Using a data-informed strategy to improve health outcomes for Hispanic Americans

Hispanic Americans make up nearly 18% of the total population, according to the latest U.S. census data, and the diversity of ancestry within that population makes a difference when it comes to health outcomes. The Centers for Medicare and Medicaid Services (CMS) Office of Minority Health released a data highlight report last month based on survey results from the 2013–2015 Medicare Health Outcomes Survey (HOS) Baseline Cohorts 16, 17, and 18, and it showed that over half of the Hispanic population reported fair or poor health. While this self-rated total may indicate that this population is at an increased risk for future hospitalization, use of mental health services, and mortality, the report also showed significant differences across Hispanic groups in reporting fair or poor health.

The report’s key takeaway is that the U.S. Hispanic population represents a highly heterogeneous group, and treating Hispanic Americans as a single ethnic category fails to acknowledge variations in health within the Hispanic population. Among the Hispanic respondents to the survey, 30.8% self-identified as Mexican, 30.7% as Puerto Rican, 26.2% as other Hispanic, 6.8% as multi-ethnic, and 5.5% as Cuban. The report added that additional research to improve the understanding of the health needs of different ethnic groups within the Hispanic population is warranted.

Some of the key findings of the survey included:

• At least half of all Hispanic beneficiaries (50.2%) reported fair or poor health. Significant differences were observed across Hispanic groups, ranging from 42.5% of Cubans to 55.8% of Puerto Ricans.
• The rate of positive depression screen was significantly different across groups, as 25.2% of Cubans and 34.9% of multi-ethnic Hispanics screened positive for depression.
• With the exception of Cubans (31%), at least one-third of beneficiaries in each Hispanic group were classified as obese.
• Nearly one-third (31%) of Hispanics reported that pain had interfered with daily activities quite a bit or very much over the past seven days, and rates ranged significantly across groups from 24.3% of Cubans to 37.4% of Puerto Ricans.
• More than half of Hispanic beneficiaries (56%) reported less than ideal average sleep duration (< 7 hours), and these rates ranged from 49.3% for Mexicans to 61.5% for Puerto Ricans.

The results of surveys like this are a first step to building a data-informed strategy that will allow CMS to understand the diversity within the Hispanic community and identify unique challenges those communities may face in accessing care that meets their needs, said Cara V. James, Ph.D., director of the Office of Minority Health, in a CMS blog post last month.

To assist healthcare organizations in developing data-informed strategies, CMS has developed resources like the Compendium of Resources for Standardized Demographic and Language Data Collection to assist in setting up data collection efforts to better understand patients, identify disparities in quality of care, and target quality improvement interventions.