Improving Health Equity through Collective Community Action Forum Health Equity, Inequity, and Disparities in Hispanics in the United States Jorge Gomez, MD, PhD University of Arizona Improving Health Equity through Collective Community Action Forum Yuma, Arizona June 13, 2018

Health Equity, Inequity, and Disparities Definitions Health Equity: Attainment of the highest level of health for all people. Health Equity means efforts to ensure that all people have full and equal access to opportunities that enable them to lead healthy lives. Health Inequities: Differences in health that are avoidable, unfair, and unjust. Health inequities are affected by social, economic, and environmental conditions. Health Disparities: unequal burden of disease in a population due to race, ethnicity, gender, education, socioeconomic status, disability, geographic location, sexual orientation, cultural or religious believes (DHHS)

Health Disparities Resulted from historical and current unequal distribution of social, political, economic, and environmental resources (CDC). Specifically: Poverty Environmental Threats Inadequate access to Health Care Individual and behavioral factors Educational inequalities

Health Disparities Directly Related to Inequities in Education Groups/Individuals with less education experience higher health risks Obesity Substance abuse Shorter life span Teenage pregnancy Poor dietary choices Inadequate physical activity Lack of understanding of basic health information Inappropriate (or lack of) health decisions

Disease-Specific Health Disparities: Cancer People with lower SES have higher cancer rates Higher risk at developing cancer: don’t follow prevention, screening, early diagnosis guidelines Less chances of surviving cancer: late diagnosis, adherence to treatment, changing life styles Race and Ethnicity AA men higher cancer incidence and mortality and lower survival rate Native Americans: cancer is the second leading cause of death and poorest 5 year survival rate after diagnosis Asian Americans have the highest cancer rates for liver and stomach cancers. Twice as likely to die of these cancers than whites Hispanic/Latinos highest cancer rates associated with infection: liver, stomach, and cervical cancers Overall lower incidence of cancer, BUT diagnosed at advanced state and more likely to die from cancer than whites

Elimination of Health Disparities: Recommendations (Surgeon General) Strategic focus on communities at greatest risk Reduce barriers to quality health care Increase the capacity of the prevention workforce to identify and address health disparities Support research to identify effective strategies to eliminate health disparities Standardize and collect data to better identify and address health disparities

Cancer Health Disparities Project Open Invitation To better understand the natural course of cancer in the Hispanic population in Arizona To correlate risk factors specific to Hispanics and clinical outcomes To correlate known clinical parameters to pharmacogenetics/genomics in Hispanics in Arizona