1987 Rios formed the National Latin American Medical Student Network.
From 1995 to 1996, the U.S. Department of Health and Human Services (HHS) Health Resources and Services Administration supported 5 regional meetings with Hispanic health leaders around the country. The following year, NHMA convened its First Annual National Conference. In October 1998, Dr. Rios became the Executive Director of NHMA after receiving Federal funding through a Cooperative Agreement with the HHS Office of Minority Health. In 2000, NHMA opened its first office, expanded its staff , and began to receive funding from a number of Foundations , government, and the private sector for a variety of programs, including launching the Hispanic-Serving Health Professional Schools, NHMA Leadership Fellowship, the Resident Leadership Fellowship, the NHMA Public Health Fellowship, the NHMA Research Network, Cultural Competence Curriculum Project, eh National Hispanic Health Leadership Summit, Hispanic Health Professional Student Scholarship, Congressional Hispanic Health Briefing Series, Over the past 9 years, a total of $11.5 million has been raised for project support, although the core staff has remained very lean, averaging an annual budget of $1.5 m.
In 2005, NHMA completed a strategic review and has recently expanded its Board of Directors to include nationally recognized leaders in the health sector and NHHF established its Corporate Advisory Council. A formal affiliation was signed with NYU-Wagner. In 2006, NHMA contracted with a fundraiser to expand corporate sector financial support and an association development company to develop the strategy for infrastructure to support dramatic increases in membership. A first step in this strategy was the establishment of an association of State Medical Societies and a network of national Hispanic health professional organizations which NHMA will develop through its Obesity and Diabetes Education Project and new portal (www.hispanichealth.info).
Opening Remarks
Health Disparities and Hispanics Leadership Summit
Garth Graham, M.D.
Director
Office of Minority Health
U.S. Department of Health and Human Services
Good afternoon. I know we’re all eating to get everyone more energetic. So I am going to keep my comments short. That is one of the things my dad taught me. If you ever want to be invited back keep it short and sweet. I am glad to see a lot of good old friends and colleagues from a number of different areas.
I am going to tell you a little bit about the federal government, one of the things that we are doing. More important, I want to tell you why in our earlier planning Elena and NHMA leadership, why it was important for this group to come together and how this is going to feed in to our overall set of processes that we are trying to generate around this country in terms of creating a cohesive agenda around health societies.
So two sections are about the Federal Office of Minority Health so you get a better picture of how the different people in the jigsaw puzzle fit together. So the Federal Office of Minority Health was really put in place a little bit more than 10 years ago as a result of something called Secretary’s Passports on Black and Minority Health. It was the passports that were pulled back together back, you know, in 1985 or so. By then the Secretary of Health Education and Welfare, a very interesting lady by the name of Secretary Margaret Heckler.
Interesting, when you look at the nomenclature and the name of the report and a lot of the kind of various data points in the report you see where we were back in 1985 when we were looking at this issue on health society. That should, you see really more importantly where we were back in 1985 in terms of health and healthcare status for minority populations across the board and how that was viewed from the federal level and also at the state level as well. Interestingly it was called the Secretary’s Passports on Black and Minority Health, so back in 1985, 1986 really the preponderance of data that we had was in the African American population. There was some data, actually a good deal of data on the Hispanic population. Some is kind of what I was taking data on the Asian American population and some other data that was reported back then on the Native American Population as well. But it was called the Secretary’s Passports on Black and Minority Health because that was how things were viewed back in 1985, 1986 with the focus on the African American population because that was where the majority of data was collected.
Interestingly enough I have seen over the past 20 years we’ve seen a real surge, if not a real growth in the Hispanic population overall. I would venture to say, if you look at a lot of the challenges that our country are facing, you can look at kind of this asynchronous debate that we were having around immigration and all these various kinds of things that we have been talking about. We are probably struggling with these things as a country together, really that is starting to define where America is going to go in the future from where we are now in the present to where we need to be in the area.
So I started by giving you that data point back in 1985to give you a better understanding to why it is important when we get together in groups such as this how we define the problem, how we shape the problem, but more importantly how we shape our solution for the future. What Elena has done here is of pull together all of us to bring our various thought patterns around what needs to be done around health societies at this point in time.
We are at an interesting point in our country. I was telling about the point in our country we were in back in 1985 to 1986 and really what a lot of the health status indicators showed back then like I showed you before, was that minority populations across the board were disproportionably affected by disease. We know in 2008 that minority populations are still disproportionably affected. So not much has changed in terms of those health status indicators.
So then what do we need to do at this point? What is it that needs to be done? How do we get our country to where we want to be? It is interesting, like I was saying to your earlier, if you look at where we are as a country still the United States is ranked number 37 in terms of all the varied nations in terms of health status indicated across the board. We are spending about 18% of our GDP on healthcare. We are spending trillions and trillions and trillions of dollars on healthcare, yet our health status indicators actually are declining in many areas. For many of our minority populations, especially the Hispanic population if you look at the last National Healthcare Disparities Report in many of those indicators the actual outcomes are actually widening as well, so that health disparities are not getting smaller as we are spending more money. They are actually getting larger.
Now I want to give you the vision for the future in terms of how we get there. If you look at the history of healthcare in our country, you realize that healthcare is truly a team sport. Now what do I mean when I say that? You have all kind of big players in the healthcare industry. You have the federal government, and the federal government is a huge player when it comes to healthcare. You have state. You have private sector companies, and when I say that I mean medical device manufacturers to the pharmaceutical industry. You have the major health plans. You have large academic institutions. You have providers, entities from CNAs to nurse practitioners, to physicians, to physician assistants. Then you have the patients who are at the end of that overall spectrum in terms of people that need to be influenced.
All of those people make up the entire team when we look at health and healthcare. So if you do not have all the players on the field all at the same time then it is going to be pretty hard to win the game. So what we have been trying to do over the next year or two is actually to have a series of meetings, such as this. Elena has gladly taken on the leadership in terms of helping us craft an agenda for the Hispanic population. We were trying to have a series of meetings where reported from various experts, all of those different players that I was talking to you about, and start to reshape the agenda for how we actually make progress in the next 10 to 20 years.
I was telling you before that between 1985 and 2007 we really have not done much in terms of actually decreasing that gap and, in fact, in many instances those gaps have widened. So we cannot keep on doing what we have been doing all along. We need to start changing course. For us to be able to do that, we are going to need your thoughts, your ideas, your passion, we are going to need whatever ingredients that you bring to the table. We are going to need those to feed into the overall process.
This is actually a very, very serious endeavor for us. The other day I was doing a radio show and one of the radio callers called in and she said, so what are you guys going to do about fixing healthcare. I said, well, what are we going to do about fixing healthcare, because as I pointed out earlier it is really about how we all kind of come together in this overall teamwork pattern that I was talking about. We do not have to agree on everything. We do not have to have the same affiliations, whether that be academic or political. What we do have to agree on is that there are things that need to be done and that we each have an individual role and responsibility in terms of executing, if not actually coming up with that overall action plan that needs to be done from here on.
The other thing that I think Elena touched on a little bit earlier, is this is a very ripe season for healthcare. Opportunities abound when we look at the chance to make a change in healthcare. There are presidential politics that I do not need to talk to you about. There are state activities that I do not need to talk to you about. There are various things occurring at the federal level. So this is really the right time for us to have your input, your thought pattern, and your ideas as we move forward. I should tell you that concurrent to this train that is moving along, and as I understand moving along pretty well today, we have similar trains moving in varied industries and you will see some announcements coming out in the near future about different things from the Office of Minority Health. We are trying to pull together all of the various players in this overall team, in this overall spectrum of folks that we believe need to be included in the whole tapestry that will actually effectuate change.
So, all of that is to say that this is, again, a very important get together. Elena is going to have three of such meetings across the nation in different geographic locations so that we can really get the flavor for where things are happening, so another meeting in California, another meeting in Texas, and really try and pull together all of the pinpoints in terms of things effecting the Hispanic population.
I will say this last comment in terms of, again, understanding just how important the future of this country is intertwined with the growth of our Hispanic population across the board. I know I am speaking to the choir when I say this; but in most of our major urban cities right now the Hispanic populations are making up, if not the majority of those populations already are very close to doing that. Right? So we are seeing where the change in demographic in our country is really kind of defining where we are right now, but more importantly it is going to define where we are over the next 20, 15, 10 years, whatever time period you want to actually kind of draw a marker by.
So what does that mean? Well I said to you earlier that right now the United States is at number 37 and falling. There is no other way for us to actually reverse that tide in terms of starting to actually incrementally making our way up. But we have to start putting the ingredients in place that will actually start getting us moving from number 37 to number 1, and I actually believe that this meeting is part of how we go about doing so.
So with that being said and done, can I take two more seconds to talk a little bit, one second to talk a little bit about some of the other things we are doing. So, some of the other things that we are doing at the same time are building a lot around the business case around health disparity. We believe that the private sector is an important engine in our country’s motorcade around healthcare overall. As we are focusing on not just issues related to community-based organizations and academia we are also building a pretty strong network of folks in the private sector industry to help build the case for why health disparity is important.
From a business standpoint we are seeing where many of the major corporations and the major industries from GM to Ford are actually large healthcare organizations that just happen to make cars. So we are seeing where the major challenges that these folks are hitting are in the realm of health and healthcare. We are also seeing where a number of other major private sector industries, especially those folk, because you had a big meeting with those folks in the hotel industry who employ huge amounts of Hispanics and African Americans, and many Asian Americans as well. We are seeing where a lot of the bottom line in terms of how they are facing their future financing and infrastructure is based on dealing with health disparities and dealing with healthcare overall.
It is like I said to you; I mean this is a big team. It is a big, huge team. You all have been drafted as a part of this team. Really our goal over the next year or two is to start to pull all of these different tracks together so we actually have a successful agenda for our country over the next 5, 10, 15, 20 years, as I said before. So that being said and done I am going to stop right there. Thank you all again. I would like you to please take your work here seriously, even though it is in green, red, and all different kinds of colors. Elena is going to pull it together in actual black and white in a way that is readable and actionable and really we are going to start to pull of these things and varied ideas together so we can really elevate health disparities on the map across the board.
President & Chief Executive Officer
National Hispanic Medical Association
On behalf of the NHMA and the US DHHS OMH, I would like to welcome you to the Health Disparities and Hispanics Leadership Summit Series –this is the first of 3 summits that we are convening. We will present the collective Federal health policy recommendations at the NHMA 12th Annual Conference in Washington, DC on April 18th.
At the outset, I want to thank the Summit Planning Committee – Guadalupe Pacheco, Claude Coliman and the others of the U.S. Department of Health and Human Services Office of Minority Health, George Friedman Jimenez, Norma Villanueva, Mark Diaz, Martha Zaragoza -Diaz of NHMA and all the Facilitators – NHMA Leadership Fellows, and staff – Tim and interns and our facilitator, Ralph Bates.
Thanks to Dr. Graham, Deputy Assistant Secretary of Minority Health, for his leadership and collaboration with NHMA to help promote the issues that can improve Hispanic health across all the agencies at the Department. I would also like to acknowlede Dr. Jo Ivey Boufford, President, The New York Academy of Medicine for hosting us at this historic site of medical education. Dr. Boufford is an outstanding leader in public health and we look forward to working with her as she directs the Academy’s programs and research to reduce health disparities.
The National Hispanic Medical Association was established in 1994 in Washington, DC. The NHMA mission is to improve the health of Hispanics and other underserved. We actively develop Federal health policy and advocacy with the Congressional Hispanic, Black and Asian Caucuses and with Senator Kennedy and Senator Frist/now Senator Cochran, in collaboration with many partners – National Coalition on Hispanic Health, the Racial/Ethnic Health Disparities Coalition, Out of Many One and other boards we participate with in DC.
We also focus on developing leadership within our networks ---The Boards of Directors of NHMA and NHHF, the NHMA Council of Medical Societies, the National Hispanic Health Professionals Leadership Network, NHMA Leadership Fellows, NHMA Public Health Fellows, the NHHF Corporate Advisory Council, and all our members and partners.
We established our Foundation, the NHHF, which is now affiliated with Robert F. Wagner Graduate School of Public Service, New York University to develop educational and research efforts. For example, we established our National Hispanic Health Professional Student Scholarship Program to build our leaders for the future and our Portal (www.hispanichealth.info) ---to serve the clinicians for the new America. Besides our Scholarship Program, we are developing a new partnership with the Major League Baseball to reduce childhood obesity with our medical societies and a new partnership with the Office of Minority Health to develop health education and online community discussions through our new portal. We have developed partnerships with our NHMA Leadership Fellowship, Federal advocacy efforts, and cultural competence and medical education training through our annual conference.
The Institute of Medicine report, “The Future of the Public’s Health System in the 21st Century” discusses the approach to improving health ---by understanding the factors that determine health –at the individual, family, institutional, community levels and their interrelationships…and the solutions at the society level are within different sectors. I believe that NHMA will be a stronger advocate if we can identify, with your help, those strategies that can transform the health of Hispanics in their communities.
The purpose of the Summit today is to discuss major barriers and priority recommendations to advance U.S. Federal policies and programs to better improve the health of our people ---those with the culture, values, beliefs, families & traditions from Mexico, Puerto Rico, Dominican Republic, Cuba and Central and South America.
There have been policy efforts within the Department on Hispanic health – especially, the Executive Order on Educational Excellence for Hispanic Americans started under the first President Bush; President Clinton Administration’s Hispanic Health Agenda of 1996 (which incorporated Surgeon General Novello’s TODOS Report), Culturally and Linguistically appropriate services (CLAS) guidelines and the Limited English Proficiency (LEP) Executive order of 2000, disparities research and Centers of Excellence and health professions focused on Hispanics, Healthy People 2010; which mandates that this country eliminate racial and ethnic health disparities by 2010; and HRSA’s clinic collaborative, the HIT, CMS’s performance projects on plans and doctors, AHRQ’s quality programs, the CDC Future’s Initiative transforming the agency research and programs based on new population and life stage-based health goals.
In Congress, the policies we are focused on are the Health Equity and Accountability Act (Solis/Fortuno) and Senate and House Minority Health and Health Disparities Improvement Act (Kennedy/Cochran and Jackson Jr.) and we will need your support in letters at our website --- http://www.nhmamd.org.
The future portends that Health Care Policy will rise to the forefront of our national policy agenda, especially, given the squeeze on the domestic budget brought on by the war in Iraq, at a time when there will be optimal demands based on chronic diseases in the aging baby boomers, the rise of the uninsured in the middle class, the rise in costs of health insurance in small businesses, the shortage of doctors and nurses, the call for expanded Federal entitlements and fiscal incentives in the marketplace for more efficiencies. At the same time, we have tremendous opportunity as all the major Presidential candidates are supporting health care policy as a priority in the next White House. And, some of the candidates have prioritized health care disparities – so we have to be ready when they calls on us for solutions for the next National Health Care Reform Debate and the next Executive Order for Hispanic Americans and the nominations for future Hispanic Leaders for DHHS.
What we need in Washington, DC ---are new approaches and more effective ways to target existing and future Federal policies and programs to address racial and ethnic health disparities. And that includes all of your perspectives in dealing with the Hispanic community –business and worksites, health industry, schools, health provider, labor and community leaders.
In summary, today we ask you to focus your discussion on recommendations to improve Federal policies and programs to be more responsive to the needs of Hispanic – individuals, families, neighborhoods, institutions, worksites, community environment, as well as patients in the health care delivery system. You are the solution to improving health for our community.
Developing the Summit Recommendations
We will first hear from leading experts regarding the current issues surrounding each subject matter affecting the Latino/Hispanic communities across America and then the major recommendations for this particular topic. In terms of the getting to consensus, we hired a facilitator, who trained NHMA physicians to be the facilitators at each of the ten tables in the room. Each table consists of a mix of stakeholders invited. (See the Appendix for the participant lists)
Speakers have been assigned to address three topics, Access to Care, Prevention of Obesity and Diabetes, and Increasing Hispanic Health Workforce. Following each speaker, the participants were assigned to a table to discuss barriers and then vote on Priority Barriers and report out. Then there will be a working discussion on each Priority Barrier with Recommendations and a vote on Priority Recommendations and report out.
At the end of the three Summits, the Priority Recommendations will be consolidated in one database, by ranking, and we will produce a Final Report highlighting the speeches and top ranked Priority Recommendations to provide to Federal policymakers.
Lastly, we have collected samples of model programs, and conducted current literature reviews on each topic for the Summit participants.
Recommendations for Improving Access to Health Care for Hispanics
POLICY RECOMMENDATION #1:
Develop universal and affordable health insurance coverage to increase the insured Hispanic population that addresses the following key policies:
Expand eligibility for insurance for Hispanics
Despite the development of health care insurance for the uninsured, in order to increase Hispanic participation in these insurance programs, it will be necessary to develop new policies that address eligibility. Since Hispanics are generally low income and working for small businesses, it is important to develop affordable policies such as subsidies by income, discount premiums for families, incentives for small businesses.
Expand public health insurance programs
Hispanics can’t afford health care insurance. Moreover, they work for small businesses, which have decreased providing health insurance and the individual market is out of range. Thus, expanding Medicaid with a higher Federal poverty rate or expanding Medicare with a lower than 65 years age limit or creating a new public health insurance program would greatly increase the Hispanic coverage.
Support comprehensive benefit packages
In order to increase health status of Hispanics, it is critical to support a comprehensive benefit package that is based on prevention and medical treatment, oral health, mental health, and vision care. Optimally, the benefits should be linked to incentives for the average Hispanic, who is young and healthy, to consider seriously. For example, there could be tax deductions for gym memberships or for purchasing nutritious food or for cooking and physical activity and lifestyle change training courses.
Support individual mandates and automatic coverage
It would be important to provide individual mandates and automatic coverage protocols in the reform of health insurance.
POLICY RECOMMENDATION #2:
Develop the health care system that is more responsive to Hispanics by focusing on the following key areas:
Public-Private Partnerships and Community Demonstrations for Low Cost Health Care Delivery
It is critical for low income neighborhoods to have clinics become the focus of the medical care development and that they are developed with public-private partnership demonstrations that are evaluated for future widespread adoption. The Hispanics make-up a large proportion of clinic patient populations and with health care reform, this population would be expected to increase tremendously.
Standards for Culturally and Linguistically Appropriate Services
The Federal standards established by the U.S. Department of Health and Human Services should be adopted by all Federal programs that are related to health care delivery. The standards call for the improvement of care for multicultural and LEP populations and could lead to quality health care.
Develop cultural competence training of all health care providers, incentives through pay for performance and reimbursement, Federal clearinghouse
The U.S. Department of Health and Human Services Office of Minority Health should be supported to develop a national clearinghouse for cultural competence training programs for providers, to add to the current valuable internet self-instruction modules for doctors and nurses.
Develop language services training for health care providers, pooling of resources and expanding reimbursement by Federal programs
Language services, translation and interpretation, are needed in the health care sector to in facilitate communication between health care providers and patients as well as at the health care sector level with the community. To increase the insured, Hispanics who have a strong link to Spanish and some of whom are limited English proficient and have low literacy skills, need extra attention on language development. The training of health care students and providers, pooling of resources to have more efficient programs, and the reimbursement of language services by Federal programs are key priorities to increase Hispanic focus of the health sector.
Mandate data collection on race, ethnicity, and language preference
In order to follow trends in Federal program responsiveness, it is vital to develop and evaluate the data collection effort for Federal support to health care providers through the Medicare and Medicaid program - that includes race, ethnicity and preferred language. The evaluation of the quality of health care as well as resource planning can be targeted to Hispanic communities more expeditiously taking into account the resulting data profiles.
Support providers who serve in the underserved communities
In our nation, there are medically underserved areas and health professional shortage areas with high proportion of Hispanic and other ethnic bicultural groups who face limited health care facilities and limited access to quality health care services. In order to decrease health care disparities, it is important to support those providers who are the safety net – hospitals, clinics, medical practices through increased DHS funding, special reimbursements, loan repayment programs and the National Health Service Corps. The health system should refocus incentives toward improving the opportunities for quality care in underserved areas – where patients are sicker and require more time and education as well as more complex treatment regimens and referrals for co-morbid conditions, especially chronic disease and mental illness.
Invest in a diverse health care workforce
In order to increase the trust and responsiveness of health care programs to Hispanic patients, it is vital that the Federal government invest in the recruitment and retention as well as the deployment geographically of a diverse health care workforce. Incentives for the provider and the health professions schools need to be developed as well as an accountability system at the U.S. Department of Health and Human Services Health Resources and Services Administration to follow the trends in the workforce. See the workforce section for specific strategies.
Medical home that focuses on primary care and patient centered care
The medical home concept would increase the use of primary care providers and teams and would serve as a basis for a new reimbursement scheme for value of care management rather than episodic care. We strongly recommend that the community clinic become a medical home for safety net populations, with referral linkages to hospital networks of physicians.
Portability, Quality measures, Accountability
Other key issues that are recommended to be built into a reformed health insurance system include portability, quality measures and accountability.
Portability would permit more mobility among Hispanics moving from one employer to another, that is a part of the current economic climate as well as is related to economic and career advancement.
Quality measures are important to advance the quality of health care policy development. In order to address the quality of care that will reduce health disparities for Hispanics, these policies must include cultural competence and language measures. These measures have been discussed initially with the Hedis measures for health plans and hospital accreditation bodies. Of note, Hispanic health care providers should assist with the design of quality measures for health care delivery in Hispanic communities.
Accountability should include knowledge with data collected not only of racial and ethnicity but also language preference. Hispanics are a population with strong preferences for Spanish language; however, it is not asked in the health care system.
POLICY RECOMMENDATION #3:
Develop a major focus on health care education and marketing for Hispanics to increase awareness and participation in health care programs, through the following:
Standard health education curriculum in K-12
The priority mechanism to develop healthy lifestyle information as well as health care workforce careers to the Hispanic community is to institutionalize curriculum in the K-12 schools that focus on health promotion and disease prevention with fundamental concepts that can change behavior and increase critical thinking about personal responsibility for health. Most educational curriculum includes health through a science class which discussion is limited and dependent on the familiarity of the health care sector with the teacher. In addition, high school counselors need to be trained about encouraging K-12 Hispanic students to pursue higher education, especially to pursue health care professional careers.
Community health workers or “promotoras” increase access to services
Due to the lack of familiarity of health care systems, it is important to establish the community health worker or “promotora” as a part of the health staff, educating individuals about health promotion and disease prevention through basic information exchange. Peer education in public health would benefit the Hispanic community and at the same time assist with the enrollment and
National Hispanic health insurance media campaign
U.S. Department of Health and Human Services should plan and implement a national campaign through the Office of Minority Health on enrollment and awareness about health insurance options on an annual basis, built on the successful Medicare Spanish media campaign. Most Hispanics receive their health information from word of mouth and from the media, which warrants a health communication multimedia effort that could be co-branded by the National Hispanic Medical Association, other national Hispanic health professional organizations and community based programs.
Patient education expansion with health care provider incentives and reimbursement
In order to increase patient education services, there is a need to provide incentives beginning with increased reimbursement codes for primary care providers to provide the services. In addition, there should be incentives for hospitals and medical practices to provide group education that has been shown to be more effective (peer influence and support group positive affects to changing patient behavior) as well as to decrease costs of staff time. For Hispanics, these programs should be done by bilingual staff in Spanish and English and be focused on different generations within families and include caregivers.
Recommendations for Prevention of Obesity and Diabetes
For Hispanics
POLICY RECOMMENDATION #1:
Establish Education and Awareness Programs targeted to Hispanics about Diabetes and Obesity
In the Schools -
Standardize K-12 curriculum on health to include prevention
K-12 curriculum in general currently focuses on health within a science class. In order to decrease diabetes and obesity in the next generation, it is critical that the U.S. Department of Education reform K-12 curriculum to a comprehensive health and wellness curriculum. This curriculum should instruct our children on what is diabetes and obesity, the complications related to these diseases, and how to lead healthy lifestyles in terms of nutrition, physical activity and understanding their linkage to reduction of diabetes and obesity. Federal policies should require partnership with Hispanic physicians and health professionals to share knowledge with the school curriculum committees and students.
The Federal school lunch program should provide healthy foods and beverages
The Federal school lunch programs in K-12 schools are an important source of nutrition for poor Hispanic children. The U.S. Department of Health and Human Services and the U.S. Department of Agriculture should develop incentives for these programs to offer nutritious foods such as fruits and vegetables and beans and nuts, and decrease high sugar content foods and beverages.
The Federal policies should encourage school districts to purchase healthier foods and to develop nutrition education programs and materials for cafeteria workers, faculty and students.
In the Community -
Support community prevention coalitions in Latino communities
The Office of Minority Health, the Centers for Disease Control and Prevention and the National Institutes of Health should increase support and require programs that support community coalitions to include awareness of diabetes and obesity prevention among Latino populations, who are at higher risk for these diseases compared to the majority population.
These coalitions should include advisory committees and partnership among Latino community based agencies, civic organizations, businesses, and key Latino leaders that address prevention of obesity and diabetes and develop new programs that can be echoed throughout the communities.
Support the increase of green market penetration
In most low income inner city Latino neighborhoods, the community does not have access to fresh fruit and vegetables in the local independent markets. Federal policies should provide incentives to cities to have fresh fruits and vegetables sold in public venues.
Develop a new Federal nutrition program
Federal policies should require increased nutrition education that provides instruction on cooking skills, the national food pyramid, and the food label for Hispanics that decrease risk for diabetes and obesity.
Provide incentives for clinics to provide community education on diabetes and obesity
The Health Resources and Services Administration funds community health centers and rural health centers and currently, they are organized in learning collaboratives that focus on improving quality of care of patients with certain diseases, including diabetes. These programs should include a new reimbursement strategy to target community group education through face to face programs as well as multimedia technology channels in collaboration with Hispanic health providers.
Federal Leadership
The President should create an office on health policy and prevention in the White House that promotes the establishment the offices on health policy and prevention at relevant federal department. The Federal policies need to be increased focus on health prevention within each office.
The US Department of Health and Human Services Secretary should work with all the departments to lead prevention efforts. The Surgeon General should be supported to lead a public dialogue on healthy living and health promotion with the regional offices, states and local government public health leaders.
Federal Prevention and Health Disparities
The Office of Minority Health needs to have an advisory role to the Federal health offices through the Secretary of US DHHS on how to reduce health disparities.
The Director of the Office of Minority Health should be supported to 1) develop leadership among Hispanic health professional associations; 2) convene public health and private health industry leaders to increase Hispanic leadership as well as a focus on supporting Hispanic community with health promotion and wellness activities; and 3) develop Hispanic public health leadership resources – role models, career pathways, resources.
POLICY RECOMMENDATION #2:
Enhance Marketing Programs targeted to the Health Professionals who serve Hispanics as well as the Hispanic Consumer
Establish a new Federal multi-agency social marketing effort, led by the White House, with private sector partnerships to promote healthy lifestyles at the community level.
Federal policies should address the development of Health Information Technology programs for social networking purposes to increase dissemination of health information to Hispanics across generations. This multi-agency initiative should be part of a national vision to change health information from disease focus to prevention focus and from the HHS health care arena to the agencies such as Labor, Housing, Commerce, Energy, Agriculture, VA, DOD, Transportation that combined can address the social determinant of health and decrease health disparities.
Establish a National Hispanic Diabetes and Obesity Education Campaign
The U.S. Department of Health and Human Services should develop aNational Hispanic Diabetes and Obesity Education Campaign across all the HHS agencies, led by the Office of Minority Health, in collaboration with the Centers for Disease Control and Prevention and the National Institutes of Health. This program should build upon the current programs that provide education for diabetes and obesity and expand the support for Hispanic health professionals to lead media efforts in the major Hispanic markets and in English and Spanish media across the nation.
POLICY RECOMMENDATION #3:
Federal Government should Promote Healthy Food in the United States
Reform farm subsidies, the Women, Infant and Children (WIC) and the Food Stamp programs to offer healthier foods
The Department of Agriculture should change the farm subsidy, the WID, and the food stamp programs to provide nutrition information to the participants in addition to increasing incentives for the programs to promote healthy foods – fruits, vegetables, dairy, and nuts.
Ban the food industry from marketing unhealthy foods to children
The Food and Drug Administration and the Federal Communications Commission should develop policies to ban food industry from marketing unhealthy foods to children through multimedia channels. There should be a report to Congress on the impact on marketing across multimedia in the U.S.
Strengthen nutrition literacy through food labels, restaurant menus
Federal policies should standardized evidence-based health education in schools and strengthen health literacy for nutrition by improved food labels and restaurant menus that address at a minimum fat, sodium, carbohydrate content and calories.
Redefine traditional Hispanic recipes as healthy
Federal programs should provide support to redefine traditional Hispanic recipes with healthy preparation and ingredients and disseminate the recipes to Federal websites, conferences and grantees.  Hispanic families, especially, have a strong link to their traditional recipes and will need education to change their diets in ways that modify the ingredients in a more healthy way.
Federal policies should improve healthy food in schools
Federal policies should improve health food in schools by banning vending of junk foods/sodas,
Requiring report cards with health information, providing incentives to good schools based on the report cards, and develop state standards
POLICY RECOMMENDATION #4:
Federal policies should increase Physical Activity
Build a healthier environment for poor Hispanic communities
The US Department of Housing and Urban Development should build safer public areas such as parks, sidewalks, and walking and bike trails in low income communities where Hispanics tend to reside.
Establish physical fitness programs in Hispanic communities
The Presidents Council of Physical Fitness should work with the U.S. Department of Health and Human Services to increase exercise programs in schools and after schools. Exercise programs should be supported for community agencies and worksites with incentives to the employers to offer Federal supported programs.
POLICY RECOMMENDATION #5:
Reform the Health System to increase Focus on Prevention Services
Increase Reimbursement for Prevention Services
The Centers for Medicare and Medicaid Services should change reimbursements to increase for primary care and prevention services and should support incentives to increase provider participation in prevention related to quality care and health information technology projects. The National Institutes of Health and the Centers for Disease Prevention and Control should expand incentives, including loan repayment programs for prevention and health disparities research and public health careers.
Redesign waiting rooms furniture, machinery for obese patients
CMS should provide infrastructure funding for clinics and health providers to fit their furniture and machinery for the growing obese patients.
Develop Demonstration Program that addresses low cost interventions
CMS should develop a demonstration program in regions of the country with high Hispanic populations that develop low cost interventions for prevention services with chronic diseases and their complications.
Provide Healthy Food in Hospitals
US DHHS should promote a public-private partnership to increase health food and education about nutrition in hospital cafeterias as a model to the patients and staff.
Develop CME requirements for physicians for prevention services
Support increased community-based research for prevention interventions targeted to Hispanics
Support health care with Multidisciplinary teams, including nutritionists and educators
Recommendations for Increasing Hispanics in the
Health Professions Workforce
POLICY RECOMMENDATION #1:
Build Political Will
The Federal government has supported programs to increase recruitment and awareness for health professions careers through the US DHHS Health Resources and Services Administration for K-12 and undergraduate students through the Health Careers Opportunity Program since the 1960s; the Hispanic Center of Excellence Program since the early 1990s. The medical school grantees show a positive impact on the diversity of the admissions statistics compared to the medical schools without these programs.
Policy experts, however, recognize that the programs need political support since having been criticized by the Office of Management and Budget Performance Evaluation Program for a lack of effective impact evaluation. Since December 2005, the programs have had drastic cuts from Congress and are in need of political will for the need to expand Hispanic representation in the health professions.
POLICY RECOMMENDATION #2:
Strengthen Educational Pipeline
Improve K-12 education
The education training of K-12 public schools in minority communities tends to be of lower quality with poor outcomes - higher drop out rates, lower achievement test scores and lower college application and admissions rates. In order to increase the number of Hispanics becoming health professionals, we must strengthen the K-12 education - math and science education, faculty preparation, health career counseling, and college preparatory education.
The Department of Education should target funds to low income school districts to increase counseling and faculty awareness about health careers
US Department of Health and Human Services grantees for the Health Careers Opportunity Program should be working with the Department of Education grantees in low income school districts with targeted funding to increase counseling about health careers and academic preparation for college.
Health career tracks in high schools –magnets, tutoring
There should be more support for high school education that has magnet schools with health sciences education, including academic preparation and counseling and tutoring for a greater cadre of students in the next generation who excel in math and sciences.
Provide more Hispanic mentors & role models from the health professions at all educational levels
Federal programs should support mentorship programs with Hispanic health professionals in order to provide role models to students who are already in the health care career pathway --- K-12, college, medical school and residency levels. Mentorship programs can increase the motivation of talented students interested in science education to continue to pursue their goals of a health care career. The National Hispanic Medical Association should develop a national mentorship program with its fellow medical societies in partnership with the Federal government.
Support Hispanic students in higher education by providing scholarships & loan repayment programs
Federal agencies should increase scholarships and loan repayment programs, such as the National Health Service Corps targeted to Hispanic students pursuing medical and dental careers who agree to work in clinics in underserved areas upon completing their education. In addition, Federal loan repayment programs should be increased for Hispanic students interested in careers in working in nonprofits and the Federal public health government agencies.
POLICY RECOMMENDATION #3:
Develop Health Career Outreach Programs for Students and their Parents in Low Income Neighborhoods
Develop value of education and awareness of financial aid
Health career training should include information to parents and students about the importance of a successful academic preparation, beginning with math and science achievement in high school and college. The education requirements for medical school need to be discussed to begin the understanding about the long-term commitment to higher education by parents and students. In addition, most low income parents have no knowledge about financial aid in higher education and that funding needed can be obtained as an investment in their child’s future.
Federal health career programs should link to clinics, libraries, science museums
Federal health careers preparation programs, in order to outreach to more students and parents, need to provide information through community organizations in targeted regions that can link to clinics, libraries, science museums, and Hispanic Serving Institutions.
Develop a Marketing Campaign about health careers
Federal programs should develop a marketing campaign through multimedia that targets K-12 students and parents as well as college students about the opportunity for health careers and refers them to a national recruitment website. It would be important to measure the outcome and to provide resources such as academic preparation in regions of the country.
POLICY RECOMMENDATION #4:
Reform the Admissions Process of Health Profession Schools to Increase Accepted Hispanics
Fund COE and HCOP & expand focus
The Health Careers Opportunity Program and the Centers of Excellence Program have been supported by the Health Resources and Services Administration to increase the number of disadvantaged students, including minority students, admitted to medical school, dental school and public health school and other health professions.
HRSA has demonstrated that the schools with HCOP programs have had higher rates of admission of minority students compared to the schools without the HCOP program. Since the literature shows that minority physicians and dentists provide increased health care to minority, uninsured and Medicaid patients, we conclude that the HCOP program can increase access to care for underserved populations. The COE program has promoted cultural competence curriculum and minority faculty training which results in more role models to attract more minority students. Both programs have resulted in diversity in medicine.
In 2005, the Congress decimated the funding for both programs. It was strongly recommended that federal government continue to fund both programs at a greater rate and to expand the focus of the activities to enhance the admissions numbers of Hispanic students in medicine and health professions.
Change admissions – increase focus on background, leadership, and underserved interest vs. #s
Federal agencies should work with the medical school grantees to encourage admissions changes from focusing on the academic scores (GPA and the MCAT test scores) to an understanding about the need for students from underserved communities and with well rounded experience showing interest in a health career (leadership in student activities, extracurricular activities in health care, community service).
Increase Hispanic representation on health professions schools admissions committees and on decision making committees
Federal agencies should support leadership development programs that encourage health professions schools to include Hispanic faculty in admissions committees and other decision-making committees, such as dean’s advisory committees and Boards of Trustees.
Link recruitment to professionals, alumni
Federal agencies should encourage linking the deans of medical, nursing, public health, dental schools and leaders of Hispanic health professional associations and Hispanic alumni to increase diversity in recruitment efforts of students and faculty
Conclusion
Elena Rios, M.D., M.S.P.H.
President & Chief Executive Officer
National Hispanic Medical Association
The National Hispanic Medical Association and the U.S. Department of Health and Human Services’ Office of Minority Health sponsored the “Health Disparities and Hispanics Leadership Summit Series” that brought together 300 leaders from a range of occupations in New York, California, and Texas. These stakeholders were asked to discuss the challenges for the Hispanic community about access to health care; prevention of obesity and diabetes; and increasing Hispanics in the health care professions, and to come up with recommendations for Federal policy development for the next five years.
The Summit participants supported the charge for the National Hispanic Medical Association to share the recommendations with Federal policy-makers and to identify those who are the champions for health disparities to educate their colleagues during the future health reform debate.
The National Hispanic Medical Association and the U.S. Department of Health and Human Services’ Office of Minority Health recommend that now is the time, during the national health reform debate, to call for a new vision for a comprehensive plan that includes eliminating health disparities and strengthening the health of all Americans.
Acknowledgements
We would like to acknowledge the U.S. Department of Health and Human Services’ Office of Minority Health, New York Academy of Medicine, Senator Van De Putte’s Office, the Summit Series Planning Committee, the NHMA staff, interns and consultants, and the speakers and participants for their commitment to improving health of our Hispanic populations and communities by reducing health disparities.
Appendix I
National Hispanic Medical Association
And
U.S. Department of Health and Human Services
Office of Minority Health
“Health Disparities and Hispanics Leadership Summit”
New York Academy of Medicine
November 26, 2007
AGENDA
8:30 – 9:00 am           Continental Breakfast
9:00 – 9:20 am           Welcome and Overview
Jo Ivey Boufford, M.D.
President, New York Academy of Medicine
Elena Rios, M.D., M.S.P.H.
President and CEO
National Hispanic Medical Association
9:20 – 9:35 am            Review of Ground Rules and Role of Facilitators
Ralph Bates
Bates & Associates
Huntly, VA
Facilitator
9:35 – 9:50 am          “Increasing Access to Health Care for Hispanics”
Maxine Golub, M.P.H.
Senior Vice President
The Institute for Family Health
Bronx, New York
9:50 – 11:30am           Small Group Discussion
11:30am–12:00pm     Small Group Reports
12:00 – 12:45pm        Lunch
Garth Graham, M.D., M.P.H.
Deputy Assistant Secretary
Director, Office of Minority Health
U.S. Department of Health and Human Services
12:45 – 1:00 pm          “Increasing Prevention of Obesity and Diabetes”
Ileana Vargas, M.D.
Assistant Clinical Professor of Pediatrics
Pediatric Endocrinologist
Columbia University
1:00 – 2:25 pm           Small Group Discussion
2:25 – 2:35 pm           Break
2:35 – 3:05 pm            Small Group Reports
3:05 – 3:20 pm            “Increasing Diversity in the Health Professions”
Nilda I. Soto, MS, Ed
Assistant Dean
Office of Diversity Enhancement
Albert Einstein College of Medicine
3:20 – 4:45 pm           Small Group Discussion
4:45 – 5:15 pm           Small Group Reports
5:15 – 5:30 pm           Concluding Remarks and Next Steps
5:30 – 6:30 pm           Reception


Appendix II
National Hispanic Medical Association
And
U.S. Department of Health and Human Services
Office of Minority Health
“Health Disparities and Hispanics Leadership Summit”
Sheraton Grand Sacramento Hotel
January 22, 2008
AGENDA
8:00 – 8:30 am           Continental Breakfast
8:30 –9:00 am           Welcome and Overview
8:30-8:35am                            Guadalupe Pacheco, MSW
Special Assistant to the Director
Office of Minority Health
U.S. Dept. of Health and Human Services
Rockville, MD
8:35-8:45am                            Elena Rios, MD, MSPH
President & CEO
National Hispanic Medical Association
8:45 – 9:00 am            Review of Ground Rules and Role of Facilitators
Ralph Bates
Facilitator
Bates & Associates
Huntly, VA
9:00 – 9:20 am          “Increasing Access to Health Care for Hispanics”
Richard Figueroa
Healthcare Advisor
Office of Governor Arnold Schwarzenegger
Sacramento, CA
9:20 – 11:30am           Small Group Discussion
11:30am–12:00pm     Small Group Reports
12:00 – 12:45pm        Lunch
Robert Ross, MD
President
The California Endowment
Los Angeles, CA
12:45 – 1:00 pm          “Increasing Prevention of Obesity and Diabetes”
Laura Brainin-Rodriguez MPH, MS, RD
Coordinator
Feeling Good Project
San Francisco Department of Public Health, Nutrition Services
San Francisco, CA
1:00 – 2:25 pm           Small Group Discussion
2:25 – 2:35 pm           Break
2:35 – 3:05 pm            Small Group Reports
3:05 – 3:20 pm            “Increasing Diversity in the Health Professions”
Kathy Flores, MD
Director
UCSF–Fresno Center for Medical Educational Research
California Area Health Education Center & Health Education Training Center
Fresno, CA
3:20 – 4:45 pm           Small Group Discussion
4:45 – 5:15 pm           Small Group Reports
5:15 – 5:30 pm           Concluding Remarks and Next Steps
Appendix III
National Hispanic Medical Association
And
U.S. Department of Health and Human Services
Office of Minority Health
“Health Disparities and Hispanics Leadership Summit”
Texas State Capitol
Legislative Conference Center
Room E2.002
March 6, 2008
AGENDA
8:00 – 8:30 am           Continental Breakfast
8:30 –9:00 am           Welcome and Overview
8:30-8:40am                            Jenee Garza Gonzales
Deputy Legislative Director
Office of Senator Leticia Van de Putte
Austin, TX
8:40-8:45am                            Garth Graham, M.D., M.P.H.
Deputy Assistant Secretary for Minority Health
Office of Minority Health
U.S. Dept. of Health and Human Services
Rockville, MD
8:45-9:00am                            Elena Rios, M.D., M.S.P.H.
President & CEO
National Hispanic Medical Association
Washington, DC
9:00– 9:10am              Review of Ground Rules and Role of Facilitators
Ralph Bates
Facilitator
Bates & Associates
Huntly, VA
9:10 – 9:25 am          “Increasing Access to Health Care for Hispanics”
Juan Flores
Health Policy Director
Clinica La Fe
San Antonio, TX
9:25 – 11:30am           Small Group Discussion
11:30am–12:00pm     Small Group Reports
12:00 – 12:45pm        Lunch –
Captain Henry Delgado, MS, CIH
Regional Minority Health Consultant
PHS-Region VI
U.S. Department of Health and Human Services
Dallas, TX
12:45 – 1:00 pm          “Increasing Prevention of Obesity and Diabetes”
Eduardo Sanchez, MD
Director
Health Policy Institute
University of Texas
Austin, TX
1:00 – 2:25 pm           Small Group Discussion
2:25 – 2:35 pm           Break
2:35 – 3:05 pm            Small Group Reports
3:05 – 3:20 pm            “Increasing Diversity in the Health Professions”
Ciro Sumaya, M.D., M.P.H.T.M.
Chairman of the Board of Directors
National Hispanic Medical Association
Dean
Rural Public Health School
Texas A&M
3:20 – 4:45 pm           Small Group Discussion
4:45 – 5:15 pm           Small Group Reports
5:15 – 5:30 pm           Concluding Remarks and Next Steps
Appendix IV
National Hispanic Medical Association
And the
U.S. Department of Health and Human Services
Office of Minority Health
“Health Disparities and Hispanics Leadership Summit Series”
Planning Committee
Guadalupe Pacheco, MSW
Special Assistant to the Director
U.S. Department of Health and Human Services
Office of Minority Health
Rockville, MD 20852
Phone: 240-453-6174
Fax: 301-597-0767
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
CAPT Henry Delgado, MS, CIH
Regional Minority Health Consultant
PHS - Region VI (TX)
1301 Young Street, Suite 1124
Dallas, TX 75202
Phone: 214-767-3882
Fax: 214-767-3209
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
(Arkansas, Louisiana, New Mexico, Oklahoma, and Texas)
Claude Marie Colimon
Regional Minority Health Consultant
PHS - Region II (NY)
26 Federal Plaza, Room 3835
New York, NY 10278
Phone: 212-264-2127
Fax: 212-264-1324
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
(New Jersey, New York, Puerto Rico, and Virgin Islands)
Christina L. Perez, MN, FNP, RN
Regional Minority Health Consultant
U.S. Department of Health and Human Services
Office of Public Health and Science
Office of Minority Health, Region IX, (CA)
90 7th Street, Suite 5-100
San Francisco, California, 94103-6706
Phone: 415-437-8124
Fax: 415-437-8004
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
(Arizona, California, Hawaii, Nevada, U.S. Associated Pacific Basin: American Samoa, Commonwealth of the Mariana Islands, Guam, Federated States of Micronesia, Republic of the Marshall Islands, and Republic of Palau)
George Friedman Jimenez, MD
Medical Director
Bellevue NYU Occupational & Environmental Medicine
650 First Ave.
Room 518
New York, NY 10016
Office: (212) 263-6083
Fax: (212) 263-8570
Home: 201-836-2801
This email address is being protected from spambots. You need JavaScript enabled to view it.
Norma Villanueva, MD
Network Chief of Child & Adolescent Health
Lutheran Hospital
150 55th St. Station 20
Brooklyn, NY 11220
Office: 718- 630-6794
Fax: 718-492-5090
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Ciro Sumaya, M.D., M.D.H.T.M.
Chairman, NHMA Board of Directors
Dean, The Texas A & M University System
Health Science Center
School of Rural Public Health
260 Centeq Building
College Station, TX 77843-1266
Office: (979) 862-4445
Fax: (979) 458-1878
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
Asst: Ruth Yeager
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
Mark Diaz, M.D.
Chairman, National Hispanic Health Foundation Board of Directors
Qualified Medical Evaluator
Alivio Medical Group
3009 K Street
Suite 202
Sacramento, CA 95816
Work: 916-448-2998
Fax: 916-448-3199
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
Family Practice, Occupational Medicine
Elena Rios, M.D., M.S.P.H.
President & CEO, NHMA
1411 K Street, NW
Suite 1100
Washington, DC, 20005
Work: 202-628-5895
Fax: 202-628-5895
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
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Tim Mahony
Assoc. Dir. Government Affairs
NHMA
1411 K Street, NW
Suite 1100
Washington, DC, 20005
Work: 202-628-5895
Fax: 202-628-5895
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NHMA Interns
Jeff Levine
Max Roman
Consultants
Ralph Bates, Facilitator
Martha Zaragoza-Diaz,
NHMA Government Affairs
John A. Rios, M.B.A., M.H.A., M.P.P. - Writer/Editor
Policy Consultant
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
Appendix V
References
Access to Health Care for Hispanics
Doty, Michelle M. Hispanic Patients’ Double Burden: Lack of Health Insurance and Limited English. New York, NY. The Common Wealth Fund, February 2003.
Anderson, R. and Smith, B. Deaths: Leading Causes for 2001. National Vital Statistics Reports; Vol. 52, No. 9, Table 2. Hyattsville, MD: National Center for Health Statistics, 2003.
Fiscella, Kevin, Franks, Peter, Doescher, Mark P., and Saver, Barry G. Disparities in Health Care by Race, Ethnicity, and Language Among the Insured: Findings from a national Sample. Medical Care, Vol. 40, No. 1, (Jan. 2002), pp. 52-59.
Andersen, Ronald, Lewis, Sandra Zelman, Giachello, Aida L., Aday, Lu Ann, and Chiu, Grace. Access to Medical Care Among the Hispanic Population of the Southwestern United States. Journal of Health and Social Behavior. Vol. 22, No. 1, (Mar. 1981), pp. 78-89.
McNamara, Eileen. Great Divide is Growing. The Boston Globe. Dec. 3, 2006 Sunday First Edition. Section: Metro; p. B-1.
Davis, Karen. Inequality and Access to Health Care. The Milbank Quarterly, Vol. 69, No. 2, Health , Society, and the “Milbank Quarterly:” Essays in Honor of David P. Willi’s Editorship, (1991), pp. 253-273.
Kirby, James B. and Kneda, Toshiko. Neighborhood Socioeconomic Disadvantage and Access to Health Care. Journal of Health and Social Behavior, Vol. 46., No. 1, (March, 2005), pp. 15-31.
Ahern, Melissa M., Hendryx, Michael S. and Siddharthan, Kris. The Importance Sense of Community on People’s Perceptions of Their Health Care Experiences. Medical Care, Vol. 34, No. 9, (Sept., 1996), pp. 911-923.
Ramirez, Amelie G., McAlister, Alfred, Gallion, Kipling J., and Villarreal, Roberto. Targeting Hispanic Populations: Future Research and Prevention Strategies. Environmental Health Perspectives, Vol. 103, Supplement 8 (Nov. 1995), pp. 287-290. Published by: The National Institute of Environmental Health Sciences (NIEHS).
Burnette, Denise and Mui, Ada C. Physician Utilization by Hispanic Elderly Persons: National Perspective. Medical Care, Vol. 37, No. 4 (Apr., 1999), pp. 362-374.
Escarce, Jose J. and Kapur, Knika. Racial and Ethnic Differences in Public and Private Medical Care Expenditures Among Aged Medicare Beneficiaries. The Milbank Quarterly, Vol. 81, No. 2 (2003), pp. 249-275.
Vesely, Rebecca. An Uneven Paying Field?; Studies Indicate Pay-For-Performance Can Exacerbate Disparities in Access. Modern Healthcare. March 17, 2008. Section: Payers and Purchasers; p. 32.
Schlotthauer, Amy E., Badler, Amy, Cook, Scott C., Perez, Debra J., and Chin, Marshall H. Evaluating Interventions to Reduce Health Care Disparities: An Robert Wood Johnson Foundation Program. Health Affairs, March/April 2008. Vol. 27, Number 2. pp. 568 – 573. Health Affairs, Bethesda, MD.
Hibbard, Judith H., Greene, Jessica, Becker, Edmund R., Roblin, Douglas, Painter, Michael W., Perez, Debra J., Burbank-Schmitt, Edith, and Tusler, Martin. Racial/Ethnic Disparities and Consumer Activation in Health. Health Affairs, September/October 2008. Vol. 27, Number 5. pp. 1442 – 1453. Health Affairs, Bethesda, MD.
Welnick, Robin M., Caglia, Jacquelyn M., Friedman, Elisa, and Flaherty, Katherine. Measuring Racial and Ethnic Health Care Disparities in Massachusetts. Health Affairs, September/October 2007, Vol. 26, Number 5. pp. 1293 – 1302. Health Affairs, Bethesda, MD.
Kenney, Genevieve and Yee, Justin. SCHIP at a Crossroads: Experiences to Date and Challenges Ahead. Health Affairs, March/April 2007. Vol. 26, Number 2. pp. 356 – 369. Health Affairs, Bethesda, MD.
Cisneros, Henry, ed. Latinos and the Future of the Nation First-Order Need: Improving the Health of the Nation’s Latinos by Elena V. Rios, M.D., M.S.P.H. Arte Publico Press. Houston, Texas. Jan. 2009
Obesity and Diabetes Prevention in the Hispanic Community
National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Statistics, 2007 fact sheet. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, 2008.
Health Statistics Related to Californians and the Workplace. California Department of Health Services Fact Sheet. September 2006. Brochure No. 150.
The Diabetes Epidemic Among Hispanics/Latinos. National Institutes of Diabetes and Digestive and Kidney Diseases, National Diabetes Statistics, 2007. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, 2008. http://www.diabetes.niddk.nih.gov/dm/pubs/statistics/
Institute of Medicine of the National Academies (U.S.). Committee on Prevention of Obesity in Children and Youth. Preventing Childhood Obesity: Health in the Balance. Koplan, Jeffery, Liverman, Catharyn, and Kraak, Vivica (Editors). 2005.
Institute of Medicine of the National Academies (U.S.). Committee on Prevention of Obesity in Children and Youth. Preventing Childhood Obesity: Health in the Balance. Koplan, Jeffery, Liverman, Catharyn, and Kraak, Vivica (Editors). 2005.
Institute of Medicine of the National Academies (U.S.). Committee on Prevention of Obesity in Children and Youth. Preventing Childhood Obesity: Health in the Balance. Koplan, Jeffery, Liverman, Catharyn, and Kraak, Vivica (Editors). 2005.
Institute of Medicine of the National Academies (U.S.). Committee on Prevention of Obesity in Children and Youth. Progress in Preventing Childhood Obesity: How Do We Measure Up? Koplan, Jeffery, Liverman, Catharyn, and Kraak, Vivica (Editors). 2007.
Institute of Medicine of the National Academies (U.S.). Committee on Prevention of Obesity in Children and Youth. Progress in Preventing Childhood Obesity: How Do We Measure Up? Koplan, Jeffery, Liverman, Catharyn, and Kraak, Vivica (Editors). 2007.
Foreyt, John P.   Cultural Competence in the Prevention and Treatment of Obesity: Latino Americans. The Permanente Journal, Spring 2003, Vol. 7, No. 2, pp. 42-45.
Haigh, Christian. Hispanic Boys Face Unique Issues With Obesity Prevention. Am J. Prev Med. 2008; 34:pp. 153-160. Endocrinetoday.   http://www.endocrinetoday.com/print.aspx?rid=26387
Kumanyika, Shiriki and Grier, Sonya. Targeting Interventions for Ethnic Minority and Low-Income Populations. The Future of Children, Vol. 16, No. 1, Childhood Obesity, (Spring, 2006), pp. 187-207.
National Center for Health Statistics, Health, United States, 2004, with Chartbook on Trends in the Health of Americans (Hyattsville, MD., 2004), table 70.
Increasing Hispanics in the Health Professions Workforce
Senate HELP Committee. Affordable Health Choices Act: Title IV— Health Care Workforce. (2009), pp. 421-580.
A.H. Strelnick et. al. Diversity in Academic Medicine No. 3: Struggling for Survival
Among Leading Diversity Programs. Mount Sinai Journal of Medicine, Vol. 75, (2008), pp. 504-516.
Association of American Medical Colleges (AAMC). Diversity in Medical Education: Facts and Figures 2008, (Washington, DC, 2008).
B.D. Smedley, A.S. Butler, and L.R. Bristow, eds. In the Nations Compelling Interest: Ensuring Diversity in the Health Care Workforce,(Washington, DC: National Academies Press, 2004).
B.D. Smedley, A.Y. Stith, and A.R. Nelson, eds. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, (Washington, DC: The National Academies Press, 2002).
Council on Graduate Medical Education and the Department of Health and Human Services (U.S.). Council on Graduate Medical Education 12th Report: Minorities in Medicine, (1998).
Health Professions and Nursing Education Coalition. By the Numbers: Impact of the Title VII and VIII Health Professions Programs, (2003).
Government Accountability Office (U.S.). Health Professions Education Programs: Action Still Needed to Measure Impact, (2006).
HHS, HRSA, and BHP. The Rationale for Diversity in the Health Professions: A Review of the Evidence, (Oct. 2006).
J.E. Maupin and W.J. Riley. Commentary: Funding the Diversity Programs of the Title VII Health Professions Training Grants: An Urgent Need, Academic Medicine, Vol. 83, No. 11, (2008), pp. 999-1001.
United States Congress. Key Features of the Tri-Committee Health Reform Draft Proposal in the U.S. House of Representatives, (2009).
K. Grumbach and R. Mendoza. Disparities In Human Resources: Addressing the Lack of Diversity in
the Health Professions, Health Affairs, Vol. 27, No. 2, (2008), pp. 413-422.
M.E. Lewin and B.R. Rice. Balancing the Scales of Opportunity: Ensuring Racial and Ethnic Diversity
in the Health Professions, (Washington, D.C.: National Academy Press, 1994).
Smedley et. al. The Right Thing to Do, The Smart Thing to Do: Enhancing Diversity in the Health
Profession, (Washington, D.C.: National Academy Press, 2001).
Sullivan Commission on Diversity in the Healthcare Workforce, “Missing Persons: Minorities in the Health Professions,” (2004).
United States Congress. Title VII—Health Professions Education.Public Health Services Act, (2005).
Senate Finance Committee. Transforming the Health Care Delivery System: Proposals to Improve Patient Care and Reduce Health Care Costs. (2009), pp. 33-37.

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