GIS Review of Health Professions in a Hispanic Community

Transcription

1 GIS Review of Health Professions in a Hispanic Community Kathleen Urbansky Christine Aguilar, MD MPH Roberto Villarreal, MD MPH The University of Texas Health Science Center at San Antonio South Texas Health Research Center

2 The Issues: Throughout the US ethnic and racial health disparities exist in minority communities. The Hispanic population is the fastest growing population in the US. Minority healthcare providers are decreasing in the US.

3 What Research Says: Minority Health Professionals (MHP) are more likely to serve minority and medically underserved populations MHP are well suited to overcome cultural and health belief barriers A report of the Sullivan Commission on Diversity in the HealthCare Workforce. Missing Persons: Minorities in the Health Professions. (Sep. 2004)

4 Why Bexar County? Bexar County is located in South Central Texas and is home to San Antonio, the 2 nd largest city in the state 56% of the total population of Bexar County is Hispanic (primarily Mexican American) Bexar County has one of the largest and fastest growing Hispanic communities in Texas

5 El Paso Dallas Fort Worth Austin Houston Bexar County, Texas Laredo

6 Bexar County Demographics Category Population Estimate 2000 Population Estimate 2005 % Difference Total Population 1,392,931 1,476,351 6% Hispanic 54% 56% 4% White (non-hispanic) 36% 34% -5% Black 7% 7% 0% Other 3% 2% -3%

7 Texas Ethnicity 2004 Other 4% Hispanic 35% White 50% Black 11% Bexar County Ethnicity 2004 Other 3% Hispanic 56% White 34% Black 7%

8 Projected Bexar County Population by Race and Ethnicity 2000 to ,200,000 1,000,000 Population 800, , , , Year NH White African American Hispanic Other

9 Research Questions: How is Bexar County currently positioned in terms of MHP? What are the issues affecting MHP accessibility? What are the factors that affect MHP hiring, recruitment, and retention?

10 Methodology: Quantitative analysis of state and county data on active health professionals Qualitative analysis of health care administrator responses to open-ended ended interviews Spatial analysis of clinics, health professionals, and population

11 Results: Quantitative analysis shows Bexar County has more Hispanic health professionals per capita than the state of Texas. Interviews indicate local clinics need bilingual Hispanic physicians and nurses, and retaining quality minority staff is difficult. Spatial analysis helps resolves the difference between data and healthcare administrators experiences.

12 Medical Profession to Population Ratios for 2004 Medical Bexar Texas % Diff Profession Ratio per 100,000 Ratio per 100,000 Bexar vs. Texas Physician (Primary + Direct Care) % Physician Assistant % Registered Nurse % Licensed Vocational Nurse % Pharmacist %

13 Physician Ethnicity for Texas and Bexar County 100 Percent White Black Hispanic Other Bexar County Texas

14 Population to Primary Care Physician Ratios Ratio Type Bexar County State of Texas Tot Pop / Physician 523:1 645:1 Tot Pop / Hisp. Physician 2,278:1 5,747:1 Tot Hisp. Pop / Hisp. Physician 1,275:1 1,994:1 Federal HPSA Designation population to physician ratio is 3500:1

15 Results: Quantitative analysis shows Bexar County level of Hispanic health professionals is higher than state levels Interviews indicate local clinics need bilingual Hispanic physicians and nurses, and retaining quality minority staff is difficult. Spatial analysis helps resolves the difference between data and healthcare administrators experiences.

16 Interview Results: Clinics Primary Needs Hispanic HP Nurses Physicians Allied Health Translation Spanish Speaking Spanish Reading Spanish Writing Training Cultural Beliefs Language Prof. Dev. Employee Recruitment & Retention Competitive Salaries Qualified Candidates

17 Interview Results: Primary Barriers Competitive Salary Language Skills Unqualified Minorities Distance to Work Barriers Insufficient Minority Health Professionals Lack of Training or Experience Cultural Beliefs

18 Results: Quantitative analysis shows Bexar County level of Hispanic health professionals is higher than state levels Interviews indicate local clinics need bilingual Hispanic physicians and nurses, and retaining quality minority staff is difficult. Spatial analysis helps resolves the difference between data and healthcare administrators experiences.

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22 Conclusions: Data suggests Hispanic healthcare professionals in Bexar County exceed state levels, but clinics experience indicates a lack of qualified MHP. Spatial analysis explains this difference by showing care providers are not in close proximity to Hispanic communities. GIS is a strong analytical and communication tool for public health issues. The maps make the information more meaningful.

23 Thank You!

24 Percent Projected Bexar County Population by Percent Race and Ethnicity 2000 to NH White African American Hispanic Other

25 Population to Total Physician Ratios Ratio Type State of Texas Bexar County Tot Pop / Physician 448:1 373:1 Tot Pop / Hisp. Physician 3,731:1 1,623:1 Tot Hisp. Pop / Hisp. Physician 1,295:1 909:1