CITY OF PORTLAND, MAINE Health and Human Services Department, Public Health Division

CITY OF PORTLAND, MAINEHealth and Human Services Department, Public Health Division

Minority Health Program

HEALTH (CANCER) RISK ASSESSMENT: TELESCOPING THROUGH THE CULTURAL

EYES

Presentation by

Kolawole A. Bankole, M.D., M.S.

Let’s celebrate diversity

Contents

Project Aim / Goal Background/Demographic paradigm Diversity in Maine Methodology and Approach Results and Outcome analyses Clinical / Public health implications Minority Health Program’s

interventions Conclusion

Project Aims / Goals

Reduce health disparities among Portland, Maine’s racial/ethnic minority through computerized health risk assessments, counseling and referral for quality and affordable services.

Background/Demographic paradigm

Changes in the diversity of Portland, Maine demographics with > 57 different ethnic language groups

Increase in primary & secondary immigrants

Largest 11 ethnic/language groups: Khmer, Arabic, Spanish, Acholi, Somali, Serbian/Croatian, Vietnamese, Nuer, French, Chinese, and, Russian.

Diversity in Maine

In 2005: 20,000 Hispanics 19,000 Asians 8,000 African

Americans 7,000 Native

Americans

– Source: www.pressherald.com

– National Center for Cultural Competence, 2004

ACS: American Community Survey

City Fact sheet: Portland, Maine Summary City Data (and Source)Population (2003 CB est.): 63,635Population (2000 Census): 64,249 Foreign-born Population (2000 Census):4,895

Share Foreign Born (2000): 7.6%

Population Projection 2025 (FAIR*): 64,000

*FAIR: Federation for American Immigration Reform

Journey to “Well-Being”Journey to “Well-Being”Link between migration & Link between migration &

resettlement health burden:resettlement health burden:

• Pre-migrationPre-migration:: exposure to exposure to infectious & parasitic infectious & parasitic diseases, physical & diseases, physical & psychic traumapsychic trauma

• During migrationDuring migration:: malnutrition, malnutrition, exposure to the exposure to the elements, physical & elements, physical & psychic traumapsychic trauma

• Post-migrationPost-migration:: increasing increasing susceptibility to chronic diseases, susceptibility to chronic diseases, problems of resettlement problems of resettlement ((racism, racism, unemployment, ESL, crime, etc.)unemployment, ESL, crime, etc.)

Methodology and Approach

Exploratory, outreach/research Project ~ Aug. ‘05 – June, ’06.

Sample size: 202 individuals across 6 racial/ethnic groups

Africans~A/Americans: Somali, Sudanese, Great Lakes of Africa/French Asians: Cambodian, Vietnamese Caucasians: Russian

Eleven community meetings and outreach educational sessions held.

Confidential individualized health risk assessment (HRA) survey implemented

Survey results with computer software analyses (TRALE, Inc. software)

Cancer / health risk variables assessed

Demography: Gender, Age, and Ethnicity Tobacco smoking status and Alcohol Nutrition and physical activity Stress and depression Current health status & medical care status Family history Women and Men’s health statuses Vehicle safety Readiness to change Biometric measures ~ height, weight, blood

pressure

Results and Outcomes analyses

Overall wellness score was 67.– A score below 80 indicates elevated

likelihood of developing certain medical conditions

Individual variable scores below

Overall Wellness: Score 67

Risk Areas

Demographic: Gender

Demographic: Age

Demographic: Ethnicity

Cancer Risks

Controllable cancer risks: Weight, Nutrition, and Tobacco use

Uncontrollable cancer risks: Family history, age, race, and sex

Overall cancer score: 68

Direct Cancer Risk effects

Overall Score: 68 Some cancers directly affected 3% of

the groups' population Runs in families:

Breast cancer 2%Ovarian cancer 24.8%Colon or Rectal cancers 11.4%

Cancer Risk Factors

Men’s Health

Self-Testicular Exam

Women’s Health

Women’s Health

106 female participants 59.4% ~ Pap smear within past 3yrs 26.5% ~ Digital rectal exam within past

2yrs 61.2% ~ Mammogram within past 2yrs

(aged >40yrs) 2.8% ~ Have at least one immediate

relative who had breast cancer

Tobacco

Cigarette Smoking

Physical Activity: Score 49

Body Mass Index: Average Women~18.2; Men~17.2

Weight Management

Mental Wellness: Score 69

Stress and Depression

Nutrition: Score 51

Nutrition Risk

Alcohol: Score 94

Blood Pressure: Score 51

Diabetes: Score 61

Self-reported Blood Sugar

Heart Health

Motor Vehicle Safety: Score 84

Clinical / Public health implications

Qualitative health status information for public health interventions

Counseling and referrals for needed services

Improved racial/ethnic data collections Attempts to reflect goals & objectives

of Maine Comprehensive Cancer Control Plan/ ME CDC & Prevention

Clinical / Public health implications

Improving awareness and understanding of health care services

Strengthening health care providers’ capacities to better understand risk areas and create infrastructure to meet health needs of communities

Acknowledge value of holistic approaches in health healing within ethnic minority communities

Minority Health Program’s Interventions

“Latinos Exercise for Health and Love” event:

– 737 participants– 85 screened for diabetes & HPTn; 4 alarm values– 67 without PCPs; 41 now connected with PCPs

“3rd Annual Latino Soccer Tournament” 6 teams; 577 attended

“2nd Annual Festival of Nations’ Soccer Tournament”; 8 teams; ~655 attended

“Somali/Sudanese Walk for Life” event 65 participants

Minority Health Program’s Interventions

“BRISK”/ breast cancer prevention project

Diabetes prevention & healthy nutrition DM prevention & mgt educational series “Let’s Go” Healthy Weight Initiative

“Somali/Sudanese Exercise for Health and Love” event: May 19, 2007

Contact info.

Kolawole A. Bankole, M.D., M.S.Minority Health Program Coordinator /Access Project DirectorPublic Health DivisionHealth & Human Services DepartmentCity of Portland, Maine389 Congress St., Portland, ME 04101Tel 207-874-8773, Fax 207.874.8913Email: [email protected] site: http://www.portlandmaine.gov/hhs/phminority

.asp