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16 August 1999 Vol. 18, Nos $16 AUGUST1999 VOL.18, NOS.2-3 6 , ii*e 22 .V t fir, N.C. Center for Public Policy Research Board of Directors The North Carolina Center for Public Policy Research is an Chair Secretary independent, nonprofit organization dedicated to the goals of a Ned Cline Elaine F. Marshall better-informed public and more effective, accountable, and Vice Chair Treasurer responsive government. The Center identifies public policy issues Loleta Wood Foster Peter Keber facing North Carolina and enriches the dialogue among citizens, the media, and policymakers. Based on its research, the Center makes John Alexander recommendations for improving the way government serves the David E. Benevides Rann Carpenter people of this state. In all its efforts, the Center values reliable and Sue W. Cole objective research as a basis for analyzing public policy, inde- Keith Crisco pendence from partisan bias and political ideology, the richness of MargaretB. Dardess the state's diverse population, and a belief in the importance of Philip R. Dixon citizen involvement in public life. Virginia A. Foxx Thomas J. Harrelson The Center was formed in 1977 by a diverse group of private Donald Harrow citizens "for the purpose of gathering, analyzing, and disseminating Fletcher Hartsell information concerning North Carolina's institutions of gov- David Jones ernment" It is a nonpartisan organization guided by a self-elected Betsy Y. Justus Board of Directors and has individual and corporate members Phil Kirk Georgia Jacquez Lewis across the state. Angie McMillan Center projects include the issuance of special reports on Garrie Moore major policy questions; the publication of a magazine called North Tom Morrow Carolina Insight; joint productions of public affairs programs with Joyce Peters Katherine Skinner WUNC-FM, WPTF-AM, the N.C. Radio News Network, WRAL- Craig Souza TV, and WTVD-TV; and the regular participation of members of the Russ Stephenson staff and the Board in public affairs programs around the state. An Bertram E. Walls attempt is made in the various projects undertaken by the Center to Cameron P. West D. Jordan Whichard III synthesize the thoroughness of scholarly research with the readability of good journalism. Each Center publication represents an effort to amplify conflicting ideas on the subject under study and to reach conclusions based on sound rationalization of these competing ideas. ExecutiveDirector Center Staff Intern Ran Coble Mike McLaughlin Joanne Scharer Teresa Savarino Laurita Ray Carolyn Waller Nancy Rose NORTH CAROLINA INSIGHT is a magazine published by the North Carolina Center for Public Policy Research, Inc. (a nonprofit, tax-exempt corporation), Suite 701, 5 W. Hargett St., P.O. Box 430, Raleigh, N.C. 27602. Telephone (919) 832-2839. Annual membership rates; Individual, $36; Organizational, $50; Supporting, $100; Corporate, $200; Full-Service, $250; Corporate Donor, $300; Supporting Corporate, $500; Patron, $1000; Benefactor, $2000. Third class postage paid at Raleigh, N.C. Copyright 1999 by the North Carolina Center for Public Policy Research, Inc. Articles may not be reprinted without permission. Graphic design by Carol Majors. Production by PUBLICATIONS UNLIMITED. Printed by Theo. Davis Sons, Inc., Zebulon, N.C. The Center is supported in part by grants from the Z. Smith Reynolds Foundation, as well as by 13 other foundations, 190 corporate contributors, and almost 900 individual members across the state. The views expressed in this publication are those of the authors and are not necessarily those of the Center's Board of Directors or staff Published August 1999. Printed on recycled paper with soy ink. Cover photo by Karen Tam Visit the Center's website at www.ncinsider.com/nccppr Q Pwareowrrx SOYINK Insight Vol. 18, Nos. 2-3 August 1999 2 Hispanic /Latino Health in North Carolina: Failure to Communicate ? -Joanne Scharer ' `s es alimentos,, 14 The Meaning of Hispanic and Latino -Joanne Scharer I 47 Building Bridges : The Chatham County Family Resource Center -Joanne Scharer 54 People Caring for People: Blue Ridge Community Health Service -Joanne Scharer 65 Selected Resources on Hispanic /Latino Health -Joanne Scharer 66 Do Wood Chip Mills Threaten the Sustainability of North Carolina Forests? -John Manuel 91 Recommendations on Sustainable Forestry and Wood Chip Mills -Mike McLaughlin 94 From the Center Out- Special Provisions in Budget Bills: Pandora's Box Is Open Again -Ran Coble 101 Legislative Battle in 1971 Forecasts Key University Issues in 1999 and Beyond -Carolyn Waller 103 Index to Volume 17 EDITOR Mike McLaughlin GRAPHIC DESIGN Carol Majors PRODUCTION Publications Unlimited I 2 NORTH CAROLINA INSIGHT Hispanic/Latino Health in North Carolina: FAILURE TO Co CATE? Executive Summary North Carolina is experiencing a wave of Hispanic/Latino immigration that shows no signs of cresting. The U.S. Census Bureau and state officials estimate that the Hispanic/Latino population has nearly doubled since the 1990 Census to more than 200,000, or some 2 percent of the state's population. Some estimates range as high as 350,000. Of course, not all Hispanic/Latino residents are immigrants. Many have lived in the state for years, speak fluent English, and are firmly entrenched in the middle class. Yet the influx of new or recent immigrants, most of whom speak little or no English, is creating a chal- lenge for providers of public services in North Carolina. In the health care arena, Hispanics/Latinos are heavy users of state services, which means that service providers must make a special effort to meet their needs. This article examines how Hispanics/Latinos are currently being served by local health agencies and discusses how local health agencies might better serve Hispanics/ Latinos in the future. The Center first discussed the new wave of Hispanic/Latino immigration in a 1993 edition of North Carolina Insight entitled "North Carolina's Demo- graphic Destiny. " In that issue, the Center identified the rise in the Hispanic/ Latino population as a major demographic trend for years to come. Health is- sues involving Hispanics/Latinos surfaced in our 1995 study entitled, "The Health of Minority Citizens in North Carolina. " Thus, the Center was well po- sitioned to undertake a more detailed study of Hispanic/Latino health in North Carolina. This most recent study included a review of recent literature, extensive in- terviews and field visits, and a survey of all 87 local health departments, 22 community and migrant health centers, 34 rural health centers, and 75 rural hospitals. The response to this survey was excellent, with 94 percent of local health departments participating, and majority participation by each of the re- maining types of health care providers. The survey centered on key health is- sues concerning Hispanic/Latino residents, as well as barriers to receiving ad- equate care, and steps taken by health care providers to address these barriers. AUGUST 1999 3 Barriers To Receiving Care. The primary barrier affecting Hispanic/ Latino health issues in North Carolina is the language barrier, respondents indicated. Asked to identify the three most significant barriers to Hispanics/ Latinos obtaining adequate health care in their communities, respondents most frequently cited: (1) the language barrier, followed by (2) lack of insurance or other means to pay for services, and (3) lack of transportation. A distant fourth was lack of information and/or awareness about services available. Most Significant Health Issues. Asked to indicate the three most signifi- cant health issues affecting Hispanics/Latinos in their communities, respon- dents ranked access to health care and no or inadequate health insurance as two of the three most significant health issues. The significance of remaining issues varied by the age and gender. For example, prenatal care ranked as the most significant issue for females. For males, health care providers indicated that the key issues beyond access and health insurance were (1) on-the job-in- juries, (2) sexually transmitted diseases, and (3) drug and alcohol abuse. For children, the key issues were (1) immunization rates, (2) dental care, and (3) nutrition. Steps Taken To Address Barriers. Nearly all of the respondents indicated that they use interpreters to address the language barrier, including all but one of the North Carolina health departments that responded to the Center's sur- vey. More than half the health departments had interpreters on staff (57.7 per- cent)-but many of these employees had multiple duties. Health departments also used contract and volunteer interpreters, as did other types of service pro- viders. Other steps most frequently taken to reduce health care barriers for Hispanics/Latinos included: (1) offering bilingual information and materials; (2) providing Spanish language training and/or cultural training for staff; (3) conducting outreach efforts such as health fairs; (4) offering transportation or providing outreach or home visits for people without transportation; (5) opening clinics on weeknights more than one night a month; and (6) hiring bilingual staff. Other Key Findings. The Center also found that Hispanics/Latinos are underserved by the state's mental health system and that Hispanics/Latinos are overrepresented among workers who are injured on the job. Many local health departments and other types of service providers are making a strong effort to provide health services for the burgeoning Hispanic/ Latino population in North Carolina. However, more could be done.
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