Post on 16-Jan-2015
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transcript
“The coming Communications Crisis in US Healthcare”
Plain Talk Conference 2012
Chris Gibbons, MD MPH J O H N S H O P K I N S U R B A N H E A L T H I N S T I T U T E
Can You Hear Me Now?
“BIG” Problems in US Healthcare
Cost of Healthcare
Access to Healthcare
Prevalence in Chronic Disease
Increase numbers of Seniors
Increase in numbers of immigrants and minorities
Intractable Disparities
Provider Shortage
Others????
Which one is the BIGGEST Problem?
Cost of Healthcare
Access to Healthcare
Prevalence in Chronic Disease
Increase numbers of Seniors
Increase in numbers of immigrants and minorities
Intractable Disparities
Provider Shortage
????
The BIGGEST Problem?
Inability to Communicate with the Healthcare system
Definition – Inability to understand or be understood.
The largest drivers of the Problem?
Poor Health Literacy
Poor English Language Fluency
How big is the Problem?
2007 Census/ACS
Does this person speak a language other than
English at home?
What is this language?
How well does this person speak English
(very well, well, not well, not at all)
People speaking below the “very well” category are thought to need English assistance in some situations
How big is the Problem?
The Voting Rights Act of 1965 uses these criteria to determine the need for bilingual election materials.
Self-reported data on English-speaking ability have demonstrated the measure to be highly reliable and usable.
“How Good Is How Well? An Examination of the Census English-Speaking Ability Question,”
<http://www.census.gov/population/www/socdemo/lang_use.html>.
How big is the Problem?
In 2007 55 million people (20% US pop) spoke a language other than English at home.
What are they Speaking? Spanish including Spanish, Spanish Creole, and Ladino. (62%)
Other Indo-European languages including most languages of Europe and the Indic languages of India. These include the Germanic languages, such as German, Yiddish, and Dutch; the Scandinavian languages, such as Swedish and Norwegian; the Romance languages, such as French, Italian, and Portuguese; the Slavic languages, such as Russian, Polish, and Serbo-Croatian; the Indic languages, such as Hindi, Gujarati, Punjabi, and Urdu; Celtic languages; Greek; Baltic languages; and Iranian languages. (19%)
Asian and Pacific Island languages include Chinese; Korean; Japanese; Vietnamese; Hmong; Khmer; Lao; Thai; Tagalog or Pilipino; the Dravidian languages of India, such as Telugu, Tamil, and Malayalam; and other languages of Asia and the Pacific, including the Philippine, Polynesian, and Micronesian languages. (15%)
All Other languages include Uralic languages, such as Hungarian; the Semitic languages, such as Arabic and Hebrew; languages of Africa; native North American languages, including the American Indian and Alaska native languages; and indigenous languages of Central and South America (4%)
How big is the Problem?
50% (25 million) of non English Speakers reported that they did not speak English “Very Well”
Proportions were higher among older Spanish speakers 57% of those aged 41-64
65% of those over the age of 65
7 of 17 languages had more than 1 million speakers Spanish – 34 million
Chinese – 2 million
French, Tagalog, Vietnamese, German, Korean – 1 million
How fast is the Problem changing?
From 1980-2007
Vietnamese saw 511% increase
> 200% increase
Spanish, Russian, Persian, Chinese, Korean, Tagalog
Substantial variability across states
W Virginia (2%), California (43%)
Southwest and East Coast States had substantial rates
All 50 states had some increase
Bottom Line
In 2007
25 million people were not able to speak English Very well
Their numbers are rapidly increasing
They are not just in New York, California, Florida and Texas
Most speak Spanish, but also many other languages involved
The full Story
Dialects, slangs, vernaculars, Jargons Gullah
Southern Drawl
Urban - Phat, Cold, Mad, Badonkadonk
In 2012 ~ 30 million people with LEP
Healthcare Reform – 30 million more in 2014
Health Literacy? 40% of Americans can not understand health information
115 million people
Impact on Healthcare System
Sites of “care” Hospital
Clinic
Emergency Room
Doctor’s Office
Pharmacy
School
Work
Impact on Healthcare System
Patient Trust Engagement Satisfaction with care Healthcare decision making Adherence
Provider Patient centeredness Readmissions Reimbursements Outcomes
System/Population Costs Waiting times Disparities
Impact on Healthcare System
Add in Aging Provider workforce
Nursing shortage
Inability to manage “care in the community”
Recipe for a
“Communication Crisis in Healthcare”
What can we do about it?
Wait for the Healthcare system
Explore powerful emerging resources More U.S. adults used the Internet than doctors to obtain
health and medical information
The Internet has considerably more influence over consumer health decisions and actions than traditional channels like print, TV and radio
Thousands of Translator Apps (Google, Android and Apple)
WordLens, Google Translate, many others
Refuse to accept the status quo
What can we do about it?
Refuse the status quo in health communication Now – one time, paper based, word dense communication
Future - Paper +
Electronic information – thumb drives etc
Take anywhere
On Demand health information – 1-800 xxx xxxx
Obtain anytime
Video based vs. Graphic Based information
Culturally appropriate
Cloud based web services information
Access by any device
PN & CHW based services
Bottom Line
Refuse Status quo
Utilize available emerging tools & technologies
Request/Inform
Advocate City, state and government Reps
Organize Information support groups
“Patients like me”
“Cure together”
Let your voice be heard Editorials, Blogs, Petitions
Be Part of the Solution
Prepare to be the advisors and expert consultants they will need.
Design our own new innovative solutions.
Prepare to be tomorrows designers and developers.
Thank You
Together, we will find the “cure” for
the coming “communications crisis”.