Issues to examine

1. Factors that contribute to longevity of Hispanics.
   The health outcomes of the Hispanic population are challenging long-held notions about health and well-being. Traditional risk factors such as lack of health insurance, poverty, and low educational status have not been predictors for higher mortality rates in the Hispanic community. Indeed, despite having less access to health services, lower income, and less education, Hispanics have a longer life expectancy than non-Hispanic whites. There is a need to encourage research that explains these differences for the benefit of all.
   
   
2. How Hispanics manage chronic disease.
   The longer years of life for many Hispanics are marked by chronic illnesses and disease. Some of these include:
   
   
   • Asthma – The prevalence of asthma among Hispanic children is 76.1% with dramatic increases in prevalence happening over the past decade.
     
   • Diabetes – The rate of adult diabetes for Mexican Americans (23.9%) and Puerto Ricans (26.1%) is about twice that for non-Hispanic whites (12.0%) with about one-third of Hispanic cases being undiagnosed.
     
   • Depression – Approximately half of Hispanic adult women (53%) report moderate to severe depressive symptoms compared to 37% of non-Hispanic white women.
   
   A growing body of research is showing that healthy lifestyle practices that reduce mortality are eroding as the Hispanic community adopts U.S. cultural norms. For example, rates of smoking, sedentary lifestyle, and unhealthy dietary practices are higher for first generation Hispanics compared with immigrant Hispanic populations.
   
   The incidence of chronic illness and disease coupled with lack of access to health care providers is a devastating combination for the health and well being of Hispanic communities. Chronic illness and disease requires ongoing access to a health care provider for management and treatment. The lack of regular access to care has increased the incidence of: diseases which could have been avoided as well as serious complications such as lower leg amputations from diabetes; missed school days from asthma attacks; and, suicide attempts as depression remains untreated.
   
   As the standard of living improves and populations become more mobile, new methods and technology must be used to provide persons with information on prevention and early intervention with respect to chronic diseases.
   
   
3. Special needs of older persons.
   The increase in lifespan necessitates the development of support services for a growing aging population. Not only are persons living longer throughout the Americas but the illnesses they experience and the care they require demand new approaches to providing care.
   
   With broad experience in developing innovative community-based services, Alliance members are uniquely poised to build new models of community care, life enhancement, and caregiver services built on a tradition of community and family care. The demographics of Hispanic communities and aging in the Americas make this a unique time in history to build models of caring at the beginning of a growth trend and put community-wide services in place now as the need is beginning to grow.
   
   
4. Improving quality of care and saving money.
   A key challenge is to encourage efforts that represent the best practices in health services and which build on opportunities to address quality as a part of cost effective or efficient practices; recognize the benefits and long term cost savings offered by technology; and, promote scientific research. The Alliance is a founder of the field of cultural proficiency in healthcare and has helped to define this evolving area.
   
   New work is needed to insure that the ability to communicate with a patient is viewed as a fundamental quality of care issue and essential to reducing medical errors. Furthermore, additional efforts must be directed at the appropriate use of evidence based medicine and protocols
   
   
5. Health across borders.
   The need for the Alliance to be fully responsive to domestic health issues has propelled the necessity to reinforce existing programs and build new relationships throughout the Americas. Through the establishment of HFA, the Alliance will be able to actualize its vision for Hispanic health services. In this future the unique texture and vitality of each community is leveraged with a unity of purpose that is driven by solutions that extend across borders. Such joint action would increase the likelihood of a healthy future throughout the Americas.
   
   To solidify this vision, the Alliance sought and has been granted official non-governmental organization (NGO) status with the Pan American Health Organization (PAHO). The Alliance was the first national organization in the United States to achieve this recognition. Building on this and other existing relationships the HFA will work to create a future marked by promise and evidenced by renewal.