Senator Eliot Shapleigh - El Paso, Texas

"Medical Center of the Americas" ~ The Capitol of Hispanic Healthcare

MD Anderson and Sloan-Kettering are famous for cancer research and treatment. The Houston-based Texas Heart Institute has made a name for itself in cardiac care. These institutions have harnessed the expertise to become world class institutions, attracting top researchers and providing unparalleled care. What will be the medical niche of El Paso’s health professionals?

Let’s imagine that, one day, a Medical Center of the Americas opens its door to 100 medical school students who will soon be known as the hemisphere’s best doctors in Hispanic heath. Students will move back and forth between the Paso Del Norte International Children’s Hospital and the state-of-the art pediatrics unit at Thomason General Hospital, the largest public hospital on the U.S.-Mexico Border. Residents learn innovations in trauma care at William Beaumont Army Medical Center. Just across the quadrangle, students attend the UTEP allied health programs in nursing, physical and occupational therapy, and speech-language pathology. UTEP’s master’s degree candidates in Public Health work with interns from the Silva Magnet School to conduct research in environmental and behavioral health. Next door, El Paso Community College students attend bi-national courses in nursing and medical information technology. Regional law enforcement, including the local police department, county sheriff, FBI, and Border Patrol have opened the best forensic lab in Texas. Community leaders are planning to invest in a four year dental school.

With vision, leadership, and resources, El Paso will be the Capitol of Hispanic Health. Our city has the opportunity to lead the nation as the first medical center to focus on education, research, and care focused on the opportunities and challenges unique to Hispanics in the United States.

El Paso is the logical place to realize this vision. As the second largest American city on the U.S.-Mexico border, more than 80 percent of El Paso residents are Hispanic, compared with 32 percent statewide and 12.5 percent nationally. Together, El Paso and its Mexican neighbor, Ciudad Juarez comprise the world’s largest bi-national metroplex, with more than 2.4 million residents. El Paso also has a formidable medical presence. The city is home to the largest public hospital on the U.S.-Mexico border, five private hospitals, a world-class Army medical facility, and an expanding academic medical center. To reach our full potential, we must focus our resources and expertise into a "Medical Center of the Americas."

El Paso's Existing Medical Center

El Paso is already a healthcare hub for much of the Southwest and Mexico. The city is home to R.E. Thomason General Hospital, a 327-bed public hospital that is the largest public hospital on the border. The William Beaumont Army Medical City, near Fort Bliss has 479 beds. Five private hospitals are based in El Paso, with a combined 1,568 beds.

Also based in El Paso is the Texas Tech University Health Sciences Center, which employs more than 1,000 faculty and staff. It is an active research center, a busy metropolitan care facility, and a hub for border healthcare. In 2003, Texas Tech El Paso had 22,000 admissions, 62,000 emergency room visits, and a total of 233,000 clinic visits in 11 specialty areas.

The El Paso City-County Health Department runs innovative programming and the Maxine T. Silva Magnet High School of Health Care Professions trains the next generation of health leaders.

In 2003, El Paso’s medical institutions had operating budgets totaling $340 million and employed 2,829 health professionals and support staff.

In the past several years, El Paso’s health care community has been expanding. Thomason Hospital completed an expansion of its facility that included $20.5 million in capital expenditures and $7 million in new equipment. Texas Tech completed a $14-million remodeling of its El Paso facilities and will complete a new $38.5 million research facility next year. The El Paso City-County Health Department invested $1 million to consolidate several of its programs in a medical campus. Private investment has spurred development of nearby support services, such as physician offices, lab space, restaurants, and shopping.

Let's build on this growth. El Paso’s medical center still lacks a four-year medical school, which state lawmakers and local officials have worked toward since 1996. We feel confident that by year end we will secure the $45 million necessary to fund medical school faculty for the first and second year student. Right now, Texas plans to open doors in August 2008 to 80 first year students. Our goal is to keep that date with destiny!

Hispanic Healthcare Challenges

Hispanics living in the United States face a distinct set of healthcare opportunities. Diabetes is nearly twice as common among Hispanics as among non-Hispanic Whites. Overall, more than 10 percent of Mexican-Americans 20 years or older have diabetes. In addition, within the Hispanic American/Latino population, diabetes is more prevalent in women than it is in men. Obesity also is more common among Hispanics than in the general population.

Hispanic women's health problems also need more research and education. Among breast cancer patients, Hispanic women tend to have larger tumors than non-Hispanic Whites. They also have 1.7 times the cervical cancer rate of non-Hispanic White women. In addition, Hispanic women are twice as likely not to seek early prenatal care.

Hispanics also disproportionately endure the harms of environmental contaminants. The lack of safe drinking water, for example, is a source of disease that has hit Hispanics particularly hard. Bacteria and parasites in drinking water affect more than 7 million people each year nationwide. Research in New York and Los Angeles has shown that Hispanics suffer higher rates of some water-borne diseases than other ethnic groups.

Lead poisoning also poses a disproportionate threat to Hispanics. Twice as many Hispanic children as non-Hispanic White children have elevated blood lead levels high enough to be considered a risk of lead poisoning by the Centers for Disease Control and Prevention (CDC). Lead poisoning can stunt brain development in children, leading to IQ deficits and cognitive problems.

Language barriers, low rates of health insurance coverage, and limited knowledge of healthcare services also contribute to health disparities among Hispanic populations. For example, Hispanics nationwide are five times less likely to have health insurance than other races. In 2002, 43 percent of Hispanics in Texas were uninsured. Overall, 35 percent of El Pasoans lack health insurance, making it the most uninsured large city in the country. Recent budget cuts to Medicaid and CHIP have made these already under-utilized safety nets even less available to El Paso's needy.

Research is needed to uncover the roots of these demographic disparities. Medical education must focus on disparities in care and teach the next generation of doctors the skills and cultural competencies they need to treat across cultures. Basing this work in the border region with a large Hispanic population is a natural choice.

The Next Step: Build El Paso's Medical School

Doctors are not evenly distributed in Texas, with Hispanic-dominated west Texas (including El Paso) facing the greatest shortage in health professionals. For example, Far West Texas had only 92 physicians per 100,000 people in 2001, and the Rio Grande Valley had only 118 per 100,000. The shortage of health professionals extends to many other disciplines. While Texas has 37 dentists per 100,000 population, El Paso only has 15 per 100,000 population. The Border is also considered a medically underserved area because of the lack of pharmacists, nurses, and physician's assistant.

While the Texas population is growing, medical school graduation rates have not kept up with this increase. Without a medical school in the border region, it has been difficult to attract doctors to this underserved area.

A four-year, fully funded medical school is critical to making the Medical Center of the Americas a reality. As the only large medical center in the region, El Paso already serves the medical needs of the large Hispanic communities in West Texas, New Mexico, and northern Mexico. A more dedicated focus on Hispanic health challenges would have an immediate benefit for Hispanic individuals.

Caregivers in El Paso are the most in touch with Hispanic populations and their needs. The city's location allows caregivers and researchers to stay in touch with Hispanic populations and their unique needs. With staff members proficient in Hispanic cultural competency and sensitivity, El Paso's medical facilities would be a natural base for this research.

A full-fledged, four-year medical school would bring thousands of medical professionals, researchers, and students to El Paso. In addition, medical facilities could draw additional focused federal grants to support new projects, centers, and research efforts. A new medical school and research center would provide the incentive for biomedical and biotechnology companies to invest in the El Paso medical community.

The Paso del Norte region is the obvious location for a medical center than can coordinate health care, education, and research focused on Hispanic healthcare. In 1998, our office drafted and passed the Border Health Institute statute to better coordinate and fund healthcare delivery and research in fields of study affecting the border region, such as Hispanic health, diabetes, infectious diseases, environmental health, and children's health.

Our initiative faces competition. In Phoenix, for example, city leaders worked with university officials to plan a biomedical research center and medical school that will put 15,000 students in downtown Phoenix. The new center, a partnership between Arizona State University and the University of Arizona, will be based in a $150-million facility on a 13 acre-tract donated by the city. Clearly UTEP must cooperate in relocating programs to the Medical Center of the Americas per longstanding agreements. As other cities catch up, we need to act quickly to harness our city's natural advantages to build an expanded medical center in El Paso, and insist on cooperation between public agencies that must serve public goals.

Conclusion

The health challenges facing the Border region offer a preview of the future health care challenges facing the entire state. As an integrated international community, the El Paso region provides a unique environment to base health research and education focused on our multi-cultural and multi-national population. By building a Medical Center of the Americas anchored by a full-fledged medical school, world-class research, and expert care, we will attract the best minds in medicine to collaborate on the future of healthcare for the border region and for the entire state. El Paso has the opportunity to move to the forefront of this effort, and to become the Capitol of Hispanic Health.