ree ye SURGEON Here A. NATIONAL HISPANIC/LATINO _HE@LTH INITIATIVE oT-0:'D-0'S° TOGETHER ORGANI/ ED mint vanhie FRING SOLIDARITY TODOS ORGANIZADOS DiLIGEN evernil oT Reet 3OLIDARIDAD One Voice, One Vision — Recommendations to the Surgeon General To Improve Hispanic/Latino Health “NATIONAL LIBRARY OF BEDICINE June 1993 One Voice One Vision Executive Planning Committee ¢$¢¢ 6606 ¢ Executive Planning Committee To each of the Executive Planning Committee members of the National Hispanic/Latino Health Initiative, I applaud your tireless efforts and commend you from the heart. By speaking and acting as one to address our most critical issues, you have fostered the health and well-being of Hispanics/Latinos in commu- nities across America. For all of this, | thank you. A cada miembro del Comite Ejecutivo de Planificacion de la Iniciativa Nacional de Salud Hispana/ Latina, les felicito de todo corazon por sus incansables esfuerzos con respecto al bienestar de nuestra comunidad. Al hablar y actuar como representantes de nuestra sociedad, han fomentado la salud y el bienestar de los Hispanos/ Latinos en comunidades en todos los Estados Unidos. Y por todo esto les extiendo mi sincero agradecimiento. Ske aC Apyg Antonia Coello Novello, M.D., M.P.H. Surgeon General U. S. Public Health Service Lydia E. Soto-Torres, M.D., M.P.H. National Coordinator Surgeon General's National Hispanic/Latino Health Initiative Washington, DCe Charter Members Castulo de la Rocha, J.D. President and Chief Executive Officer AltaMed Health Services Corporation Los Angeles, CA Co-Chair: Los Angeles Regional Health Meeting (PHS Regions IX and X) Jane L. Delgado, Ph.D. President and Chief Executive Officer National Coalition of Hispanic Health and Human Services Organizations Washington, DC Helen Rodriguez-Trias, M.D. President American Public Health Association Brookdale, CA Co-Chair: Los Angeles Regional Health Meeting (PHS Regions IX and X) Raul Yzaguirre, B.S. President National Council of La Raza Washington, DC in Memoriam Rodolfo B. Sanchez President Sanchez and Associates Arlington, VA ooo ooooeoeoeoeo Standing Members Marilyn Aguirre-Molina, Ed.D. Assistant Professor Robert Wood Johnson Medical School Piscataway, NJ Co-Chair: New York/Newark Regional Health Meeting (PHS Regions I, II, and If) Mari Carmen Aponte, J.D. Attorney Gartrell, Alexander, Gebhardt and Aponte Washington, DC Rosamelia de la Rocha, B.A. Director Office of Equal Employment and Civil Rights Food and Drug Administration Rockville, MD Eunice Diaz, Ph.D., M.P.H. Commissioner National AIDS Commission/ Infant Mortality Commission Santa Barbara, CA John W. Diggs, Ph.D. Deputy Director of Extramural Research National Institutes of Health Bethesda, MD Robert G. Eaton, J.D., M.B.A. Associate Administrator for Program Development Health Care Financing Administration Washington, DC Carola Eisenberg, M.D. Consultant Harvard Medical School Cambridge, MA Anna Escobedo Cabral, M.S. Executive Staff Director U.S. Senate Republican Task Force on Hispanic Affairs Washington, DC George R. Flores, M.D., M.P.H. Public Health Officer Sonoma County Public Health Department Santa Rosa, CA Executive Planning Committee John Flores Past Director White House Initiative on Education Excellence for Hispanic Americans U.S. Department of Education Washington, DC Aida L. Giachello, Ph.D. Assistant Professor University of Illinois—Chicago Chicago, IL Co-Chair: Chicago Regional Health Meeting (PHS Regions V and VII) Paula S. Gomez Executive Director Brownsville Community Health Center Brownsville, TX Co-Chair: San Antonio Regional Health Meeting (PHS Regions VI and VIII) Robert Gomez, B.A. President National Association of Community Health Centers Tucson, AZ lleana C. Herrell, Ph.D. Associate Administrator Office of Minority Health Health Resources and Services Administration Rockville, MD Peter Hurley Associate Director for Vital and Health Care Statistics Systems National Center for Health Statistics Hyattsville, MD Sharon Katz, M.P.A. Special Assistant Centers for Disease Control and Prevention Washington, DC Leonard R. Klein Associate Director for Career Entry Office of Personnel Management Washington, DC Laudelina Martinez, M.A. President Hispanic Association of Colleges and Universities San Antonio, TX One Voice ® One Vision One Voice o One Vision Executive Planning Committee Father Vidal Martinez, O0.B.M. Pastor La Asuncion Catholic Church Perth Amboy, NJ Janie Menchaca Wilson, Ph.D., R.N. Immediate Past President National Association of Hispanic Nurses San Antonio, TX Enrique Mendez, Jr., M.D. Assistant Secretary for Health Affairs U.S, Department of Defense Washington, DC Hermann Mendez, M.D. Associate Professor of Pediatrics State University of New York Brooklyn, NY Carlos Perez, M.P.A. Area Administrator Office of Health Systems Management New York State Department of Health New York, NY Co-Chair: New York/Newark Regional Health Meeting (PHS Regions I, Il, and III) Luisa del Carmen Pollard, M.A. Director RADAR Network Center for Substance Abuse Prevention Rockville, MD Michael E. Ramirez, B.S.W., M.P.A. Personnel Officer D.C. Office of Personnel Washington, DC Mario Ramirez, M.D. Vice Chairman University of Texas System Board of Regents Rio Grande City, TX Jaime Rivera-Dueno, M.D. Executive Director San Juan AIDS Institute Santurce, PR Blanca Rosa Rodriguez Acting Executive Director White House Initiative on Educational Excellence for Hispanic Americans U.S. Department of Education Washington, DC $6 OOO HHHH HHH Vey Rene Rodriguez, M.D. President The InterAmerican College of Physicians and Surgeons New York, NY Ramon Rodriguez-Torres, M.D. Chief of Staff The Mary Ann Knight International Institute of Pediatrics Miami Children’s Hospital Miami, FL Co-Chair: Miami Regional Health Meeting (PHS Region IV) Raul Romaguera, D.M.D., M.P.H. International Health Officer Office of International Health Rockville, MD Margarita Roque Executive Director Congressional Hispanic Caucus Washington, DC Jose M. Saldana, D.M.D., M.P.H. President University of Puerto Rico San Juan, PR Shiree Sanchez Assistant Director Office of Public Liaison, The White House Washington, DC Ruth Sanchez-Way, Ph.D. Director Division of Community Prevention and Training Center for Substance Abuse Prevention Rockville, MD Maria D. Segarra, M.D. Associate Director for Policy and Internal Affairs Office of Minority Health Rockville, MD Belinda Seto, Ph.D. Deputy Director Office of Minority Programs National Institutes of Health Bethesda, MD $e OOOOH HHHH HOS Ciro V. Sumaya, M.D., M.P.H.T.M.. Associate Dean for Affiliated Programs and Continuing Medical Education University of Texas Health Science Center San Antonio, TX Co-Chair: San Antonio Regional Health Meeting (PHS Regions VI and VIII) Sara Torres, Ph.D., R.N. President National Association of Hispanic Nurses Tampa, FL Co-Chair: Miami Regional Health Meeting (PHS Region IV) Fernando M. Trevino, Ph.D., M.P.H. Dean, School of Health Professions Southwest Texas State University San Marcos, TX Steve Uranga McKane, D.M.D., M.P.H. Program Director W.K. Kellogg Foundation Battle Creek, MI Co-Chair: Chicago Regional Health Meeting (PHS Regions V and VII) Frank Vasquez, Jr., M.B.A. Executive Director Hidalgo County Health Care Corporation Pharr, TX Richard A. Yeloz, J.D., M.P.H. Staff Director Select Committee on Aging U.S. House of Representatives Washington, DC Marcelle M. Willock, M.D., M.B.A. Professor and Chairman Department of Anesthesiology Boston University Medical Center Boston, MA Alternates for the April 22-23, 1993, Meeting Esther Aguilera Legislative Assistant for Health and Judiciary Congressional Hispanic Caucus Washington, DC Executive Planning Committee Olivia Carter-Pokras Public Health Analyst Office of Minority Health Rockville, MD Evelyn Day Chief, Diverse Education Division Office of Personnel Management Washington, DC Lily O. Engstrom, M.S. Assistant Director Office of Extramural Research National Institutes of Health Bethesda, MD Carlos Esparza Director of Federal Liaison Hispanic Association of Colleges and Universities San Antonio, TX Adolph P. Falcon, M.P.P. Senior Policy Advisor National Coalition of Hispanic Health and Human Services Organizations Washington, DC Patricia M. Golden, M.P.H. Special Assistant to the Director Division of Epidemiology and Health Promotion National Center for Health Statistics Hyattsville, MD Amelia Gutierrez Ramirez, Dr.P.H. Assistant Director for Administration and Community Health South Texas Health Research Center San Antonio, TX Christina Lopez, M. Ed. Director, Health and Elderly Component National Council of La Raza Washington, DC William C. Parra Deputy Associate Director for HIV/AIDS Centers for Disease Control and Prevention Atlanta, GA One Voice o One Vision One Voice o One Vision Contents © 06666666 HHH HHH HHH O14 4 Contents Message from the Surgeon General * 2 Chapter 1: Introduction ¢ 5 Chapter 2: Charge to Farticipants 9 Chapter 3: Hispanic/Latino Health Issues Fanel—Background Summary Fapers * 15 Improving Access to Health Care in Hispanic/Latino Communities ® 15 Improving Data Collection Strategies * 17 Increasing the Representation of Hispanics/ Latinos in the Health Professions * 19 The Development of a Relevant and Comprehensive Research Agenda to Improve Hispanic/Latino Health 21 Health Promotion and Disease Prevention ® 23 Chapter 4: National Workshop Recommendations® 27 Access to Health Care * 27 Data Collection ® 31 Research Agenda ¢ 33 Health Professions * 36 Health Promotion and Disease Prevention * 40 Chapter 5: Presentation of National Workshop Recommendations¢ 45 Access to Health Care * 45 Data Collection * 49 Research Agenda ® 51 Health Professions * 54 Health Promotion and Disease Prevention ® 57 FHS HHHHHHHHHHHHHH OS Contents Chapter 6: Closing Remarks ¢ ol Chapter 7: Regional Health Meetings ¢ 67 Introduction * 67 The Miami Hispanic/Latino Regional Health Meeting * 70 The Chicago Hispanic/Latino Regional Health Meeting * 72 The San Antonio Hispanic/Latino Regional Health Meeting * 74 The New York Hispanic/Latino Regional Health Meeting * 76 The Los Angeles Hispanic/Latino Regional Health Meeting * 78 Chapter 8: Priority Recommendations® &1 Cross-Cutting Issues * 82 Access to Health Care * 83 Data Collection * 88 Research Agenda * 92 Representation in Health Professions # 95 Health Promotion and Disease Prevention ® 97 Appendix A National Workshop Participants * 101 Appendix B National Workshop Agenda #117 Appendix C Regional Health Meetings—Executive Planning Committees and Agendas #121 Appendix D Regional Sponsors and Co-Sponsors * 149 Appendix E National Workshop Speakers #151 One Voice o One Vision