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Every October, our nation is awash in a sea of pink. Everywhere we look we see pink as a reminder of survival and that our fight against breast cancer is not over yet. In my family, as in other families impacted by this disease, it is a reminder of perseverance and of our ability to press on until we find a cure.
Whenever I think about breast cancer, I think about the courage and strength of my aunt, whose diagnosis didn’t come until the cancer had already spread. And I think about the impact that breast cancer had on our whole family – the diagnosis was issued to my aunt, but the disease touched every single one of us. My family is not alone in this kind of loss. We must all focus our efforts on making sure more women survive this devastating disease and thrive in their recovery because there is life after breast cancer.
This month, the Centers for Disease Control and Prevention (CDC) reported that there’s good news and bad news when it comes to breast cancer disparities: we see a decline in death rates from breast cancer by age group for black and white women (the two groups with the highest death rates in the United States), but disparities persist. When compared to white women, the likelihood that a black woman will die after a breast cancer diagnosis is still considerably higher. In addition, breast cancer remains the leading cause of cancer death among Hispanic women.
And while providing information on early detection, diagnosis and treatment is crucial, it is only the first step in the journey of survival for many women diagnosed with breast cancer. There is life after breast cancer to think about and for many women that also means life after a mastectomy. Many women with breast cancer may be surprised to learn that if they are undergoing or considering a mastectomy, they may be entitled to certain rights under the Women’s Health Cancer Rights Act of 1998.
This important law requires group health plans and health insurance companies to cover breast reconstruction and prostheses if they also cover mastectomy. Raising awareness of these rights is even more important for minority women who are often less likely to be informed by their health care provider of their breast reconstruction options compared to white women. As a black woman or Latina undergoing a mastectomy, it’s especially important to know the facts about breast reconstruction.
An updated fact sheet from the National Cancer Institute, with support from the Centers for Medicare & Medicaid Services, Centers for Disease Control and Prevention, HHS Office on Women’s Health, HHS Office of Minority Health, Health Resources and Services Administration’s Office of Rural Health Policy, outlines options on breast reconstruction after mastectomy. It also provides answers to basic questions such as: “What is breast reconstruction?” and “Will health insurance pay for breast reconstruction?” While it’s important for women to know that federal law mandates most health insurance plans to include coverage of breast reconstruction and prostheses, women who have Medicare or Medicaid should check with their insurance plan to see if reconstruction is covered.
Breast Cancer Awareness Month is about so much more than a disease. It’s about rebuilding lives and ensuring that all women have an equal opportunity to a healthier future.
For more information about breast reconstruction surgery, visit breast cancer patient education resources from the HHS Office of Minority Health.
J. Nadine Gracia, MD, MSCE, is the Deputy Assistant Secretary for Minority Health and the Director of the Office of Minority Health at the U.S. Department of Health and Human Services.
HHS OMH and Salud Today will host a bilingual (Spanish/English) Healthy Latinos Twitter Chat in honor of Hispanic Heritage Month (HHM) on Tuesday,
October 11 at 1 pm ET. The discussion will highlight the importance of healthy living for achieving optimal health and provide an opportunity for partners
to share resources to help inform Hispanic/Latino communities about making healthier choices.
Join HHS OMH along with other federal agencies and partners as we share important resources and information about Hispanic/Latino health and ways we can
address health disparities in the Hispanic/Latino community. Tweet with us using the hashtag #SaludTues.
Learn more about Hispanic Heritage Month.
When Maria Schinstock’s father was diagnosed with diabetes, she asked him to move closer to her so she could help him manage his condition and day-to-day activities. He eventually moved closer to Maria, but by that time his diabetes was in an advanced stage. Taking care of her terminally ill father made her more aware of the lack of information and support patients with chronic illnesses received in her community. This awareness also influenced her work as a promotora de salud, or community health worker.
In Maria’s words, “sometimes you need to be in the situation to understand others and to be more involved in the community to care more.” As a result of this experience, she was inspired to fill that gap to educate her community and to connect patients to important and sometimes, lifesaving resources by becoming a promotora de salud to provide health education and prevention in a manner that is culturally and linguistically appropriate for Latinos in Nebraska. Her Health Equity Change Makers story, part of a new HHS Office of Minority Health (OMH) digital storytelling project, is one of many that shares compelling testimonials of everyday people who have been personally affected by health disparities, and who have used their experience to raise awareness and inspire change.
Over the years, promotores de salud like Maria have been key partners to the U.S. Department of Health and Human Services. In 2011, OMH launched the National Promotores de Salud Initiative, as part of the HHS Action Plan to Reduce Racial and Ethnic Health Disparities, to recognize the important contributions of promotores de salud in reaching underserved Latino/Hispanic populations. Whether by tailoring or translating outreach materials to make them relevant for their communities, providing workshops and orientation at health fairs or faith-based organizations, or assisting Latinos in accessing health care coverage and navigating the health care system, promotores de salud have been allies in supporting health education and prevention efforts and access to health insurance programs. And thanks to the Affordable Care Act, along with the support of promotores de salud and other partners across the country, our nation’s uninsured rate has dropped to 8.6 percent. This is the lowest uninsured rate on record for our nation with Hispanic adults showing the greatest percentage decrease.
Promotores de salud also play a key role in ensuring health and social services organizations have the tools and resources they need to provide services that are respectful of and responsive to an individual’s cultural health beliefs, preferred language, health literacy level, and communication needs through the implementation of the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (National CLAS Standards). Developed by OMH in collaboration with federal and non-federal partners across the country, the National CLAS Standards are intended to advance health equity, improve quality, and help eliminate health care disparities by operationalizing the concepts of cultural and linguistic competency into a series of actionable items. Effectively, the National CLAS Standards provide a blueprint for health and health care organizations in delivering culturally and linguistically appropriate care and services to our nation’s diverse communities.
This unique resource is hosted on the newly redesigned Think Cultural Health website, a site dedicated to advancing health equity at every point of contact. The website features basic information on CLAS, free continuing education e-learning curricula, and other resources for health professionals. Other resources for promotores de salud include a free, bilingual (English and Spanish) e-learning curriculum titled, Promoting Healthy Choices and Community Changes designed to encourage changes at the individual and community-level that will help individuals make better choices when it comes to their health.
This #HHM2016, as we celebrate the culture, traditions, and heritage of the Latino community, I invite you to discover OMH resources in English and Español that help advance health equity for the Latino population. Let's honor our commitment to achieving health equity and thank our health care providers, public health professionals, promotores de salud, community health workers, and community- and faith-based organizations who work to educate our communities about their health and health care decisions by lifting up a message of disease prevention and health promotion in a culturally and linguistically appropriate way.
For more information on the HHS Office of Minority Health, visit www.minorityhealth.hhs.gov. For more resources on cultural and linguistic competency, visit Think Cultural Health at www.thinkculturalhealth.hhs.gov.
J. Nadine Gracia, MD, MSCE, is the Deputy Assistant Secretary for Minority Health and Director, Office of Minority Health, U.S. Department of Health and Human Services.
Zika is a frightening disease few people had heard of until recently. Over the last few months, many Americans have become aware of the virus, spread by mosquitoes that if acquired during pregnancy can cause microcephaly (babies born with small heads) and other severe fetal brain defects. A few weeks ago, Harris County Public Health (HCPH) announced that the first child in the state of Texas was born with Zika-related microcephaly. The mother contracted the disease in Colombia, but gave birth at a one of our local hospitals. Our thoughts and prayers are with the child and family who are dealing with this heartbreaking consequence of the spread of the Zika virus.
As public health workers, this is one child too many to be born with this birth defect due to a mosquito-borne disease. The lifetime cost of treating a child with microcephaly is estimated to be more than $10 million. For public health, Zika is a very real threat in our communities. Especially since Harris County has the mosquito species that carries Zika.
Harris County has the nation’s foremost mosquito and vector control program in the U.S. However, even with a program as comprehensive as ours, we need your help to combat the virus. Since there is no vaccine or treatment for Zika infection, we believe heavily in the age old mantra of public health-prevention works. And while our mosquito control program is working with software giants like Microsoft on being able to test and identify the presence of Zika in our mosquitos, we rely on education, engagement and outreach to our community to prevent the spread of Zika.
We have been working vigorously with our partners and within our community to help them understand that health happens where you live, worship, work and play. We have designed culturally and linguistically appropriate outreach materials in the primarily languages spoken in our community, English, Spanish and Vietnamese. To enhance our program effectiveness, we have partnered with our local Walmart’s, Fiesta Marts, Lowe’s and ACE Hardware stores, WIC clinics, churches, schools and parks, to name a few.
Traveling abroad to Latin America, I have seen first-hand the devastation Zika can cause on a family and its community, which is why our team has been working diligently for months on Zika prevention and response plans. But, all of us know that there is more work that needs to be done.
Just like with any other disease or condition, individuals and families must also do their part to prevent getting Zika. Mosquitos spread a variety of diseases and cause over 1 million deaths worldwide each year.
Our message to our community is very simple: ¡Prevenga la picadura de día y de noche! - Prevent the Bite Day and Night! Essentially, do your part to prevent getting bitten by mosquitos wherever you go. Reduce mosquito breeding sites in and around your home-and make sure your mother, uncle, la tía Lolita, el primo José and abuela are doing the same.
As we always say in Spanish: “La unión hace la fuerza”. – Unity makes us strong. Public health and prevention work best when as an entire community comes together to address a health concern. Let’s work together to make sure that we don’t have to tell one more parent that their child is born with Zika-related microcephaly in our country.
Elizabeth Perez, MPH, is the Director at the Office of Communication, Education and Engagement (OCEE), Harris County Public Health, Harris County, Texas
Achieving a nation free of disparities in health and health care extends beyond the walls of federal offices. As we deepen our reach into this current era of public health, we step into an age of a greater understanding of the factors upon which better health is built—the conditions in which people are born, grow, work, live and age. This knowledge underscores our goal in building stronger relationships and alliances that achieve better health outcomes for all communities by bolstering the efforts of our partners.
Take for instance Oakland, CA, where minority male youth are benefiting from one of the funding opportunities that the HHS Office of Minority Health (OMH) awards to develop and implement health programs and activities across the nation. Our grantee, Youth Alive, is implementing innovative community policing approaches through a public health framework that help improve the health and well-being of communities of color through the Minority Youth Violence Prevention initiative. This program, and others like it, reflects the heart of our work in strengthening the capacity of community-serving organizations in their efforts to reduce health disparities in ways that address the social determinants of health.
OMH and our partners continue to stand at the forefront of responding to the needs of the community and driving monumental advancements in programs, policies, data and research. Together, over the past 30 years we have led health equity efforts at the grassroots level and seen these efforts through from recommendation to implementation. Since 1986, our office has provided tangible support to state and territorial offices of minority health, multicultural health and health equity; community and faith-based organizations; national associations and organizations; institutions of higher education; tribes and tribal organizations; and research institutions dedicated to improving the health of racial and ethnic minorities.
HHS OMH grantees are committed to developing strategies that provide minority and underrepresented students with a foundation to pursue successful careers in health professions; connect minorities and underserved populations to health insurance coverage and quality, affordable care; implement tailored state-level community interventions designed to address the most pressing disparities, including HIV/AIDS; fight against lupus, a chronic, autoimmune disease that disproportionately affects racial and ethnic minority populations; and many others.
The need to accelerate our efforts in innovative approaches to improve minority health remains evident by the persistent gaps in health and health care across communities of color, consequently leading to poorer health outcomes.
Most recently, OMH funded three new grant programs in 2016 totaling more than $7 million to support public health initiatives that impact lives across the nation. Through these efforts, we aim to improve health outcomes for minority and/or disadvantaged young people in transition from jail to their communities; promote healthy behaviors among minority and/or disadvantaged youth at-risk for poor health and life outcomes due to childhood trauma; and continue our work in reducing lupus-related health disparities.
We recognize the importance of partnerships with communities and organizations in closing the gap on health disparities and achieving better health. And as we support the work of these health equity champions, we also create a future where the intersection of health and social condition serves as the crucial nexus for ending health disparities in America.