Diversity in South Texas

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1 Diversity in South Texas James E. Bonson, MPAS, PA-C Assistant Professor/Clinical Coordinator School of Health Professions Department of Physician Assistant Studies UT Health Science Center - San Antonio

2 Overview Introduction Definitions 2010 Census Data The hurdles What can we do to fix things? Resources

3 INTRODUCTION - Look Around You.. Practice Type Where is Home? Pets Age Years in practice Government employee

4 Introduction The Danger of a Single Story TED Talk Chimamanda Adichie (Nigerian Author)

5 Definitions Culture Race Ethnicity Cultural Continuum

6 Definitions Culture: Socially Inherited Characteristics Race: Common Physical Characteristics Ethnicity: Various Common Traits/Heritage

7 Definitions Cultural Competence Continuum: Destructiveness Incapacity Blindness Pre-Competence Competence Proficiency

8 2010 Census Data

9

10 Year* Total Population and Components of Population Change in Texas, Population Numerical Change Percent Change Percent Change Due to Natural Increase ,711, Net Migration ,579,677 1,868, ,196,730 1,617, ,229,191 3,032, ,986,510 2,757, ,851,820 3,865, ,782,302 3,930, ,145,561 4,293, ,674, , * All values for the decennial dates are for April 1 st of the indicated census year. Values for 2009 and 2011 are for July 1 as estimated by the U.S. Census Bureau. Source: Derived from U.S. Census Bureau Estimates for dates indicated by the Texas State Data Center, University of Texas at San Antonio. Note: Residual values are not presented in this table. 10

11 Estimated Annual Net Migration to Texas, 2000 to , ,000 International State-to-State 150, ,000 50,000 Hurricane Katrina to to to to to to to to to 2009 Source: U.S. Bureau of the Census 2009 Estimates 11

12 Percent of Migrants to Texas between 2000 and 2009 by Race and Ethnicity 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 5% 23% 28% 44% 18% 8% 15% 50% 24% Net domestic International migration migration (848,702 migrants ) (933,083 migrants) 52% of all migrants were international 12% 40% 33% Total 67% of all migrants Other Black Hispanic White Sources: Percentages of domestic and international migrants by race and ethnicity derived from the American Community Survey. Total numbers of domestic and international migrants between are from Table 4. Cumulative Estimates of the Components of Resident Population Change for the United States, Regions, States, and Puerto Rico: April 1, 2000 to July 1, 2009, U.S. Census Bureau 12

13 States with Largest Estimated Unauthorized Immigrant Populations, 2010 State Estimate (thousands) Range California 2,550 (2,350-2,750) Texas 1,650 (1,450-1,850) Florida 825 ( ) New York 625 ( ) New Jersey 550 ( ) Illinois 525 ( ) Georgia 425 ( ) Arizona 400 ( ) 6.5% of Texas 2010 Population Source: Pew Hispanic Center estimates based on residual methodology applied to March Supplements to the Current Population Survey (February 1, 2011). 13

14 Estimated domestic migration ( ) by county as a percentage of 2000 population Legend -20 to -45% -19 to -10% -9 to -5% -4 to 0% 1 to 5 % 6 to 20% 21 to 30% 31 to 65% Source: Population Division, U.S. Census Bureau, March 19, Map produced by the Texas State Data Center 14

15 Estimated international migration ( ) by county as a percentage of 2000 population Legend 0-1% 1-2.5% % 3.5-5% 5-10% Source: Population Division, U.S. Census Bureau, March 19, Map produced by the Texas State Data Center 15

16 Texas Racial and Ethnic Composition, 2000 and Hispanic or Latino 32% NH White 53% Hispanic or Latino 38% NH White 45% NH Other 4% NH Black 11% NH Other 6% NH Black 11% Source: U.S. Census Bureau and 2010 Census count

17 Population Under 1 year 4 years 8 years 12 years 16 years 20 years 24 years 28 years 32 years 36 years 40 years 44 years 48 years 52 years 56 years 60 years 64 years 68 years 72 years 76 years 80 years 84 years 88 years 92 years 96 years 100 to 104 Texas White (non-hispanic) and Hispanic Populations by Age, White (non-hispanic) Hispanic Source: U.S. Census Bureau 2010 Decennial Census, SF1 Age 17

18 Texas Population Pyramid by Race/Ethnicity, 2010 Male White, Non-Hispanic Male Hispanic Male Black, Non-Hispanic Male Asian, Non-Hispanic Male Other, Non Hispanic Female White, Non-Hispanic Female Hispanic Female Black, Non-Hispanic Female Asian, Non-Hispanic Female Other, Non Hispanic 100 to 104 years 95 years 90 years 85 years 80 years 75 years 70 years 65 years 60 years 55 years 50 years 45 years 40 years 35 years 30 years 25 years 20 years 15 years 10 years 5 years Under 1 year Source: U.S. Census Bureau 2010 Decennial Census, SF1 200, , ,000 50, , , , ,000 18

19

20 Legend co48_d00 'PROJECTIONS X$'.totpop ,000 10,001-50,000 50, , , , ,001-1,000,000 1,000,001-4,100,000 Total Population by County, 2010 Source: U.S. Census Bureau 2010 Census Counts 20

21 Change of the Total Population by County, 2000 to 2010 Legend co48_d00 'PROJECTIONS X$'.totpopch0010-3, ,000 10,001-50,000 50, , , , counties lost population over the decade Source: U.S. Census Bureau 2000 and 2010 Census Counts 21

22 Percent Change of Total Population in Texas Counties, Water 'PROJECTIONS X$'.pctch %-0% 1%-10% % 25.1%-50% 50.1%-82% Physicians per 1,000 Population 2010 'PROJECTIONS X$'.difphys -3 to to to.5 Population increase for Texas was 20.6% during this period Source: U.S. Census Bureau and 2010 Census Counts 22

23 Median Household Income by County, $18,000-30,000 $ 30,000-35,000 $ 35,000-40,000 $40,000-50,000 $ 50,000-76,000 Source: U.S. Census Bureau, American Community Survey, 5-Year Sample

24 Percent of People Below Poverty in the Past 12 Months (for whom poverty status is determined) by Metro and Non-Metro Area and County, Metropolitan Areas less than 10% 10% to 15% 15.1% to 20% greater than 20% Non-Metropolitan Areas less than 10% 10% to 15% 15.1% to 20% greater than 20% Source: U.S. Census Bureau. American Community Survey, 5-Year Sample Map produced by the Texas State Data Center.

25 Percent of People Lacking Health Insurance Coverage by Metro and Non-Metro Area, 2009 The Census Bureau estimates that in 2009 Texas had the highest uninsured rate in the country, at 26.1%, or 6.4 million people. Metropolitan Areas less than 20% Metropolitan Areas 20.0% to 22.9% less than 20% 23.0% to 25.9% 20.0% to 22.9% over 26% 23.0% to 25.9% PUMAs over 26% Non-Metropolitan Areas PUMAs less than 20% Non-Metropolitan Areas 20.0% to 22.9% less than 20% 23.0% to 25.9% 20.0% to 22.9% over 26% 23.0% to 25.9% over 26% Texas also had the highest uninsured rate of children, with 17.4%, or 1.28 million children lacking insurance. Source: U.S. Census Bureau American Community Survey. Map produced by the Texas State Data Center. 25

26 Physicians per 1,000 Population Aged 65 Years and Older by County, 2008 Physcians per 1,000 persons aged 65+ 'Age 65p County$'.Physper1k65p 0 GT 0 - LE 5 GT 5 - LE 10 GT 10 - LE 20 GT 20 Source: U.S. Census Bureau Population Estimates. Texas Medical Board. Map produced by the Texas State Data Center. 26

27 Physicians per 1,000 Population, 2010 Physician Rate Physician Rate Change, Physicians per 1,000 Population 2000Physicians per 1,000 Population 2010 'PROJECTIONS X$'.phys001 'PROJECTIONS X$'.difphys 0-3 to to to Source: U.S. Census Bureau and 2010 Census Counts. Texas Medical Board. Maps produced by the Texas State Data Center. 27

28 Physicians per 100,000 by Metro & Border Status of Counties, Not Border Border Not Border Border 159 Non-Metro Non-Metro Metropolitan Metropolitan Total 2009 Sources: U.S. Census Bureau Estimates. Department of State Health Services. Health Professions Resource Center Database. 28

29 Projected Racial and Ethnic Percent, Texas, % 60% 50% 40% 30% 20% 10% Anglo Black Hispanic Other 0% Source: Texas State Data Center 2008 Population Projections, Migration Scenario 29

30 Projected population by county, Texas, Population P_ Texas State Data Center, vintage 2008 population projections. Migration scenario 2 ( ).

31 Projection of Ethnicity of Texas Population Aged 65 Years and Older, 2000 to Anglo Hispanic African American Other Source: Texas State Data Center Population Projections, Migration Scenario. 31

32 Projected Increase in Obesity in Texas by Ethnicity, 2006 to 2040 Source: Office of the State Demographer projections, using migration scenario population projections 32

33 Projected Number of Adults with Diabetes by Race and Ethnicity, Texas, ,000,000 6,000,000 4,000,000 2,000,000 Total Latino Anglo African American Other 0 Source: Office of the State Demographer,

34 Projected Percent of the Adult Population with Diabetes by County, 2010 and 2040 LE 15% 15-20% 20-25% 25-30% %

35

36

37

38 The Hurdles

39 The Hurdles Self Sum of our experiences, values Work place Limitations of time, space, exposure, attitude Society Rules, policies, inequality/inequity Shifting cultural pendulum

40 What can we do to fix things? Let them tell their stories Engage them at their level Reception, Direction, Connection Give them the tools they deserve. Know where to find resources where you live Apps for you AND for them to translate/search

41 Resources Cultural Competency for the Health Professional Cultural Diversity in Health and Illness Working with Latino Families South Texas Environmental Education and Research (STEER) Community facilities (Church, shelter..) Medical Spanish Workshop at each TAPA conference

42 Summary Introduction Definitions 2010 Census Data The hurdles What can we do to fix things? Resources

43 Diversity in South Texas James E. Bonson, MPAS, PA-C Assistant Professor/Clinical Coordinator School of Health Professions Department of Physician Assistant Studies UT Health Science Center - San Antonio

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