1. Ethnogeriatrics and the US Healthcare System February 7-23, 2012 Course Directors: Seema S. Limaye, MD Assistant Professor of Medicine Pat MacClarence, MA, LCSW Outpatient South Shore Senior Center Section of Geriatrics and Palliative Medicine University of Chicago

2. Pre-Test

3. WELCOME and Introductions

4. Course Introduction: Why does this stuff matter? Complexities of US HCS. Multiple geriatric health care settings. Interprofessional is real-world. Growth of ethnogeriatric population

5. US Census Bureau 2000: Projected Population Growth of Elderly Whites Blacks, American Indian/Alaska Natives, Asian and Pacific Islander, Hispanic/Latino 84% 36% 64% 16% 2000 2050

6. GOAL & OBJECTIVES Medicare Module Long-Term Care Module Health Literacy Module Hospice and Palliative Medicine Module FOCUS: –“System” basics –Health disparities –Ethnogeriatrics—WHAT???

7. Intersection of the Studies of Aging, Ethnicity, and Health Ethnogeriatrics Health Ethnicity Aging GeriatricsEthnogerontology Transcultural Health

8. How will we learn about this topic?

9. Course Schedule: Please note room changes

10. Small Group Projects PURPOSE: 1.Highlighting a geriatric healthcare disparity 2.Identifying various “levels” at which this disparity exists, and 3.Developing potential interventions to narrow this disparity.

11. Definition of Health Disparity Operation of HCS; Legal and Regulatory Climate Discrimination: Biases, Stereotyping, and Uncertainty Clinical Appropriateness and Need; Patient Preferences Disparity Non- Minority Minority Quality of Health Care Difference Gomes and McGuire, 2001

12. More Definitions… What is race? –Socially constructed categories based on parentage and physical appearance What is culture? –The way of life of a population, including shared knowledge, beliefs, values, attitudes, rules of behavior, language, skills, and world view among members of a given society What is an ethnic group? –A group of individuals with a shared sense of peoplehood based on race, religion, or national origin (Gordon, 1964), now commonly used to refer to a group with a distinctive culture

13. A few more definitions… Health Status Health Care

14. Disparities in Health Status and Health Care How extensive are health care disparities? Why do health care disparities exist? What are the perceptions of providers and the public regarding disparities?

15. Small Group Projects REQUIREMENTS: –Assigned Groups. –Pick a topic. Confirm topic by Thursday, Feb 9, 2012. –30 minute presentation. –Feedback.

16. Developing an Intervention Use the strengths of all your colleagues. Be creative! Consider various levels on which to develop your intervention: 1.National: Federal policy 2.Regional: Local/State policy, community programs, grassroots. 3.Institution/Facility/Practice 4.Clinician-Patient-Family

17. Other Topics to Consider Disparities in cancer detection/treatment in older minority patients Disparities in long-term care facilities Disparities in access to food for income- limited seniors Other thoughts?

18. On to Dr. Rush…