Preparing for the Next Generation

Latino Health in California

Verónica Montoya, Policy DirectorLatino Coalition for a Healthy California

California’s Healthcare : Measuring the Need

Background

Demographics

LCHC

Areas of Priority

Current Issues

Recommendations

Summary

Total population in California expected to increase- - Expected to add 10 million residents by 2020 - Brings the total state population to 46 million

Californians are getting older – A 73% expected increase in this population between 2000 - 2020

Our income is declining – Lower average pay in currently growing industries

Income and job gap in California is expected to widen – A quarter of California’s jobs pay $10 or less per hour

Background:

Source: California Budget Project, Paving the Way

Majority of California’s low-wage workers are adults and/or full-time workers -- - 84% of all workers are between the ages of 25 - 64 - Of those, nearly 60% are low-wage workers

Most workers depend on employer-based health care coverage –Nearly 18 million California residents receive health insurance coverage through their employer

Employer-provided coverage is declining -- In 2000, nearly 60% of all those with healthcare coverage received it through their employer. Only four years later (2004), this had declined to 54%

Approx. 6.5 million Californians are uninsured --More than one out every six people is uninsured

California’s Healthcare : Measuring the Need

Background

Demographics

LCHC

Areas of Priority

Current Issues

Recommendations

Summary

Source: California Budget Project, Paving the Way

Latino Health and Healthcare Coverage

Background

Demographics

LCHC

Areas of Priority

Current Issues

Recommendations

Summary

Demographics:

Nationally:• 13% of the US population is Latino• 1/3 of nation’s Latinos live in California • By 2050, 1/4 of the nation’s population will be Latino

Statewide:• 33% of Californians are Latino (11 million)• By 2040, half of the state’s population will be Latino (majority of new population growth will be within the Latino community)• One of every two children born in California is Latino

Source: 2000 U.S. Census

Latino Health and Healthcare Coverage

Background

Demographics

LCHC

Areas of Priority

Current Issues

Recommendations

Summary

Latinos tend to be younger -- The Californian median age is 34 versus 25 for Latinos

Latinos tend to have higher workforce participation rates but lower wages – Latinos continue to have one of the highest, but continue to comprise the largest population of low-wage earners – making up 57% of the current 59% of all workers who are low-wage earners

Latinos tend to be of the working age but have lower rates of employer-provided coverage –Only 43% of Latinos have employer provided coverage compared to 76% for Whites

Latinos are often uninsured –- Latinos continue to be the majority of those over-represented- Currently, 54% of the uninsured are Latino

Source: U.S. 2000 Census, U.S. Dept. of Labor, California Budget Project

Source: Institute of Medicine, Unequal Treatment

Latino Health and Healthcare Coverage

Latinos continue to increasing health disparities - Have higher incidence rates in chronic and LT

illnesses - Nearly one out of every five Latino adults over the age of 50 report they have diabetes, twice the rate for their White counterparts- Most recent data indicates that gap is getting worse with 59% of disparity measures widening for Latinos (Agency for Healthcare Research & Quality)

Latinos continue to be under-represented in health and medical professions- Despite being a third of California’s population, less than 5% of all practicing physicians, nurses and dentists are Latino- Continuing decline in medical school enrollment

Latinos physicians more likely to practice in underserved areas Minority physicians are more likely to provide care to minority population, practice in under-served areas and serve uninsured patients.

Background

Demographics

LCHC

Areas of Priority

Current Issues

Recommendations

Summary

Background

Demographics

LCHC

Areas of Priority

Current Issues

Recommendations

Summary

Access to Healthcare

Priorities in Latino Health

Community Health

Health Disparities

1

2

3

Issue: Latinos are the majority of California’s uninsured. Focus: Strategies that work to increase access to high quality, culturally and linguistically appropriate care in a timely manner

Issue: Less than 5% of all actively practicing physicians in California are Latino. Focus: Work to develop a diverse, culturally and linguistically competent health care work force

Issue: Nearly one in five Latino adults over the age of 50 report that they are diabetic, twice the rate of Whites Focus: Need to build healthy communities through collaborative, multi-sect approaches to prevent disease

Overcoming Health Disparities: Latinos in the Health Professions

Background

Demographics

LCHC

Areas of Priority

Current Issues

Recommendations

Summary

2

Economic and Workforce NeedAllied health accounts for 60% of the healthcare workforce

Continued projections on healthcare workforce ‘shortages’

Top 30 fastest growing jobs through 2010 in the U.S. expected to be in allied health jobs

Combining supply with demandAging population will place new demands on long-term careOpportunity to match (and educate) next generation of Latinos with demand

Impacting increasing cost in healthcare Patients’ perceived treatment (“concordance”) may positively impact

and reduce ongoing healthcare disparities in treatment & outcomes

Goal: to curb or decrease skyrocketing healthcare cost; Decreased cost(s) could enable more to be covered

Source: Commonwealth Fund, Disparities in Patient

Experiences

Source: UCSF Center for Health Professions

Overcoming Health Disparities: Latinos in the Health Professions

Background

Demographics

LCHC

Areas of Priority

Current Issues

Recommendations

Summary

CA Pop

Nurses MD DDS

Latino 31% 4% 4% 6%

Af. Am. 7% 4% 3% 2%

Nat. Am.

0.9% >1% >1% 0.2%

API 12% 13% 21% 41%

White 49% 79% 72% 52%

Source: U.S. Census 2000,

Overcoming Health Disparities: Latinos & Allied Health

Background

Demographics

LCHC

Areas of Priority

Current Issues

Recommendations

Summary

Source: U.S. Census 2000, UCSF Center for Health Professions

Estimated 200 different allied health professions – complicates data collection

Estimated 11 million workers

Latinos = Approx. 6-8%

Facts:

Projected Shortages:Per 100,000 U.S. CAMedical Asst. 233 217EMTs/Paramedics 63 46Respiratory Care Practitioners 29 26Clinical laboratory workers 102 76

What’s Been Done With Building Latinos in Healthcare?

Background

Demographics

LCHC

Areas of Priority

Current Issues

Recommendations

Summary

AB 2394 (Firebaugh)

Review of Policy:

Established the Task Force on Culturally and Linguistically Competent Physicians and Dentists to develop recommendations for a continuing education program for physicians and dentists. Also established sub-committee to study feasibility of establishing a pilot program to allow Mexican & Caribbean-licensed physicians and dentists to practice in non-profit community health centers in CA’s medically under-served communities.

1999

AB 1045 (Firebaugh)As follow up to AB 2394, AB 1045 created a pilot program for licensed physicians to practice medicine and dentistry in CA for 3 years. Also required a training program to be created by visiting clinicians. To date, program remains unfunded.

2002

What’s Been Done With Building Latinos in Healthcare?

Background

Demographics

LCHC

Areas of Priority

Current Issues

Recommendations

Summary

AB 938 (Yee)Creates Licensed Mental Health Service Provider Education program that provides loan assumption for mental health professionals.

2003

2003AB 982 (Firebaugh) LCHC sponsoredCreates the California Medical and Dental Student Loan Repayment program (later named the Stephen L. Thompson Loan Repayment plan) to provide loan repayment to doctors and dentists who agree to practice in under-served areas.2005

SB 63 (Committee on Budget & Fiscal Review)Creates SNAPLE (State Nursing Assumption Program ofLoans for Education) that allows loan forgiveness for those going into the teaching profession for nursing or nursing programs.

What’s Been Done With Building Latinos in Healthcare?

Background

Demographics

LCHC

Areas of Priority

Current Issues

Recommendations

Summary

Would have requested that the UC Regents take further information into consideration regarding the admissions process.

2005

2005AB 327 (De La Torre)Creates voluntary assessment of an additional $50 per application fee to be diverted specifically into the Medically Underserved Account that provides financial incentives to physicians and surgeons practicing in a medically underserved community.

2006

SB 1309 (Scott)Makes changes to the State Nursing Assumption Program ofLoans for Education program from full time to part time.Status: Before the Governor.

SB 780 (Ortiz) -- VETOED

Other Current Issues

Background

Demographics

LCHC

Areas of Priority

Current Issues

Recommendations

Summary

AB 2283 (Oropeza) LCHC sponsoredWould report data of physician cultural

ethnicity and languagePublic reporting annuallyOpportunity to begin public planningStatus: Before the Governor

Proposition 86: Stephen L. Thompson Loan Repayment Plan Issue of cost -- funding

Portion expected to continue funding programOpportunity to use as mirror programStatus: On November ’06 ballot

Recommendations: Thoughts for the Future

Background

Demographics

LCHC

Areas of Priority

Current Issues

Recommendations

Summary

Latinos

K-12 High School

CollegeHealth

Profession School

Inadequate educational programs

Drop Out No Applications

Academic Difficulty

Rejection

Health professionals

Financial difficulty

Source: Developing the CA Health Care Workforce of Tomorrow, CA Wellness Found.

Recommendations: Thoughts for the Future

Background

Demographics

LCHC

Areas of Priority

Current Issues

Recommendations

Summary

Need to continue collecting workforce data

Need to continue collecting patient data

Need to develop overall long-term, mid-range, and short-term strategy

Need to develop directed policy goals and objectives that will begin meeting the needs of the workforce (expected shortages)

Review of alternative non-policy strategies

Your Role Conclusion

Background

Demographics

LCHC

Areas of Priority

Current Issues

Recommendations

Summary

Opportunities to Collaborate:

Participate in HELhP (Health Enhanced by Latinos in health Professions)

Constructing strategies

Demand data

Keep updated on policy issues

See Yourself

Here.

For More Information

Latino Coalition for a Healthy California

1225 Eighth Street, Suite 500

Sacramento, CA 95814

Ph: 916.448.3234

Fax: 916.448.3248

www.lchc.orgStaff:

Lupe Alonzo Diaz, Executive Director

Verónica Montoya, Policy Director

Vanessa Cajina, Regional Networks Coordinator

Liz Dominguez, Administrative Assistant