HEALTH AND WELL-BEING

NOTES FROM CAMBIO DE COLORES, MARCH 12, 2004

 

Final Session, identifying next steps for the conference planners and interim activities for the committee to follow up on health issues.

 

Future Topics for the Conference

 

A.   Specific illnesses/conditions/issues

 

o       Focus on specific issues (e.g., diabetes, family planning and reproductive health, obesity, nutrition, HIV/AIDS, dental health, mental health, vision care, and orthopedics).  The group specified the items on the above list which mixes diseases and conditions, risk factors, and categories of health care.  Steve Hadwiger, who teaches nursing at Truman State in Kirksville, volunteered to be the resource person for diabetes.

 

B.  Interpretation

 

o       Professionally trained medical interpreters are needed.  They must be trained to be able not only to interpret language and cultural concerns from the patient’s point of view, but also to interpret the health care providers questions, comments, and directions accurately and correctly.

o       Bilingual health care providers: the provider needs to be a provider first, not a provider AND interpreter—have trained interpreter even with bilingual providers.

 

C.  Training

 

  • The issue of training is a large one, and the following issues were mentioned in connection with it:
  • The conference needs to present practical ways of making training available in out-state Missouri, in rural areas.
  • Training for medical support staff, including receptionists and clerical staff (often the first in a clinic who patients have contact with)
  • Training must present techniques for addressing cultural beliefs that have bearing on health care practices and working with health care providers.
  • Training must enable health care providers to assess cultural issues in the clinical setting. (Steve Hadwiger is a resource person for this issue.)
  • Best practices and models in use in Missouri and elsewhere for training nurses, health care providers, allied health professionals

 

D.  Working with/in the community

 

  • Assistance in doing community needs assessment
  • The promotoras model of using natural leaders in the community, providing some training to them, and having them serve as liaisons with the health care clinics/system and as community health educators
  • Community education regarding sexuality and substance abuse, with materials in Spanish, including information about new drugs such as meth and inhalants (such as X70)

 

E.  Preventive health care

 

  • Need for education about it and services for it (e.g., availability of screenings for breast, cervical, prostate, colon cancers; guidance and supportive services and community facilitation—such as walking trails and farmers markets-- for healthy nutrition and physical activity; immunizations; community anti-smoking campaigns)

 

F.  Financing

 

  • Strategies for financing care for uninsured (and underinsured) patients
  • Available care and publicly financed reimbursement for care (e.g., community health centers, temporary Medicaid, emergency Medicaid, “SOBRA,” and others), including eligibility guidelines, information for workers with immigrants and immigrants themselves about how to access and use these programs.
  • Education for hospital administrators, billing clerks, and social workers about these sources of payment, reimbursement levels and co-pays, methods of billing, and so on.
  • Information about MC+, including eligibility, covered benefits, and reimbursement guidance.

 

G.  Aggregated issues

 

  • Work-site health
  • Mental health: adjustment to immigration and new culture for immigrants to learn to negotiate; acceptance, sensitivity; seeking treatment
  • Racial and ethnic social and health disparities; comparison of Hispanic/Latino immigrants and other minority groups; related health policy.

 

Suggestion for format for next year: Have an issue forum or 3-minute tag discussions around specific topics; have facilitated discussion time so conference participants can share their expertise as well as hearing from speakers.

 

 

Resources to address these issues

 

  • Specialists in the specific areas
  • Information/literature related to illness, diagnosis
  • Ind.(?) re: cultural issues and adherence to treatment regimen, diagnosis and management
  • Utilize experts who are bicultural and bilingual
  • Look to experts in other states such as California and Texas
  • Have sessions or a panel on “Latino(a) Voices” with community members
  • Consumer education, provider education, and patient education related to access and immigration
  • Outreach and community health outreach in community areas, apartment complexes, and so on  (dense)
  • Sustainability and financing strategies re: Int. (?) and CHIP
  • Mattie Rhodes Center is a resource for sessions on mental health and cultural issues, cultural appropriateness in mental health setting

 

 

Role You Can Play?

 

  • Alianzas: Binational Health Week, October 2004, with health specialists
  • Bilingual materials/literature for diabetes education
  • Springboard conference March 27 re language and culture in health care, in Overland Park, Kansas
  • Community Health Workers/Promotoras: Sharon Lee, Columbia and Guadalupe Center for HIV/AIDS and other STDs.
  • “Essential Spanish for Health Professionals,” is a course offered by Alexis Mayo in Kansas City.
  • Use Hispanic media to get information out to the community, have health features and a column listing primary care sites.
  • Have a permanent, on-line information clearinghouse on Cambio de Colores to provide information about resources.  This will need financial support. Arlene at ARCHS offered some assistance.

 

Health Strategic Planning Committee

 

Steve Hadwiger

Enrique Rivera

Cristina Vasquez Case