BUREAU OF MINORITY HEALTH CCESS - Department of …

? BUREAU OF MINORITY HEALTH ACCESS

Eliminating Health Disparities

¡®From A Grass-roots Perspective¡¯

D. Rudy Macklin, Director

'Eliminating

Health

Disparities

through

innovation,

collaboration

and evidencebased solutions'

? 2009

? 628 NORTH 4TH STREET; BATON ROUGE, LA 70802

State of Louisiana

Department of Health and Hospitals

Eliminating Health Disparities

¡®From A Grass Roots Perspective¡¯

Prepared for:

Office of the Secretary

Department of Health and Hospitals by

Bureau of Minority Health Access

Additional information and copies may be obtained from the internet:



Bureau of Minority Health Access

628 North 4th Street; 9th Floor

Baton Rouge, LA 70802

(866) 562-9015

(225-342-3738 (fax)

[Health Disparities] Page ii

Table of Contents

Executive Summary

iv

Introduction

1

About the Bureau

14

Demographics

16

Disparities in Health Status

24

Health Status of Low-Income Adults In New Orleans PostKatrina

49

Why Health Disparities Exist

56

Obesity in Minority Populations

63

Health Effects of Childhood Obesity on Minority and Lowincome Populations

64

Health Disparities Experienced by Black Youth

65

Health Disparities From A Grass-roots Perspective

66

Action Steps for Addressing Health and Education

Disparities

80

Bureau of Minority Health Activities

83

Future Guidelines

100

Conclusions

101

References

102

Louisiana State Health Equity Report

108

Women¡¯s Health Care Disparities Graphs and Tables

112

[Health Disparities] Page iii

Executive Summary

In 2005, both hurricanes Katrina and Rita elevated the Bureau of Minority Health Access

(BMHA) to a higher level by giving it an entryway to becoming an advocate for

underrepresented, underserved and minority populations on the gulf coast of Louisiana. The

BMHA secured the necessary resources and developed action plans to aid collaboration and

partnership opportunities among state agencies, academic institutions and community groups to

assist socioeconomically disadvantaged minority populations through recovery and re-entry

efforts.

By advocating for the least of these, BMHA will help eliminate health disparities, and improve

the health status of minorities and the medically underserved, including the uninsured and

underinsured population statewide. It is the Bureau¡¯s intent to include the integration of evidence

or practice-based public health and community-based participatory approaches to support and

disseminate programmatic activities that are successful in the reduction of racial and ethnic

disparities. The Bureau of Minority Health Access draws on the large pool of existing resources

from state and community agencies in an effort to work together in planning, developing, and

implementing multilevel systematic approaches to reduce racial and ethnic disparities in health

for minorities and the underserved populations in Louisiana.

Louisiana is the 31st largest state in the United States with 51,843 square miles and an estimated

population of 4,287,768 (Census Bureau 2004), down from 4,468,976 in 2000 and a population

density of 98.6 persons per square mile. Louisiana a primarily a rural state, coupled with the

sparse population in most areas, presents obvious geographical barriers to health care access;

especially among the statewide groups of minority populations. In 2005, a Minority Health

Needs Assessment was conducted in minority, hurricane-plagued areas.

[Health Disparities] Page iv

The result of this assessment was published in the Bureau¡¯s report to the Office of Minority

Health in Rockville, MD. The assessment served as a tool to identify and prioritize health

disparities during the aftermath of both hurricanes Katrina and Rita. It also provided a view of

the overall health status of minority communities in other parishes least affected by the storms.

This report shows the need for: 1) encouragement of more in-depth examination of problems and

possible solutions affecting disparities before and after the hurricanes, 2) providing a basis for

obtaining funds to rectify these problems thereby implementing solutions, and 3) partnering with

other health and social service entities to address health disparities within their program

requirements.

Identifying health disparities in the wake of a natural disaster was the first step taken in order to

outline steps needed to resolve health disparities, including but not limited to, conducting a needs

assessment, creating a plan and strategies, developing specific goals and objectives, allocating

resources, implementing actions, and evaluating the results. A review of national and statewide

statistics indicates a significant increase in minority populations during the next decade.

Louisiana, too, can anticipate an increase in diversity. The expectation is supported by the 2004

Behavioral Risk Factor Surveillance Survey (BRFSS) data along with economic development

projections. Changes are needed to impact the expected increase in health disparities along with

a possible decrease in resources. Enhancing services, through collaboration, is just one way to

prepare for these expected changes.

In 2005, BMHA was awarded a contract from the national Office of Minority Health to

implement Operation Safe Re-entry which was designed to determine the health status of

minority communities and facilitate preventive and post-care through support for victims

devastated by hurricanes Katrina and Rita. The Bureau led the charge by mobilizing health care

stakeholders, community-based organizations (CBOs), Historically Black Colleges and

Universities (HBCUs), faith-based organizations and local city and parish governments to assist

minority communities with establishing mechanisms to improve access to health care, assist with

hurricane relief efforts and community clean up. With natural disasters coming more frequently

and violently from June to November each year, The Bureau of Minority Health Access received

a grant award from the Centers for Disease Control Emergency Preparedness to implement a

pilot program called the Community Preparedness Response Network (CPRN) that is designed

to assist low-income communities with establishing their own community emergency

preparedness plan in the event of a natural disaster or pandemic flu outbreak. This program will

provide hard-to-reach populations a point of contact during natural disasters or pan flu outbreak

and make available resources to assist them with relief and recovery efforts specific for their

communities.

[Health Disparities] Page v

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