Hispanics have highest rate of uninsured in Colo.
DENVER – Hispanics and Native Americans adults are uninsured at a “shamefully high” rate, putting them at the top of the list of people who lack health care, a state health department officials said Wednesday.
A report by the Colorado Department of Public Health and Environment shows that about 40 percent of adult Hispanics are without health insurance, the highest in the state.
“We have a long way to go and, equally, the Native American rate is just way too high,” said Alyson Shupe, the state health department’s health statistics chief. Almost 34 percent of Native Americans are uninsured, while the rate of uninsured for the entire state is about 16.6 percent, according to the report, which analyzed health issues that disproportionally affect Hispanics, African-Americans, Asian/Pacific Islanders, and Native Americans.
The previous such report was in 2005, but this is the first time officials have acknowledged the impact that a lifetime of discrimination can lead to conditions such as high-blood pressure and hypertension, said Ned Calonge, the state’s chief medical officer.
“The other issue is, we actually have evidence that health care providers treat people differently and it’s almost subconscious,” he said, adding that an example would be a doctor not offering a screening for an illness or preventive care because they don’t believe the patient will follow through.
The report said language barriers sometimes contribute to inadequate health, but Calonge said medical providers also should better understand their patient’s cultures and attitudes toward health care.
“Just having translators and knowing the language, that’s only a fraction of cultural competence,” he said.
Shupe said socio-economic factors also play a role in a group’s ability to receive adequate health care, noting that about one-third of Hispanic and African American children are living in poverty.
The report analyzed various state health department databases, including birth and death certificates and their registry of infectious diseases.
Other key report findings:
– African-Americans have the highest percentage of adults with diabetes at 9.1 percent, followed by Hispanics at 6.2 percent. The total state average was 4.9 percent. But Hispanics had a much higher diabetes mortality rate than the rest of the population with 45 deaths per 100,000, compared to the state’s average rate of 18.4. The report said this may be because Hispanics have a higher rate of undiagnosed cases.
– Hispanics have high obesity rates among children and adults. Children ages 2 to 14 have an obesity rate of 24.1 percent, the highest in the state as a whole, which is 24.1 percent. Native Americans have the highest obesity rate among adults at 27.2 percent, followed by Hispanics at 25.1 percent. The state’s total average rate is 18 percent.
– African-American women have the highest percentage of low-weight births at 15.2 percent compared to the state average rate of 9 percent. Hispanic women had the lowest rate of low-weight births at 8.5 percent. Researchers said that’s because Hispanic women are less likely than others to drink or smoke in the last three months of their pregnancy.
– African American women have the highest infant mortality rate at 16.9 deaths per 1,000 live births, a figure Shupe called “embarrassingly high, frighteningly high.” The infant mortality rate for the state was 6.1.
Shupe said researchers are still trying to determine why one group does better in some areas and struggles in others. For example, the Asian/Pacific Islander population appears to be healthier than other groups, with the lowest incidence of all cancers, as well as low rates of diabetes and obesity, but has a much higher rate of chronic hepatitis B than anyone else with a rate of 114.1 cases per 100,000 people. The total average rate is 11.3.
Asian/Pacific Islanders also had the highest rate of tuberculosis with 21.3 people per 100,000, compared to the state rate of 2.4.
But the report cautioned that the group’s small population and possible misclassification because of their ethnic diversity may make it difficult to fully convey the extent of their health disparities. Researchers said they faced the same issue with Native Americans
About 123,000 Asian/Pacific Islanders and an estimated 44,000 Native Americans live in Colorado. Researchers had a bigger sample size for Hispanics, 1 million, and African American, 180,000.
Calonge said the report aim is to inform health organizations in different communities, as well as policy makers and grant writers.
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