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Impact on Hispanic Health Research
Hispanic Health Data Needs
In December 1991, the grants program held an agenda-setting workshop to provide an opportunity for approximately 85 leading experts in minority health and minority health statistics to assist in setting research priorities that address the critical issues affecting current and future efforts to collect and analyze data on racial and ethnic minority populations. These experts agreed that little data on Hispanic health exist since national surveys do not sample sufficient numbers of Hispanics. Many data sources also lack adequate ethnicity identifiers, and subsequently, the diversity of Hispanic communities is masked in aggregated data . There is also a lack of Hispanic researchers because the infrastructure necessary to support and train these researchers still needs to be built.
Improving Hispanic Health Statistics
Guided by the goals documented in "Setting a Research Agenda: Challenges for the Minority Health Statistics Grants Program," the grants program has taken major steps in addressing the health data needs of Hispanics. Its projects have made more baseline data available, existing resources more useful, and methods of collecting and analyzing data more accurate.
Analyzing existing data:
Through
the development of a immigrants program, a project with the Public Health
Foundation (PHF) funded five State Centers for Health Statistics to
analyze existing data on minority populations and improve State data
infrastructures. Utilizing the 20 health status indicators in Health
People 2000 Objective 22.1, California, Michigan, Rhode Island, and Texas
examined Hispanic populations in their research.
A
project with the National Coalition of Hispanic Health and Human Services
Organizations (COSSMHO) funded four projects that analyzed data from the
Hispanic Health and Nutrition Examination Survey (HHANES) and one project
that analyzed the University of Michigan 1990 Latino National Political
Survey--Panel Study of Income Dynamics Early-Release File.
Increasing access to existing data:
The
COSSMHO project reviewed 15 major Department of Health and Human Services
(DHHS) data systems that include data on Hispanic health. The results were
published in the American Journal of Public Health to support future
research utilizing these data sets.
A
project with the University of Nebraska Medical Center developed a
database on access to care studies on rural minority populations,
including Hispanics.
A
project with the University of North Carolina at Chapel Hill (UNC-CH) is
developing the Minority Health Research Catalog and the Minority Health
Database Catalog. The research catalog is the first annotated bibliography
of literature on studies, analyses, and methods for conducting research on
minority populations, and the database catalog is the most expansive
inventory of national and subnational data sets available for minority
health research. To maximize access to these catalogs, they are available
via the World Wide Web on the UNC-CH
Department of Biostatistics Home Page.
Improving data sets for access to care studies. The University of Nebraska Medical Center compiled an annotated bibliography for its database and synthesized the information into composite summaries listing the issues addressed, the databases used, the methodologies employed, and the areas identified for further research.
Developing methodologies to improve sampling frames/techniques. A project with the Western Consortium for Public Health developed the sample-resample method for estimating the prevalence of health disorders among minority populations. This sampling method is effective in working with sparse and/or incomplete data, and since data sources tend to have inadequate Hispanic ethnicity identifiers, this method will allow more useful information to be produced from existing data sources on Hispanic health.
Developing culturally sensitive tools/techniques. Using focus group and think-aloud methodologies, projects with the Northern California Cancer Center (NCCC) and the Survey Research Laboratory utilized methods drawn from cognitive psychology to develop surveys that more accurately reflect the attitudes, feelings, and behavior of Hispanic populations. Surveys were also translated into Spanish, and Spanish-speaking interviewers were used.
Elaborating the impact of race, ethnicity, and socioeconomic status on the health of Hispanics:
A
project with Harvard University is examining Hispanics in its analysis of
how race/ethnicity and socioeconomic status are related to cancer
incidence rates.
A
Loyola University Medical Center project is including Hispanics in one of
the largest multi-ethnic cohort studies available. Racial/ethnic
differences in comorbidity and the ways in which socioeconomic status,
race/ethnicity, and mortality are interrelated are being explored
Improving dissemination efforts:
Focusing
on Hispanic health, COSSMHO maintains daily communication with 35 of its
leading agencies through a computer network called HealthLink. A bulletin
board was added to HealthLink to allow researchers to easily share their
findings and to request and receive on-line technical assistance.
COSSMHO
also required its subgrants projects to produce at least two papers for
presentations at professional meetings and submission to peer review
journals. Negotiations were made with the American Journal of Public
Health to publish all of them and COSSMHO's review of 15 DHHS data systems
in a special issue on Hispanic women's health in the spring of 1995.
Building Partnerships between Researchers and Hispanic Communities
The grants program recognizes the need to build trust between researchers and the communities they study, and, the need to ensure that communities benefit from any research that is completed. Involving communities in all stages of the research process has become a priority of the program, including efforts to increase the pool of Hispanic researchers.
Training and Educational Opportunities for Current and Future Hispanic Researchers:
The
UNC-CH project also developed the Summer Public Health Research Institute
on Minority Health (SPHRI-MH) in order to allow current and future
researchers to explore innovative research strategies and methodologies
relevant to minority health research. NCHS, CDC provided scholarships for
minority graduate students to attend the institute.
The
NCCC project recruited and trained Hispanic research assistants to play a
key role in conducting and disseminating research results within their
communities.
NCHS,
CDC held two workshops to enhance the skills of researchers in minority
health statistics. In March 1994, "Research Issues to Address
Minority Health Data Needs" was held to build the proposal
development and writing skills of unfunded, but approved, applicants from
the FY 1992 competitive solicitation. In January 1995, a technical
assistance workshop was held to prepare potential applicants for future
grants program solicitations.
Community Participation in Research:
The
NCCC and the Survey Research Laboratory projects used methodologies that
required going into Hispanic communities to recruit focus group and
think-aloud participants. These methods collect qualitative data directly
from the community, providing insight into factors affecting
cross-cultural research.
The
COSSMHO project created incentives for Hispanic health research by
developing a grants program. To disseminate the project results, COSSMHO
also utilized its strong ties to Hispanic communities throughout the
United States.
The
University of Nebraska Medical Center project organized a workshop that
brought researchers and community leaders together to discuss problems and
needs in rural minority health research.
Research in Special Areas:
Hispanic
Women's Health - The COSSMHO subgrant projects analyzed existing data on
Hispanic women's health, covering areas such as risk factors of chronic
degenerative diseases, insurance status, cardiovascular disease factors,
and depression.
Rural
Hispanics' Health - The University of Nebraska Medical Center examined the
access to care of various minority groups--including Hispanics--in the
West North Central census region (Missouri, Kansas, Nebraska, Iowa, South
Dakota, North Dakota, and Minnesota).
Hispanic
Oral Health - To address Healthy People 2000 goals for oral health, a
grant was awarded to the University of Texas Health Science Center at San
Antonio to collect data needed to design more effective, preventive oral
health intervention programs. Clinical examinations of at-risk, preschool
children and interviews with these children's parents/guardians were
conducted to determine the prevalence rate of dental caries and the link
between this rate and feeding patterns.
Projects Addressing Hispanic Health Data Needs:
Jane Delgado, National Coalition for Hispanic Health and Human Services Organizations (COSSMHO), $450,000 (FY 1991-92).
Felipe Castro, M.S.W., Ph.D., Arizona State University, "Factors Affecting Risk of Chronic Degenerative Diseases in Hispanic Women," $40,000.
Adela de la Torre, Ph.D., California State University, Long Beach, "Determinants of Insurance Status of Latinas...Using the Hispanic HANES Data Set," $40,000.
Caroline Macera, Ph.D., University of South Carolina, "Correlates of Cardiovascular Disease Risk Factors Among Mexican American, Puerto Rican, and Cuban Women," $40,000.
Carmen Portillo, R.N., Ph.D., University of California, San Francisco, "The Impact of Depression and Social Risk Indices on the Health of Hispanic Women," $40,000.
Ralph Rivera, Ph.D., University of Massachusetts, "Health, Family and Work: The Experience of Puerto Rican Women in the United States," $40,000.
James Dimas, M.P.A., Public Health Foundation (PHF), "State Data Analysis: Year 2000 Health Status Indicators and Minority Health": California Center for Health Statistics, $50,000; North Carolina Department of Environment, Health and Natural Resources, $50,000; Rhode Island Office of Health Statistics, $50,000; Texas Bureau of State Health Data and Policy Analysis, $50,000 (FY 1992).
Carol D'Onofrio, Ph.D., Northern California Cancer Center (NCCC), "Improving Health Surveys for Multi-Ethnic Populations," $195,245 (FY 1992).
Lloyd Edwards, Ph.D., University of North Carolina at Chapel Hill (UNC-CH), "Assessment of Statistical Materials and Methods for Minority Health Research," $321,855 (FY 1993-94).
Franklin Garcia-Godoy, M.S., D.D.S., University of Texas Health Science Center at San Antonio, "Caries and Feeding Patterns in South Texas Preschool Children," $103,395 (FY 1992).
Ernest Hook, M.D., Western Consortium for Public Health, "Sample Resample Methods for Minority Statistics," $69,729 (FY 1992).
Timothy P. Johnson, Ph.D., Survey Research Laboratory, University of Illinois, "Minority Populations" Understanding of Health Questions," $188,128 (FY 1992).
Nancy Krieger, Ph.D., Harvard University, "Social Class, Race/Ethnicity and the Incidence of Cancer," $92,392 (FY 1995).
Daniel McGee, Ph.D., "SES, Co-Morbidity and Minority Health," $129,621 (FY 1995).
Keith Mueller, Ph.D., University of Nebraska Medical Center, "Improving Health Services Research Related to Rural Minorities," $115,251 (FY 1992).
This page last reviewed January 11, 2007
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