Introducing Kenadi's E-portfolio

Questions 1-3: This report was submitted by the Interagency State Council on Black and Minority Health Members on November 1, 2019. The issue creating this report deals with the need to improve the health of black and minorities in Indiana. 4: The opening letter from the chairman of the Interagency Council, Lynne Griffin, talks about the initial purpose of the council. She says it “was established to identify and address health disparities, their impact upon the state of Indiana, and the actions necessary to improve health outcomes for racial, ethnic, and underserved populations” (2019). She mentions the collaboration of connecting with institutions and community organizations. Aside she gives the role of the Interagency Council being to develop annual reports highlighting priority state health concerns along with rankings policies, and systems of improving health. Another letter from the Legislative Representative of the Interagency Council follows. It announces the annual report of the council on black and minorities Health. The writers Jean Breaux and Robin Shackleford say “the Interagency State Council on Black and Minority Health was legislatively introduced by Representative Charlie Brown and enacted into law in 1993” (2019). They encourage the careful viewing of the report in order to follow recommendations in addressing disparities spreading through communities of color. The Data included in the 2019 annual report goes into details on each of the following minority health aspects; Infant and maternal mortality, obesity, mental health,adult smoking, substance and opioid misuse, long-term, and kinship care. The opening data also states that Indiana ranked 41 of 50 states.with 50 being the worst for overall health outcomes.which has been a decrease since 2017 from the ranking of 38. Infant Mortality: Indiana ranks 42nd for infant mortality. This occurs when an infant dies before their first birthday. In the state there are over two and a half times more stillbirths from black babies as white. Most of which are caused by perinatal risks. Besides congenital Malformations and the “all other” category, black infants dominate the causes of infant mortality. Recommendations include programs such as Speak Life that advocate for mothers, increasing partnership between physicians, midwives, and doulas (2019). They also recommend expanding the availability and Utilization of racially diverse duelists to improve health outcomes. The healthy people 2020 infant mortality objective is to reduce the mortality rate to six infant deaths per 1,000 live births. Maternal Mortality: Indiana ranks 46 in the US for maternal mortality. This is defined as the death of a mother while pregnant or up to 42 days after the end of pregnancy from pregnancy related health problems. The main causes of maternal mortality are heart issues. Things from cardiomyopathy, cardiovascular disease, preeclampsia, embolism, as well as eclampsia. Black women had a rate of 53 deaths per 100,000 while white had 41 per 100,000 in 2018. Recommendations for improvement include standardizing maternal mortality data collection, empowering existing federal agencies to provide technical guidance and share prevention practices,authorizing evidence-based national upstairs emergency protocol and best practice and best practices to save mothers' lives. The healthy people 2020 maternal mortality objective is an average of 11.4 maternal deaths per 100,000. Obesity: Indiana ranks 39th for adult obesity.” In 2018 34.1 percent of INdiana’s adults were considered to be obese based on a BMI of ≥30 calculated from self-reported height and weight” (2019). Black Hoosiers were six percent more likely to be obese. Something to note was that black females had the highest prevalence at 46%. There are wide causes of obesity with a mixture of predispositions, food access, genetic stress and behavioral choices. Some places in Indy have far grocery stores or none at all. Inequity in healthy food options is another factory. Some can't afford healthy eating. And when it comes to getting active, some communities may be safer than others. “In 2015 less than 50% of Indiana adults met moderate physical activity recommendations” (2019). Recommendations, including increasing access to healthy and affordable food to all residents, Increasing the number of farmers markets statewide that accept SNAP, Standardizing the quality of food within all areas in establishing a chronic disease registry. Something interesting worth noting here is that the recommendations didn't include any physical recommendations and they were all eating aspects having to do with obesity. Mental health: Mental health access is access to insurance, treatment, quality and cost, and education about mental health. If health care access is low then treatments become more of a hassle than dealing with the initial issue. MMental health providers are limited in Indiana with only one professional per 500 residents in the population. This is a problem when nearly a quarter of adults in the state with mental illnesses report they are not getting proper treatment they need. With a Ranking of 22nd for access to care this shows those at the top have higher access. Some recommendations for improvement Include reimbursement rate for mental health providers equal to physical health equal, reimbursement rate for mental health providers. Funding for mental health access to care and reducing stigma as well as increased education and awareness are also recommendations. Adult smoking: Indiana ranks 44th for adult tobacco use and most.preventable cause of premature death in the United States(2019). Tobacco users are responsible for about 30% of all diagnosed cancer. In 2018 21%of adults were current smokers. The healthy people 2020 objective is to reduce the amount to 12%. Some recommendations include implementing policies systems in environmental changes to minimize tobacco use by supporting the tobacco tax increase and creating smoke free policies. Substance/opioid misuse: Indiana ranked 34th in drug related deaths according to the alliance for healthier Indiana. IIn Indiana overdose deaths affect 80% of the white population, while only 9% of the black population. This could be due to the fact that prescription of pain medications are higher in white than black populations. Still, this percentage continues to rise across all races. Recommendations for improvements in increasing education of physicians and pharmacists on dosages as well as.increasing physician competency on patients drug use history. Needle exchange programs have also been increasing even writing this today in 2024. Which was a recommendation I can see a follow through for. Long-term care: Indiana ranks fifty first for long term care services and supports. The aging of the baby boomers puts a bit of a strain on health care when it comes to the needs of providers as well as quality care for a big population. To improve long term care the Interagency Council recommends Increasing pathways to information and support to ensure people have choices to meet long term care needs. They also recommend examining interstate funding formulas used for older Americans act funding. Kinship care and grandparents: In the U.S, 1 of 11 kids less than 18 years old, live in a kinship care setting where 1 of 5 black children live in this setting. This setting is described where a child lives with a family member where their parent is not present. Many challenges occur during these kinship care settings, especially that of financial challenges. One can find themselves caring for a kid on a fixed income. Health and emotional challenges could occur too like lack of insurance or legal guardianship as well as stress. RRecommendations include offering a kinship navigator program to assist these families, Promoting the involvement of government agencies to reliably place children. Even reimbursement or pay for kinship care until the guardian gets licensed or trained can be a big help. The report then gives a warning on data limitation stating that black and African Americans are the largest minority group in Indiana. This means that much of the data available is limited to this racial group.There is limited published data on American Indians, Asians and Hispanics due to their smaller numbers. Therefore, much of the data in this report focuses on the disparities between blacks and whites (2019). General recommendations are then given from the interagency state council on black and minority health. The first thing is to update the structure of the Council with.the changing landscapes of Indiana.This includes addressing ethnic minority communities as well as under search populations. The second is institutionalized disaggregation of data for health disparities. This can be very helpful for identifying issues existing for groups that have experienced disadvantages in regards to their race. 5: By reading this agency report I learned a lot of new things. The first thing I noted was that black females are the leading demographic of obesity in Indiana. This caught my eye as an obese African American who is working on improving her relationship to food, physical activity, and my own body. They did not go into details on this subject but I can speculate that mental health also plays a role in this outcome. Something else I learned is about the second thing I noted, which was that all the obesity recommendations included that of dealing with food as opposed to physical activity. Can it be said that it's more important to focus on what and how you're eating as opposed to getting physically active? It may be easier to note recommendations for eating aspects of improving obesity because access can vary far wider than access to physical activity. Some more information on the food aspect, as opposed to the physical activity aspects of obesity, would have been helpful to include in this report that was not included. 6: This report helped me have a slightly different perspective on black and minority health. For example when looking at infant mortality, it may not have been the first thought to increase not only the amount, but the diversity of doulas could help significantly improve health outcomes for moms and babies. For something like obesity I don't know if I would have guessed that black Hoosiers could have higher prevalence even though we have the lowest access to healthy food. My thought was that food access is low period. And when looking at things like mental health data it just makes me want to advocate for it even more and encourage those in my community who have access to that access for treatment. This has definitely broadened my perspective of black and minority health. 7: I felt the recommendations for most of these were a bit broad. I understand that this report may have not been written for the general public, but as someone from the general public reading the report, recommendations for the general public would have been great and extremely beneficial to include.