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The Deputy Secretary and the Acting Assistant Secretary for Health jointly chaired the
second review of progress on sub-objectives for Hispanic Americans. The progress review
was organized around three themes: improving Hispanic data, development of Healthy People
2010, and improving access to quality health care. The Deputy Secretary shared information
on the HHS Hispanic Agenda for Action. Progress on selected Healthy People 2000
subobjectives which target Hispanics is described below.
Objectives Closing the Gap
14.1c Although Puerto Rican infant mortality rates are closing the gap with the
total U.S. population, they are still high—9.7 per 1,000 live births (1991). The year
2000 target is 8 per 1,000 live births.
14.11c Pregnant Hispanic women receiving
prenatal care in the first trimester of pregnancy increased from 61
percent in 1987 to 70 percent in 1995. Ninety percent is the year 2000
target.
15.14b and 15.14d The proportion of Mexican
Americans, between the ages of 18-74 years who have ever had their blood
cholesterol checked was 55 percent in 1993, compared to 42 percent in
1991. The year 2000 target is 75 percent.
16.11a Data from the National Health Interview
Survey indicate that, in 1994, 50 percent of Hispanic women, 50 years and
older had received a clinical breast examination and a mammogram. The
target is 60 percent.
16.2a The proportion of Hispanic women, ages
18 and over that have ever received a pap test has increased from 75
percent in 1987 to 91 percent in 1994—approaching the year 2000 target of
95 percent.
21.3a There has been an increase from the 1991
baseline of 63 percent in the proportion of Hispanics, ages 18 and older
who have a regular source of primary care. The 1994 data indicate 71
percent of Hispanic adults had a regular source of primary care -- still
lower than the 84 percent for the total population. Among Hispanics,
Mexican Americans are least likely to have a regular source of primary
care.
Improving but Not Closing the Gap
20.4c The objective is to reduce the incidence of tuberculosis among Hispanics
to no more than 5 cases per 100,000 people. In 1995, there were 18 cases per 100,000, a
small decrease from the 1988 baseline of 18.3 but a large decrease from the peak of 22.8
in 1991. Hispanics are twice as likely to have tuberculosis as the total population (8.7
cases per 100,000 ).
20.11b The percentages of Hispanic adults,
ages 65 and older receiving pneumococcal and influenza immunizations
increased in 1994 to 14 and 38 percent, respectively, as compared with the
baseline year 1989 (11 and 28 percent, respectively). The year 2000 target
is 60 percent.
Moving Away from the Target
1.2c Overweight prevalence among Hispanic women, ages 20 and older increased
from 27 percent in 1985 to 33 percent in 1993. The year 2000 target is 25 percent.
5.1b In 1991, there were 180 pregnancies per
1,000 Hispanic adolescent females between the ages of 15-19, compared with
143 per 1,000 in 1985. Hispanic adolescent females were significantly more
likely than the total population (74.6 per 1,000) to have been
pregnant.
7.1d In 1994, the homicide rate among Hispanic
males, ages 15-34 increased to 52.2 per 100,000 from the 1987 baseline of
41.3 per 100,000. The year 2000 target is 33 per 100,000.
13.14d and 13.14e In 1993, the proportion of
Mexican Americans, ages 35 and older using an oral health care system
increased to 45 percent from 38 percent in 1991. The rate for Puerto
Ricans decreased to 37 percent from the 1991 baseline of 51 percent.
17.11c While the prevalence of diabetes among
the total population increased from 28 per 1,000 in 1986 to 30 cases per
1,000 in 1994, among Mexican-Americans, the prevalence increased from 54
to 66 cases per 1,000 during the same period.
18.1c Hispanics are disproportionately
affected by the HIV/AIDS epidemic. In 1994, there were 49.9 AIDS cases per
100,000 Hispanics, as compared with 29.9 cases per 100,000 for the total
population.
21.4b In 1994, the proportion of Hispanics
under 65 years of age (32.9 percent) who were without health insurance was
twice that for the total population (17.8 percent). Among Hispanics, the
proportion of Mexican-Americans without coverage in 1994 was 37.2 percent;
for Puerto Ricans it was 17.4 percent, and for Cubans it was 27.4
percent.
H I G H L I G H T S
By the year 2010, it is estimated that
Hispanics will become the largest minority group in the U.S. — an
estimated 13 percent of the U.S. population.
In 1994, 26.4 million Hispanic Americans were
living in the continental United States: 64 percent were Mexican
Americans, 11 percent were Puerto Ricans, 13 percent were from Central
and South America and the Caribbean, 5 percent were Cuban Americans, and
7 percent were classified as "Other" Hispanics.
Of the 82 Healthy People 2000 objectives with
regularly updated data, about half have data indicating progress—in
other words a decrease in health disparity between Hispanics and the
total population. Ten percent of the Hispanic objectives show no
reduction in disparity. For twenty-two percent of the Hispanic
objectives, data are moving away from the target and for twenty-one
percent there are no data to assess progress.
On September 1996, the Secretary announced the
Department-wide Hispanic Agenda for Action: Improving the Services to
Hispanic Americans Initiative. The primary focus of this initiative is
to ensure that the workforce and programs of the Department are
reflective of and sensitive to its Hispanic customers.
To improve health information about Hispanics,
the National Center for Health Statistics will be translating the 1998
National Health Interview Survey into Spanish.
Local health departments are working with the National Center for Farmworkers Health to
improve the collection and utilization of demographic and epidemiological information
throughout the U.S.-Mexico border area.
F O L L O W- U P
The progress review concluded with a summary of action items:
1. Development of a Hispanic data collection strategy that:
- Addresses data collection priorities and
related funding decisions.
- Increases knowledge about Hispanic subgroups
and uses regional surveys in those States that have the largest number
of Hispanics.
- Identifies surveys which have adequate numbers
of Hispanics and/or Hispanic subgroups for analysis, as well as surveys
which are conducted in Spanish and specify the methods used.
- Ensures a research agenda that studies the
attributes of ethnic groups which will enable more effective
interventions to support healthy behaviors and families and to address
socioeconomic disparities.
- Ensures the collection of data on both victims and perpetrators of violent acts.
2. Development of Healthy People 2010:
- Review objectives and targets relevant to
Hispanics (not just those specifically identified for Hispanics). Draft
2010 objectives that eliminate, not just reduce, disparities, setting
targets for Hispanic Americans the same as for the total population.
- Draft 2010 Hispanic objectives addressing mental health, substance abuse, occupational
health, environmental health, and the effects of violence, focusing on morbidity.
3. Access to quality health care:
- Develop a strategy to reduce financial barriers
that impede delivery of health services to Hispanics.
- Expand training programs for Hispanic health and social service professionals.
P A R T I C I P A N T S
Agency for Healthcare Research and Quality (AHRQ)
Administration on Aging
Administration for Children and Families
ASPIRA Association
Boston University School of Public Health
Centers for Disease Control and Prevention
Congressional Hispanic Caucus
Food and Drug Administration
Health Care Financing Administration
Health Resources and Services Administration
HHS Hispanic Employees Association
Indian Health Service
National Association of Hispanic Publications
National Association of Hispanic-Serving Health Professional Schools
National Center for Farmworkers Health
National Coalition of Hispanic Health and Human Services Organizations
National Council of La Raza
Texas Department of Health
National Hispanic Medical Association
National Institutes of Health
Office of the Assistant Secretary for Planning and Evaluation
Office of the Assistant Secretary for Management and Budget
Office of Disease Prevention and Health Promotion
Office of Minority Health
Office on Women’s HealthPan American Health Organization
Substance Abuse and Mental Health Services Administration
University of California-Los Angeles, School of Public Health
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