Chartbook for Hispanic Health Care

NQS Priority: Healthy Living

Well-Child Visits

Children ages 0-17 with a well-child visit in the last 12 months, by race/ethnicity, 2000-2013

Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey, 2000-2013.

• Trends:
  • Overall, the percentage of children ages 0-17 years who had a well-child visit (as distinct from a symptom-driven visit) in the last 12 months increased from 71% in 2000 to 83% in 2013.
  • From 2000 to 2013, the percentage of children who had a well-child visit increased significantly for Whites (71.3% to 83.3%), Blacks (75.4% to 87.8%), and Hispanics (65.3% to 79%).
• Groups With Disparities:
  • In all years, Hispanic children were less likely than White children to have had at least one well-child visit during the year.
  • In all years except 2006 and 2011, Black children were more likely than White children to have at least one well-child visit.
  • There were no statistically significant changes in disparities over time.

Recommended Vaccinations for Children

Children ages 19-35 months who received the 4:3:1:3:3:1:4 vaccine series, by race/ethnicity, 2009-2012

2012 Achievable Benchmark: 72%.

Source: Centers for Disease Control and Prevention, National Center for Health Statistics and National Center for Immunization and Respiratory Diseases, National Immunization Survey, 2009-2012.
Note: The 4:3:1:3:3:1:4 vaccine series refers to 4 or more doses of diphtheria and tetanus toxoids and pertussis vaccine, or diphtheria and tetanus toxoids; 3 or more doses of poliovirus vaccine; 1 or more doses of measles antigen-containing vaccine, including measles-mumps-rubella; 3 or more doses of Haemophilus influenza (Hib) type b vaccine; 3 or more doses of hepatitis B vaccine; 1 or more doses of varicella vaccine; and 4 or more doses of pneumococcal conjugate vaccine. Full series of Hib vaccine is ≥3 or ≥4 doses, depending on brand type.

The U.S. Surgeon General, Dr. Vivek H. Murthy, and Elmo want everyone to stay healthy and get vaccinated! https://youtu.be/viS1ps0r4K0

• Trends:
  • From 2009 to 2012, the percentage of children ages 19-35 months who received the 4:3:1:3:3:1:4 vaccination series improved from 44.3% to 68.4%.
  • From 2009 to 2012, the percentage of children who received all recommended vaccinations improved for Blacks (39.6% to 64.8%), Hispanics (45.9% to 67.8%), and Whites (45.2% to 69.3%).
• Groups With Disparities:
  • In 2012, there were no statistically significant differences between Hispanic children and White children in the percentage who received all recommended vaccines, while Black children were less likely than White children to receive all recommended vaccines.
• Achievable Benchmark:
  • The 2012 top 5 State achievable benchmark was 72%. The top 5 States that contributed to the achievable benchmark are Louisiana, Maryland, Massachusetts, New Hampshire, and Ohio.
  • White, Black, and Hispanic children could achieve the benchmark within a year.

Advice for Adults About Exercise and Healthy Eating

Adults with obesity who ever received advice from a health provider to exercise more and who received advice to eat fewer high- fat or high-cholesterol foods, by race/ethnicity, 2002-2012

Left Graph (Exercise):

Right Graph (Food):

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2012.
Denominator: Civilian noninstitutionalized adults age 18 and over with obesity.
Note: Estimates are age adjusted to the 2000 U.S. standard population using three age groups: 18-44, 45-64, and 65 and over. Obesity is defined as a body mass index of 30 or higher.

• Advice About Exercise:
  • Overall Rate: In 2012, overall, 59.3% of adults with obesity had ever received advice from a health provider to exercise more.
  • Trends: From 2002 to 2012, the percentage of obese adults who ever received advice from a health provider to exercise more improved for Blacks (from 55.8% to 62.4%) and Hispanics (from 45.9% to 55.9%).
  • Groups With Disparities: In 7 of 11 years, Hispanic adults with obesity were less likely to ever receive advice from a health provider to exercise more compared with White adults with obesity. The disparity has narrowed between obese Hispanic adults and obese White adults.
• Advice About Healthy Eating:
  • Overall Rate: In 2012, overall, 50.2% of adults with obesity were reported to have ever received advice from a health provider about eating fewer high-fat or high-cholesterol foods.
  • Trends: From 2002 to 2012, the percentage of adults with obesity who ever received advice about healthy eating improved for Blacks (from 46.7% to 52.3%) and Hispanics (from 38.6% to 50.2%).
  • Groups With Disparities: In 4 of 11 years, the percentage of Hispanic adults with obesity who ever received advice about healthy eating was lower compared with White adults with obesity. The disparity between obese Hispanic and White adults has narrowed.

AHRQ Health Care Innovations in Weight Management

Lutheran Family Health Centers

• Location: Brooklyn, New York.
• Population: Children in 3rd and 4th grades.
• Intervention: With its school-based health program at PS 24, developed Cuerpo Sano/Mente Sana, a 36-week weight management program.
• Outcomes: Data on the program's effectiveness are not yet available.

Pneumococcal and Influenza Immunization

Hospital patients who received pneumococcal immunization and influenza immunization, by race/ethnicity, 2012

Key: AI/AN = American Indian or Alaska Native.
Source: Centers for Medicare & Medicaid Services, Medicare Quality Improvement Organization Program, 2012.
Denominator for Pneumococcal Immunization: Discharged hospital patients age 65 and over or ages 6-64 with a high risk condition.
Denominator for Influenza Immunization: Hospital patients discharged in October-March.

• Importance: Hospitals are important sites for ensuring people receive needed immunizations, including pneumococcal and influenza immunizations.
• Pneumococcal Immunization:
  • Overall Rate: In 2012, 89% of hospital patients received pneumococcal immunization.
  • Groups With Disparities: In 2012, the percentage of hospital patients who received pneumococcal immunization was lower among Blacks, Asians, AI/ANs, and Hispanics compared with Whites.
  • Achievable Benchmark: The 2012 top 5 State achievable benchmark was 93%. The top 5 States that contributed to the achievable benchmark are Delaware, Florida, Ohio, South Carolina, and West Virginia. All groups were below the benchmark.
• Influenza Immunization:
  • Overall Rate: In 2012, 87.2% of hospital patients received influenza immunization.
  • Groups With Disparities: In 2012, the percentage of hospital patients who received influenza immunization was lower among Blacks, Asians, AI/ANs, and Hispanics compared with Whites.
  • Achievable Benchmark: The 2012 top 5 State achievable benchmark was 93%. The top 5 States that contributed to the achievable benchmark are Delaware, Maryland, New Hampshire, South Carolina, and West Virginia. All groups were below the benchmark.

Improvement in Mobility and Shortness of Breath Among Home Health Patients

Adult home health patients whose ability to move or walk around improved and whose episodes of shortness of breath decreased, by race/ethnicity, 2010-2012

Left Graph (Movement Improved):

2010 Achievable Benchmark: 62.5%.

Right Graph (Shortness of Breath Decreased):

2010 Achievable Benchmark: 70.7%.

Source: Centers for Medicare & Medicaid Services, Outcome and Assessment Information Set (OASIS), 2010-2012.
Denominator: Adult nonmaternity patients completing an episode of skilled home health care.
Note: Starting January 1, 2010, the patient assessment instrument for home health agencies was changed to OASIS-C.

• Importance: Many patients who receive home health care are recovering from an injury or illness and may have difficulty walking or moving around safely. Maintaining and improving functional status, such as patients' ability to ambulate, improves quality of life and allows them to stay at home as long as possible. Getting better at walking or moving around may be a sign that their health status is improving. Shortness of breath interferes with activities such as walking and is an important health status indicator.
• Improved Movement:
  • Overall Rate: In 2012, 59.7% of home health patients showed improvement in walking or moving around.
  • Groups With Disparities: In all years, Hispanic home health patients were less likely than White home health patients to get better at walking or moving around. In 2011 and 2012, Black home health patients were less likely than White patients to get better at walking or moving around.
  • Achievable Benchmark: The 2010 top 5 State achievable benchmark was 62.5%. The top 5 States that contributed to the achievable benchmark are Maine, Missouri, New Jersey, South Carolina, and Utah. No group has achieved the benchmark. Data are insufficient to determine time to benchmark.
• Decreased Shortness of Breath:
  • Overall Rate: In 2012, 64.2% of home health patients had less shortness of breath.
  • Groups With Disparities: In all years, Hispanics were less likely than Whites to show improvement in shortness of breath.
  • Achievable Benchmark: The 2010 top 5 State achievable benchmark was 70.7%. The top 5 States that contributed to the achievable benchmark are District of Columbia, Hawaii, Maryland, New Jersey, and South Carolina. No group has achieved the benchmark. Data are insufficient to determine time to benchmark.

Improved Medication Management Among Home Health Patients

Adult home health patients whose management of oral medications improved, by age, stratified by race/ethnicity, 2012

2010 Achievable Benchmark: 53.5%.

Source: Centers for Medicare & Medicaid Services, Outcome and Assessment Information Set, 2012.

• Importance: Patients who have problems taking their medications as prescribed are at risk for adverse outcomes, including lack of improvement, worsening of disease, serious side effects, and death.
• Overall Rate: In 2012, 49.7% of home health patients got better at taking their medications, compared with 47.3% in 2011 and 46.2% in 2010 (data not shown).
• Groups with Disparities: In 2012, Hispanic home health patients in all age groups were less likely than Whites and Blacks to get better at taking their medications.
• Achievable Benchmark:
  • The 2010 top 5 State achievable benchmark was 53.5%. The top 5 States that contributed to the achievable benchmark are District of Columbia, Illinois, New Jersey, North Dakota, and South Carolina.
  • In 2012, White and Black home health patients ages 0-64 and 65-74 had a rate higher than the benchmark.
  • Data are insufficient to determine time to benchmark for other groups.

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