Download Slide 1 - National Hispanic Medical Association

Health Care Reform
Through the Cancer Lens
State and Private Sector Reforms for Hispanic Healthcare
National Hispanic Medical Association
15th Annual Conference
March 19, 2011
Edward E. Partridge, MD
National Board President
American Cancer Society
Through its Body of Work, the
American Cancer Society is the
leader in the global effort to
eliminate cancer disparities
among ALL populations …Because
Cancer Doesn’t Discriminate!
The Case For Equity
Population Distribution by Race/Ethnicity,
U.S. (2009)
7%
Other
16%
Hispanic
12%
Black
65%
White
0%
20%
40%
Source: U.S. Census Bureau, CPS: Annual Social and Economic Supplements
60%
80%
Uninsured Hispanic, under age 65: US,
1998-2009
(3 Year Annual Average)
Source: National Health Interview Survey (NHIS)
Leading Causes of Death, Among
Hispanics by underlying cause, ages 18+:
US/State, 1999-2007
Death Rates
Source: The National Vital Statistics System
Chronic conditions, ages 18+: US,
1997-2008 - Hispanic Population
%
%
%
%
%
%
%
Percent
%
%
%
Source: National Health Interview Survey (NHIS)
%
%
Incidence and Death Rates for All Cancers
Combined among Hispanics 1992-2006
Source: Cancer Facts & Figures for Hispanics/Latinos, American Cancer Society, Atlanta, GA
What We Know
 Suffering and death could be prevented through
more systematic methods of health screening and
early detection.
 A disproportionate number of Hispanics and
other medically underserved populations are not
fully benefiting from available resources.
 Underlying causes of cancer disparities are
interrelated and complex
Causes of Cancer Disparities
Can be linked to social determinants of health,
such as but not limited to:




Inequalities in access to care,
Language barriers,
Unhealthy environments, and
Discrimination
Disparities In Outcomes Are Related With:
1. Treatment…
Hispanics and other minority groups are more likely to be living in poverty
and are less likely to receive recommended treatment.
2. Screening…
Hispanics and other minority groups are more likely to be uninsured and are
less likely to receive timely screening.
3. Incidence…
Hispanics and other minority groups are more likely to be diagnosed with
later-stage preventable cancers.
4. Mortality…
Hispanics and other minority groups are more likely to earn a lower income
and are more likely to die from preventable cancers.
5. Risk Factors…
Hispanics and other minority groups are more likely to report cancer related
risk factors.
How Do We Address Disparities?
Focus Areas:
 Prevention and Early Detection - increasing
access to cancer screening, diagnosis and treatment
 Information – data collection and evaluation
 Quality of Life - Serving with impact
 Research
Through…






Advocacy
System Policy and Practice
Cancer Information and Empowerment
Resource Navigation
Communities of Support
Research
Lessons Learned
Task of Eliminating Disparities – Daunting or not?
1. Technical advances to be delivered not so complex
-- tobacco control
-- age appropriate screening
-- healthy diet, physical activity
2. Populations most at risk
-- geographically focused
3. Patient Protection and Affordable Care Act
-- eliminates barrier to access
4. Communities most at risk eager to engage
Easy to More Difficult Changes
Easy
1. age appropriate screening
2. tobacco control
3. high quality treatment for all
Difficult
4. healthy eating, physical
activity
Community Engagement
Create trust
Eliminate bias
Share power
Strategies to Improve Cancer
screening among Hispanics
 Effective communication initiatives are needed
to close this knowledge gap.
 Social support may improve participation in
screening.
 Local outreach programs and culturally targeted
interventions by lay Hispanic health advisors
along with physician encouragement are also
effective strategies for improving cancer
screening participation rates
A number of provisions in the
Affordable Care Act will help
reduce these disparities and
increase access to culturally
competent care for Hispanics
How Does the Patient Protection and
Affordable Care Act Help?

Expanding Coverage
 Private insurance
 Medicaid
 Medicare

Enhancing Prevention

Improving Quality of Life
Implementation
Expanding Coverage: Medicaid
 Expands coverage to all persons under 133%
FPL (up to $29,327 for a family of four)
 Simplifies enrollment into Medicaid
 Incentive programs to encourage participation
in chronic disease preventive programs
 Increases access to cessation drugs
Implementation
Addressing Disparities
 Qualified health plans must provide materials
in appropriate languages
 Strategy for increased access to language
translation services
Implementation: State activity
 Contracting of high-risk pools
 Creation of the exchanges
 Creation of state-based ombudsman programs
 Protecting mandates and Breast and Cervical
program until at least 2014
YOUR ROLE
Implementation: To do list
 Learn what’s in the bill
 Identify state publications that will update you
 Develop a relationship with your State and Local
officials, i.e. State Insurance Commissioner and
Medicaid Director
Implementation: Resources
ACS CAN Web page: http://www.acscan.org/
THANK YOU
©2010 American Cancer Society, Inc. No.0052.19