2 0 1 1 B i n a t i o n a l H e a l t h We e k Events in Kansas Juntos Center for Advancing Latino Health Department of Preventive Medicine and Public Health University of Kansas Medical Center
Latinos in Kansas…..
BHW Events in Kansas…………….......
Ventanilla de Salud…..………..….....
2011 Celebrating Healthy Families in Kansas City, KS…....
2011 Summary of Findings …...….…….
Ventanilla de Salud 2012 Calendar..…….
Among the various Mexican health initiatives in the United States, Binational Health Week (BHW) and Ventanilla de Salud have been a top priority for Mexican consulates across the U.S. and for the Institute of Mexicans Abroad, an independent agency within the Ministry of Foreign Affairs of Mexico. Since its creation in 2001, BHW has been growing in the U.S. and Mexico. In the last eleven years, BHW has been expanded in the U.S. and Canada with the support of consulates of Mexico and other Latin American countries such as Guatemala, Bolivia, Honduras, Colombia, Ecuador and Peru. The primary goal of BHW is to improve the health and well-being of the underserved Latino population living in the United States and Canada. Moreover, BHW seeks to increase public awareness and knowledge about health services available at the local level. In the state of Kansas, Juntos Center for Advancing Latino Health has been working in collaboration with the Consulate of Mexico in Kansas City, Missouri, the U.S. Department of Health and Human Services, community organizations, heath professionals, health departments, and volunteers to promote BHW initiatives across the state.
In 2011, the Consulate of Mexico in Kansas City and Juntos signed a memorandum of understanding to establish a Ventanilla de Salud Móvil. This is the 51st Ventanilla in the U.S. and the first mobile ventanilla. Juntos is committed to addressing health disparities through outreach, education, research and service. BHW is an essential component as we generate and disseminate knowledge and understanding of health disparities in underserved Latino communities. In 2011, Kansas hosted a series of BHW health events with health education stations, screenings, flu shots, and a referral system. This newsletter provides a summary of the events.
Artist: Margarita Ramirez Padilla 2011 Binational Health Week Poster
Latinos in Kansas Latinos are the largest and fastest growing minority population in the U.S., accounting for 16% of the total population. Latinos represent most of the nation’s growth—56% increase—from 2000 to 2010. Four immigration waves characterize the history of the Latino population in the state of Kansas. Latinos have been settling and establishing cultural roots in Kansas since the early 1900s. Today, Latinos represent 10.5% of the total population in Kansas. The 2010 U.S. Census indicates that the Latino population in Kansas grew 59.4% from 2000 to 2010. Figure 1 illustrates that 34 out of 105 counties have a Latino population of 7% or more. Interestingly, twelve counties in Kansas have a Latino population of 20% or more,
and ten of these counties are located in Southwest Kansas. From 2000 to 2010, 64 Kansas counties experienced over a 50% increase in the Latino population and 24 experienced an increase of over 100%. In Kansas, Latinos are 14 years younger than the average age for Non-Hispanic Whites. Moreover, Latinos are predominantly Spanishspeaking, of Mexican origin, with low income and limited resources. Healthcare access is a concern for Latino immigrants in Kansas: 59% of foreign born Latinos are uninsured (Pew Hispanic Center, 2010). This percentage is 49 times higher when compared to the NonHispanic White uninsured population. As the growth of Latinos in the state challenges the healthcare
system, it also offers an opportunity to improve our cultural competency within the health field. Latinos have arrived in numbers large enough to revitalize both rural and urban areas in Kansas. This Latino influx has also energized small communities in rural Kansas. An article published in the New York Times newspaper on November 13th, 2011 states that “Hispanic residents have pushed from hubs like nearby Dodge City, Garden City and Liberal into ever smaller communities” (Sulzberger, 2011). In sum, Latinos are an integral part of Kansas’s past, present, and future. These residents have added cultural richness, hard work, and are contributing significantly to the local and state economy.
2 0 1 1 B i n a t i o n a l H e a l t h We e k E v e n t s in Kansas Location
2010 Census % Latinos Per County
Date Of Event
Number of Collected Participants Surveys
Education stations: healthy lifestyles, smoking cessation, and cancer prevention. Screening stations: BMI, blood pressure, glucose, and glaucoma. Ask-a-doctor station
Education stations: healthy lifestyles, mental health, and health insurance coverage. Screening stations: BMI, bone density, and chiropractic services. Ask-a-doctor station Free flu shots
Education stations: Cancer prevention, diabetes, and immunizations. Screening stations: Dental, vision, chiropractic services, high blood pressure, glucose, and bone density.
Education stations: healthy lifestyles, smoking cessation, cancer prevention, and children immunization. Screening stations: BMI, blood pressure, glucose, comprehensive metabolic panel, vision, and dental. Ask-a-doctor station Free flu shots
10/15/11 Education stations: smoking cessation, healthy lifestyles, and cancer prevention. Screening stations: Glaucoma, blood pressure, and glucose. Flu shots
10/22/11 Education stations: healthy lifestyles, smoking cessation, and cancer prevention. Screening stations: BMI, blood pressure, glucose, and glaucoma. Ask-a-doctor station Free flu shots
Ve n t a n i l l a d e S a l u d i n K a n s a s Ventanilla de Salud is a health outreach program implemented through 50 Mexican consulates in the United States and local health organizations. (See Figure 2)
as the coordinator and outreach worker. On November 2011, the Consulate of Mexico in Kansas City, Missouri, and Juntos signed an agreement to establish a Ventanilla de Salud Móvil. The new mobile Ventanilla will operate at Mexican mobile consulates in Kansas (See Calendar on page 10). The Ventanilla will also foster local partnerships to support, plan, and implement BHW events.
Ventanilla de Salud provides Latino families with bilingual and culturally relevant health education, free health screenings, health insurance information, and referrals to community health services.
The inaugural ceremony was held on March 6th, 2012 at Garden City Community College (GCCC). Among the special guests were Garden City Mayor John Doll, Captain Jose Belardo from the U.S. Department of Health and Human Services -Region VII, President of GCCC Dr. Herbert J. Swender, Commissioner Robert DeLeon, Stephanie Waggoner from UMMAM clinics, Dennis Meza from the Kansas Housing Resources Corporation, Itzel Rodríguez from GCCC, Leo Prieto and Dora Ponce, both Advisors for the Institute of Mexicans Abroad, and Promotores de Salud.
In 2009, the Consulate of Mexico in Kansas City, Missouri, created a Ventanilla de Salud in partnership with Samuel U. Rodgers Health Center to offer Latino residents health prevention education and access to health services and public health programs. Since its creation, Aracely Van Kirk has served
At table (from left): Leo Prieto, Robert DeLeon, Captain Jose Belardo, Consul Jacob Prado, Paula Cupertino, Gudelia Rangel, Mayor John Doll and Dora Ponce at inauguration on March 6th, 2012. Figure 2: Map of Ventanillas de Salud in the United States
Source: Ventanilla de Salud, www.ventanillas.org Page 4
From left: Dennis Meza, Mayor John Doll, Dr. Hebert J. Swender, Dr. Paula Cupertino and Consul Jacob Prado at Ventanilla Móvil inauguration.
From left: Ramon Concepción, Mercedes Saint-Elin, Aracely Van Kirk and Promotoras de Salud at Ventanilla Móvil inauguration.
2 0 1 1 C e l e b r a t i n g H e a l t h y Fa m i l i e s Binational Health Event in K a n s a s C i t y, K a n s a s In the context of Binational Health Week, Celebrating Healthy Families has offered health screenings, education, and resources to underserved Latinos living in the Kansas City Metropolitan area.
the Department of Preventive Medicine and Public Health at the University of Kansas Medical Center.
2011 EVENT OUTCOMES
In 2011, the annual event took place on Saturday, October 8th at Memorial Hall in Kansas City, Kansas.
133 registered children
Throughout the years, this BHW initiative has grown from a one day health focus event to case management and follow-up services for Latino patients in need of a medical home.
Celebrating offered a Childrenâ€™s Corner with vision and dental screenings, and immunization information.
NUMBER OF SCREENINGS
In partnership with the Regional Lab Alliance, we provided access to comprehensive metabolic panels to participants identified at high risk for diabetes or cardiovascular disease. The most urgent cases received follow-up services as the case manager connected them to a medical home. In addition, those at high risk for developing diabetes or cardiovascular disease participated in a culturally appropriate risk reduction program.
Created in 2006, Celebrating Healthy Families is the result of a community-academic partnership between organizations such as the Coalition of Hispanic Women Against Cancer, El Centro, Inc., Heart to Heart International, Truman Medical Centers, Childrenâ€™s Mercy Hospitals & Clinics, Midwest Cancer Alliance, the Consulate of Mexico in Kansas City, Missouri, and
Celebrating Healthy Families health fair at Memorial Hall in Wyandotte County on October 8th, 2011.
Participants having their blood pressure measured at the event.
618 registered attendees
Cholesterol: 466 Blood pressure: 562
Body Mass Index: 501 Dental: 56 Skin/Sun damage: 109 Vision: 206 Comprehensive Metabolic Panel: 312 150 FREE FLU SHOTS WERE ADMINISTERED
Child receiving a free flu shot from a KU medical student volunteer.
Pictures courtesy of: Jorge Coromac from Heart to Heart International
B i n a t i o n a l H e a l t h We e k S u r v e y 2011 Summar y of Findings During Binational Health Week, the Consulate of Mexico in Kansas City, Missouri, with the support of Juntos, administers surveys to asses demographics, healthcare access and needs of underserved Latinos. In 2011, a total of 268 surveys were administered in Kansas, among participants who were 18 years old and older. The same survey instrument is conducted across the U.S. by BHW coordinators and a report is sent to local partners and to the Mexican government. Below is a summary of the 2011 findings for the state of Kansas:
Who Do We Serve? The survey findings show that BHW participants were predominantly Spanish-speaking, of Mexican origin, and residents of Kansas. Of 264 health fair participants, the mean age was 41 years old. Participants’ ages ranged from 18 to 72. Figure 3 shows age distribution. As in previous years, the majority of health fair participants were females (68%). Most participants reported Mexico as their country of origin. Of 268 respondents, 94% were Mexicans. Among these, twenty six cities and states in Mexico were indicated as place of birth. The Mexican states with the highest numbers of BHW participants were: Chihuahua (81 participants), Durango (38 participants), Jalisco (17 participants) and Zacatecas (16 participants). Other stated countries of origin were: the U.S. (2.2%), El Salvador (0.7%), Guatemala (0.7%), Honduras (0.7%), Ecuador (0.4%), and Peru (0.4%). Participants were asked about their first entrance to the U.S. Of 243 respondents, 39% entered the U.S. between 1980 and 1993, and 55% entered the U.S. between 1994 and 2005. After 2005, there was a decline in the immigration trend, with only 7% of participants who reported entering the U.S. between 2006 and 2011. Only 18% participants visited their country of origin at least once since they first migrated to the U.S.
Source: 2011 Binational Health Week Surveys
“Most BHW participants were ... Young adults … Spanish Speakers … Females ... Mexicans ... Specifically from Chihuahua, Durango, Jalisco and Zacatecas. … Residents of Kansas.”
Survey findings also show that the majority of participants (62.3%) had less than a high school education. This correlates with low literacy levels and reflects the demand for low skilled labor in Kansas.
HEALTHCARE ACCESS Six questions pertaining to healthcare access in the U.S. were included in the BHW survey. Of 210 participants, 52% declared that they did not have access to healthcare services in the U.S. These findings are consistent with previous BHW reports. Moreover, this also reflects that specialized healthcare is not accessible to the underserved Latino community. Some participants sought healthcare in their country of origin, but the majority did not travel outside the U.S. to seek healthcare services. In fact, only 11% declared to have traveled outside the U.S. in the last 12 months to receive healthcare, dental care or purchase medication. Participants were asked to rate the health services or information that they received at the BHW event: 90% said that “It was very helpful.”
43% Participants indicated that this was the first time they saw a healthcare provider in the U.S.
44% Participants declared that this was the first time they received healthcare information in the U.S.
Another question was “Is this the first time you see a healthcare provider in the U.S.?” Of 211 respondents, 57.3% indicated “No” and 43% declared “Yes.” The follow-up question was “Is this your first time receiving health information in the U.S.?” Of 219 participants, 56.2% indicated “No” and 44% answered “Yes.” Of those participants who visited a healthcare provider in the U.S., 61.5% indicated that this happened “Less than a year ago” (See Figure 4). The majority (70%) stated that they sought healthcare in the U.S. at a “Community Health Center”; others indicated a “Primary Care Physician” (17%), a “Health Department” (3%), an “Emergency Room” (2%), and some (8%) said other places such as “Health Fairs” and “Friends and Family.”
Source: 2011 Binational Health Week Surveys
Most participants seek healthcare services at … A Community Health Clinic (70%) … Primary Health Physician (17%)
HEALTH INSURANCE AND HEALTH ASSESSMENT Most BHW participants lack health insurance: 80.1% indicated not having health insurance. (See Figure 5) Among those that did have health insurance, most declared that their coverage provider was in the U.S. and only 3.1% reported having health insurance coverage in their country of origin. Additionally, the majority of these respondents indicated paying for their health insurance coverage and did not rely on public programs like Medicaid. The situation is different for children of BHW participants who reside in the U.S. Of 261 BHW participants, 71% declared to have children under the age of 18 living in the U.S., which represents a total of 407 children. Among these children, most (64.4%) had health insurance coverage while more than a third (35.6%) were uninsured.
Source: 2011 Binational Health Week Surveys
64.4% Children had health insurance coverage 35.6% Children did not have health insurance coverage The last question on the survey was “How would you rate your health?” The five response options varied from “Excellent” to “Very Bad.” A significant number of BHW participants declared “Good” or “Fair.” Figure 8 shows a distribution of responses from 220 participants: - 41.8% declared that their health was “Good” - 30.5% indicated “Fair” - 21.8% stated “Excellent” - 4.5% said “Bad” and - 1.4% noted “Very Bad.” Source: 2011 Binational Health Week Surveys
CONCLUSION Latinos in Kansas are an integral part of dynamic communities in rural and urban areas of our state. From smaller communities to larger cities, many are responding positively to the challenges of new Latinos immigrants by welcoming, understanding, and looking for resources to improve the overall wellbeing of these new residents and their communities. Collaborations among community organizations, community health clinics, local agencies, volunteers, Promotores de Salud and stakeholders are much needed to reduce health disparities in underserved communities. This, however, presents many challenges: lack of medical homes, bilingual and culturally
competent health professionals, and health insurance coverage are among the biggest barriers.
community partners will support BHW events throughout the state.
Many Latino immigrants look forward to participating in BHW events to obtain healthcare, health screenings, and bilingual and culturally appropriate health information.
It is our goal to increase not only providersâ€™ awareness of the healthcare needs of the underserved Latino community, but encourage local agencies, state programs, and volunteers to join this annual binational effort.
At Juntos Center for Advancing Latino Health, we believe that by promoting culturally appropriate health education and health prevention, we can empower underserved Latinos. One of the purposes of BHW events in Kansas is to provide services that are in high demand. In 2012, BHW events will offer education and screenings for cancer, cardiovascular disease, cholesterol, dental, vision, HIV/AIDS, and flu shots. The Consulate of Mexico in Kansas City, Missouri, Juntos and all
We would like to extend our sincere gratitude to all the health providers, volunteers, and community partners that help plan, organize and implement BHW events in 2011. Together we brought healthcare services to many underserved residents in Kansas.
Glaucoma screening during binational health week at Consulate of Mexico in Kansas City, MO. Aracely Van Kirk and Promotora de Salud Mary Ramirez providing glucose screening at binational health fair in Great Bend.
Medical student Samuel Ornelas volunteered at a binational health fair in Garden City.
Aracely Van Kirk conducting surveys at a health fair in Garden City.
Promotores de Salud and Cielo Fernandez from El Centro, Inc. at a health fair in Liberal.
Johana Bravo from Juntos at smoking cessation table in Great Bend. Page 9
Ve n t a n i l l a d e S a l u d M ó v i l 2012 Calendar of Activities Date
Saturday, March 24th
Dodge City, KS
Saturday, April 28th
Saturday, May 12th
Garden City, KS
Saturday, June 23rd
Saturday, August 4th
Great Bend, KS
Saturday, August 25th
Garden City, KS
Saturday, September 8th
Saturday, November 17th
Garden City, KS
To volunteer, provide health education or health screenings, please contact Ramón Concepción at email@example.com or (913) 945-7873.
Special Thanks to:
Juntos Center for Advanding Latino Health University of Kansas School of Medicine Department of Preventive Medicine and Public Health 4125 Rainbow Boulevard MS 1056 Kansas City, KS 66160 March 2012. Newsletter created by Mercedes Saint-Elin and Johana Bravo. Articles written by Mercedes Saint-Elin and Johana Bravo. We want to thank Ramón Concepción, Natalia Suárez, Marina Daldalian, and Octavio Estrella for their comments. For more information, please contact Dr. Paula Cupertino, Juntos Director, at firstname.lastname@example.org or (913) 588-2783 or Mercedes Saint-Elin, Research Associate, at email@example.com or (913) 588-1737.