Office of Health Equity

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Introduction

The Office of Health Equity (OHE) has taken an active role in addressing health disparities through its Minority Health Grant. The federal grant from the US Department of Health and Human Services (DHHS) Office of Minority Health targets health disparities in New Mexico, through key efforts such as raising awareness, mobilizing communities, increasing capacity, preventing disease, promoting health, focusing resources on targeted populations and delivering culturally appropriate care.

For additional information on New Mexico’s Minority Health Disparities Grant and its activities, please email LouAnn Sanchez-Lovato or call (505) 827-2895.

In order to expand its effort and focus in addressing health disparities in New Mexico in 2012 the Office of Health Equity hired Director, Dr. Carlotta A. García, Ph.D. The office also welcomes Immigrant Health Promotions Coordinator Javier Ríos as part of its ongoing statewide work in this area.

What Is Health Disparity?

“Health disparities” was first officially defined as “differences in the incidence, prevalence, mortality and burden of disease and other adverse health conditions that exist among specific population groups in the United States”.  Health disparities are relative, and are identified by comparing the health status, access to services and/or health outcomes of population groups.  Characteristics such as race or ethnicity, limited English proficiency, disabilities, sexual orientation, economic status and geographic location may affect one’s ability to achieve good health.   Although there have been national efforts to reduce health disparities and achieve health equity during the past two decades (Healthy People 2000, 2010, 2020 and the National Partnership for Action to End Health Disparities), these efforts have been hampered by a lack of consistency in collecting and reporting health data. The Patient Protection and Affordable Care Act passed in 2010 not only addresses access to care, it also addresses the need for improved data to identify significant health differences that often exist between segments of the population .  As a result the Office of Minority Health in the United States Department of Health and Human Services has released new minimum data standards for Race and Ethnicity, Sex, Primary Language and Disability Status.  Improved data will assist in efforts to target affected populations and monitor efforts to reduce health disparities and move the United States to a status of health equity — “the attainment of the highest level of health for all people”.

In other words, health disparities refer to gaps in the quality of health and health care across population groups. The National Partnership for Action to End Health Disparities (NPA) was established by the United States Health and Human Services Department to mobilize a nationwide, comprehensive, community-driven, and sustained approach to combating health disparities and to move the nation toward achieving health equity. The “2011 National Healthcare Disparities Report” states that the quality of care is improving, but access to care and disparities in care are not improving particularly for minority groups and low-income individuals. According to the US Census, in 2011 22 percent of New Mexican families were living in poverty compared to the national level which was 15 percent. New Mexico is a state where nearly one fifth of the population lives below the poverty line and the new Census numbers indicate that New Mexico is officially the poorest state in the country, with one out of every four families living in poverty.

The concept of health disparities is important for all but is especially relevant for a state such as New Mexico. New Mexico is a minority-majority state with Hispanics and American Indians accounting for over fifty percent of the population. Although the United States is increasingly diverse, Whites who are not Hispanic comprise over sixty percent of the national population compared to forty percent of New Mexico’s population. Although New Mexico has a slightly smaller percentage of foreign-born residents (NM 9.7%, US 12.7%), it has a larger percentage of individuals who speak a language other than English at home (36%) than is true nationally (20.1%). Economically, New Mexico has a lower unemployment rate than the nation (NM 6.5%, US 8.2%) but a higher rate of individuals without health insurance (NM 21%, US 16%) and a higher rate of individuals living below 100% of poverty (NM 23.8%, US 20.2%).

In Summary:

• 6 of 10 New Mexicans belong to racial/ethnic minorities
• 36 of 100 speak a language other than English at home
• 1 of 5 are without health insurance, and
• 24 of 100 live below the poverty level.

Similar to the nation, New Mexico’s older population is growing rapidly. The number of New Mexicans over the age of 65 increased 26 percent between 2000 and 2010. This number is expected to increase even more rapidly in the next decade with the aging of the “Baby Boomers” who began turning 65 in 2011.

The New Mexico Department of Health has selected nine indicators as focus areas for New Mexicans:Child and Adult Obesity, Tobacco, Diabetes, Teen Births, Adult Immunizations, Oral Health, Elderly Falls, Drug Overdose Deaths and Alcohol-Related Deaths. Among these focus areas some of the health challenges New Mexico faces are:

• Teenage pregnancy among Hispanics continues to be higher than any other racial/ethnic minority.
• Unintentional injuries are the second leading cause of death for American Indians and the third leading cause of death for Hispanics.
• Diabetes is one of the top 5 causes of death for American Indians, Asians, Blacks, and Hispanics.
• Tobacco use is substantially higher among those with low incomes.
• Male rates of suicide are three to five times that of females.

The National Healthcare Disparities Report identifies American Indians/Alaska Natives, Hispanics and poor people as experiencing disparities in access to care. As the above data demonstrate, a substantial proportion of New Mexicans fall into these categories.  In addition, New Mexico has the fifth largest land area among the fifty states but contains only four cities with populations of 50,000 or more. Thirty-two of New Mexico’s thirty-three counties contain health professional shortage areas. Over forty percent of the state’s population is estimated to live in a Primary Care Health Professional Shortage Area.

 

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Adult Vaccine Project

OHE oversees and implements the activities of the State Partnership Grant to improve minority health, which was awarded by the Federal Office of Minority Health. The funding received through this grant has enabled OHE to engage in the following program activities with the goal of improving awareness of health disparities as well as the ability of the Department to address these disparities.

The Office of Health Equity is the lead in implementing an adult vaccine pilot project. The project is geared towards increasing adult (≥ 65) vaccines and reducing deaths at a local level by developing cultural and linguistically appropriate media messages to raise the awareness and knowledge of the dangers of the lack of pneumonia vaccines and scheduling vaccine clinics in the community. OHE has effectively implemented a Community Engagement Model by which they are partnering both internally and externally with local health providers, senior citizens centers and community based organizations who are working together to provide outreach, education, and awareness to individuals age 65 and older, specifically Hispanics with low adult vaccination rates. In FY 11-12 OHE successfully held 10 adult vaccine clinics in 2 rural communities and administered approximately 1,000 adult vaccines. Please use the report links for Luna and Río Arriba Counties to read more about the Community Engagement Model, which outlines the protocol and process followed to successfully complete this project. OHE 2013 goal is to decrease the percent of Adult Hispanics age 65 and older that have never received a pneumonia vaccination from 46.6% to 42%. In FY 12-13 OHE has already administered 1400 adult vaccines.

 

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Language Access Services

These services include Spanish/English translation and medical interpreter training in both Spanish and Navajo languages. Please see the individual sections below for details.

Spanish Translations

New Mexico has a high percentage of Hispanics, 49.04% of the total population, with a substantial number of Hispanics who speak only Spanish. Translation of documents is essential to address the needs of racial, ethnic, and linguistic population groups that experience unequal access to health services.

Translation of documents is essential to focus on the Cultural and Linguistically Appropriate Services (CLAS) Standards, which are designed to address the needs of racial, ethnic, and linguistic population groups that experience unequal access to health services. Accurate translation services are also important, to improve access to health care, and improve the ability of Department of Health programs and clinics to serve clients with Limited English Proficiency.

To that end, The Office of Health Equity has a full time Spanish translator/interpreter Lilia Olivas-Whitener who provides translation services for New Mexico Department of Health programs. She will ensure materials are at an appropriate reading level in both languages and that they are culturally and linguistically appropriate for this target population.

The Office of Health Equity has a full time English-Spanish, Spanish-English translator, Lilia Olivas-Whitener, who also teaches a class for DOH staff in the County Health Clinic: "Spanish for Health Care Workers", two semesters a year. Depending on the number of DOH staff attending the class, Community stakeholders and DOH partners are also invited to attend. This class takes place in the large Conference Room at the Santa Fe County Health Clinic, 603 Letrado St. Interested persons can email Lilia Olivas-Whitener, or call her at 505-476-3656. Lilia Olivas-Whitener has several dictionaries with diverse vocabulary, including Health, Social Work and Mental Health terms. Electronic copies of the glossaries may be sent upon request to Lilia Olivas-Whitener.

If you require English-Spanish translation, please download, complete and email the translation services form and email it to Lilia Olivas-Whitener. If you require interpreter services please refer to our interpreter services list document for information in your area.

Medical Interpreter Training

The Office of Health Equity has provided both Spanish and Navajo bilingual medical interpreter training to Department of Health staff and providers of community-based services. The goal of these trainings is to increase access to health care for minority populations by decreasing cultural and linguistic barriers to care.

Spanish

The Spanish interpreter training is provided by two different consultants on contract with Office of Health Equity. The Spanish interpreter training classes provide approximately 32 hours of classroom training and include sections on medical terminology, physiology, anatomy, cultural competence, traditional Hispanic medicine, Cultural and Linguistically Appropriate Services and role-playing health care scenarios designed to address the needs of racial, ethnic and linguistic population groups that experience unequal access to health services.

Navajo

The Navajo Medical Interpreter Training provides 32 hours of classroom training and includes a review of the Navajo clan system, regional Navajo language idioms, roles of the interpreter/translator, CLAS Standards, anatomy, verbal descriptions of pain utilized by Navajo patients, common illnesses and diseases, role playing and death and dying for Navajos.

If you are interested in registering for these classes, please download, complete and email the interpreter services form to Javier Rios or call (505) 827-2573.

Culturally & Linguistically Appropriate Service (CLAS) Initiative

For a free CLAS training course and other cultural and linguistic resources, please visit the New Mexico Cultural Competency Information and Education Center website.

 

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American Indian Health

The Department of Health has compiled a list of services that specifically addresses American Indian Health (AIH) in the American Indian Health Services Brochure. We are committed to working together to speak with one voice, to improve access to our services and information, to prevent disease, promote health, and reduce health disparities.

AIH develops strategies to eliminate health disparities among American Indian populations residing in New Mexico, identify and providing technical assistance and strategizing training needs for American Indian communities, identify gaps in the existing healthcare delivery systems and developing strategies to address these gaps as well as facilitating partnerships that improve the health of American Indians in New Mexico.

Advisory Council

The American Indian Health Advisory Council (AIHAC) was created in 2006 to provide guidance to the New Mexico Department of Health on issues impacting American Indian populations residing in New Mexico.

Responsibilities of the Committee include: Developing strategies to eliminate health disparities among American Indian populations residing in New Mexico; Identifying and providing technical assistance and strategizing training needs for American Indian communities;

• Identifying gaps in the existing healthcare delivery systems and developing strategies to address these gaps; and
• Facilitating partnerships that improve the health of American Indians in New Mexico.

AIHAC consists of fifteen representatives nominated for appointment to the NMDOH by federally recognized Tribes/Nations/Pueblos and Off-Reservation Organizations serving American Indian communities. All nominations are submitted to the Secretary of the Department of Health for consideration.

AIHAC also includes the Tribal Liaisons from the New Mexico Department of Health, Human Services Department, Indian Affairs Department, Children, Youth and Families, Aging and Long-Term Services Department, and the Behavioral Health Collaborative. The Tribal Liaisons, the Tribal leaders from all 22 New Mexico Tribes, Nations and Pueblos are considered Ex-Officio, non-voting members.

Off Reservation Native American Health Commission

The Off Reservation Native American Health Commission was enacted by the New Mexico State Legislature in 2008 in response to the lack of health care resources and services for tribal members living in Bernalillo County. The Commission serves as a voice for off-reservation tribal members who have long been overlooked in policy decisions. It engages in comprehensive health planning and assists local organizations to identify and secure alternative sources of funding to expand and strengthen the off-reservation health care delivery system. It provides education, outreach, and advocacy so Native people can participate in the policy decisions that affect their health regardless of where they live.

 

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Border Health

The Office of Border Health's (OBH) role is to improve the health status and health services in the New Mexico/Mexico border region and to provide guidance and support to public health initiatives that serve the migrant and recent immigrant subpopulations throughout the state.

OBH coordinates programs with state and federal health authorities in Mexico, the other US border states of Texas, Arizona and California, and agencies of the US Department of Health and Human Services.

This is a dynamic region that is medically underserved with a population that has unique cultural and social conditions, higher uninsured rates, high rates of transborder migration, inequitable health conditions and a high rate of poverty.

Visit the New Mexico Border Health website for additional information.

Contact Information

For information on the Office of Border Health and its activities, email Paul Dulin, Director of the Office of Border Health or call (575) 528-5154.