Hispanic health

Diabetes Research Funded

The Hispanic population of South Texas has been fighting a battle against two strong opponents…diabetes and obesity. But thanks to a $5 million grant from the National Institutes of Health’s National Center on Minority Health and Health Disparities, the fight to combat these two growing health problems will be fought even harder.

Researchers from the University of Texas School of Public Health’s Brownsville regional campus plan to establish the Center of Excellence on Diabetes in Americans of Mexican Descent. The aim of this center will be to develop prevention programs for diabetes and obesity in Mexican Americans. The additional funding will help to expand a region-wide media campaign on preventing obesity and improving health.

Figures from Cameron County prove the need for just such a program.

  • 52% of county residents are obese
  • 32 % of county residents are overweight
  • 1 in 5 county residents has diabetes
  • 23% of county residents have pre-diabetes

The goal of the researchers’ work is to find programs that will work in changing behavior and making Valley residents healthier.

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Disparities in Adult Awareness of Heart Attack Warning Signs

The CDC’s Morbidity and Mortality Weekly Report for 2008-02-22 focused on a public health information issue potentially affecting hundreds of thousands of patients in the US each year. A new analysis of 2005 Behavioral Risk Factor Surveillance System (BRFSS) looked at data from 13 states and the District of Columbia, where the BRFSS included questions on the signs & symptoms of heart attack. The analysis found that overall, less than a third of all respondents were able to correctly identify the five warning signs of a heart attack, when given a list of closed-end (yes/no/don’t-know) questions. Those warning signs include:

  • Pain and discomfort in the jaw, neck or back
  • Feeling weak, lightheaded or faint
  • Chest pain or discomfort
  • Pain or discomfort in the arms or shoulder
  • Shortness of breath

Even fewer respondents indicated that they would immediately call 9-1-1 if they suspected someone was having a heart attack. And although Texas was not one of the states studied, the analysis found notable disparities in awareness of heart-attack warning signs between Hispanic adults and non-Hispanic adults: only 14.3% of Hispanic adults knew the five warning signs and indicated they would call 9-1-1 in case of heart attack, compared with 16.2% among non-Hispanic blacks and 30.2% among non-Hispanic whites. Men also lagged significantly behind women overall (22.5% vs 30.8%) in awareness of the signs and correct steps to take.

Additional information on this study:

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Dissatisfaction of Breast Cancer Decision-Making Among Latinas

The results of a study recently published in the journal Patient Education and Counseling shows dissatisfaction among Latinas, compared to other racial groups, in the decision-making process to have a mastectomy or lumpectomy. 

The study consisted of a survey of over 2,000 women (Spanish-speaking Latinas, English-speaking Latinas, African Americans, and Caucasians) who had been diagnosed with early-stage breast cancer.  The decision-making process itself was very similar in the percentages of women who, 1) let the surgeon play a mjaor role in treatment decision, 2) shared the process with the surgeon, or 3) based the surgery decision primarily on their own wishes.  However, the results also showed a greater dissatisfaction with the decision-making process among the Spanish-speaking Latinas,  and a greater feeling of regret about their decision.

Although reasons for the differences were not part of the study, one possible reason for the dissatisfaction may have been tied to one or more cultural issues, such as the need to have the family more involved in the decision-making process.  According to Dr. Sarah T. Hawley of the University of Michigan in Ann Arbor and her colleagues, “These results…suggest that additional effort may be needed by clinicians to ensure that information is understandable and culturally appropriate and improve the decision making for all breast cancer patients.”

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Effect of Acculturation on Drinking Along the Border

Acculturation to American society has often come with a price for immigrants, and that is the use of alcohol and the accompanying problems. This fact has been proven through research conducted primarily in metropolitan areas. But for the first time, research has focused on the use of alcohol on the Texas/Mexico border. Using information gathered during 2002-2003, among an almost even split of men and women, conclusions have been drawn on the effect of alcohol on the genders.

According to Raul Caetano, professor of epidemiology and regional dean (Dallas) at the University of Texas School of Public Health:

“There is a clear differential effect of acculturation by gender. While this was shown in previous research, the effects on the border seem to be more accentuated. Men drank less as they acculturated, and had a lower prevalence of alcohol-use disorders. Women drank more with acculturation, but this did not seem to lead to a higher rate of alcohol use disorders.”

The full report has been published in the February issue of Alcholism: Clinical & Experimental Research

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El Paso to take part in diabetes study

With the rising number of diabetes cases along the Texas/Mexico border, it is important to know how to manage the disease in order to live a full, productive life. But, it is also important to do all that can be done to determine who might be at the greatest risk for developing diabetes. This is especially important in families where a family member has already been diagnosed.

It is with this goal in mind that El Paso has been chosen to take part in a seven-year study on diabetes funded by the National Institutes of Health. The study, which will involve approximately 840 El Paso residents, is aimed at detecting which relatives of people who already have Type 1 diabetes might develop the disease. El Paso was chosen due to the high number of people (approximately 85,000 ) with Type 1 and Type 2 diabetes.

The study will be conducted through the El Paso Diabetes Association , and will be done in conjunction with 18 clinical centers throughout the United States and other countries.

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En Tu Biblioteca

The American Library Association is partnering with Univision Radio on a campaign to increase public library use among Hispanics. From the press release:

“The new en tu biblioteca (“at your library”) campaign, which is part of ALA’s Campaign for America’s Libraries, communicates how libraries create opportunities for Latino adults and their children. The campaign positions the librarian as a trusted source who can help library users obtain to accurate information about health, entrepreneurship and small business management, education, finances and more.”

[Thanks to Siobhan Champ-Blackwell's BHIC blog.]

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Ensuring Cultural Competence Across Care Settings

The Briscoe Library is hosting a webcast by AHRQ Health Care in the Howe Conference room on Thursday, March 18, at 3:00:

“How can health care settings meet the pressing needs of diverse populations? Join our innovators as they discuss how cultural competency can be the foundation for effective innovations on childhood obesity, health care access, and other health care services. Learn about new approaches to culturally competent services, training, and staffing and how you can use them.

“The following innovation profiles will be featured:

“Group-Based, Culturally Sensitive Weight-Loss Program for Families Leads to Improvements in Children’s Health-Related Behaviors and Declines in Body Mass Index

“Bilingual, Culturally Competent Community Health Workers Increase Insurance Enrollment, Access to Care, and Self-Efficacy Among Low-Income Latinos.”

Join us!

(Thanks to Siobhan Champ-Blackwell’s Bringing Health Information to the Community)

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EpiLink on Stress Among Latino Adolescents

The Texas Department of Health published the semimonthly Disease Prevention News for many years, but publication stopped abruptly back in 2003 in the middle of Volume 63. Under the auspices of the new Texas Department of State Health Services’ Infectious Disease Control Unit (ICDU), publication resumed with Volume 64 Issue 1 in January 2007 and continuing on a roughly monthly publication schedule with a new name: EpiLink Online Bulletin.

An article from the November issue of EpiLink has received some attention in the Spanish-language press after coverage by the Mexican news agency Notimex. The paper in question, “Current perspectives on stress among Latino adolescents” [PDF full text] was prepared by Richard C Cervantes and colleagues for the Annual Conference of the National Hispanic Network on Drug Abuse which took place in September. The paper is a review of research into the stressful living conditions that disproportionately affect Latino youth — including poverty, lack of health insurance, high school drop-out rates, increasing health problems (e.g., obesity), high teenage pregnancy rates, sexually transmitted diseases, increasing rates of HIV infections, substance abuse, and violence — and the present and future effects of that increasing stress on the health of an entire generation of Latinos.

According to the United States Department of Health and Human Services (DHHS) (Freid et al., 2003), … the highest rates of suicide consideration (26.5%) were for female Latinas. Latino and Latina youth from 9th to 12th grade overall had higher rates of attempted suicide than any other group; the male students were at 8.0% while, again, the female Latina rates (15.9%) were much higher. In an older survey, injurious suicide attempt rates were higher for Latina females 4.2%, followed by Latino males (2.5%), and then African Americans (DHHS, 1990). A study conducted by Rew et al. (2001) revealed that Latina adolescents had the highest rate of suicide attempts compared to other ethnic-gender groups. In addition, Latinas in the study also had relatively high reports of sexual abuse and suicide attempts by family members and friends. Latinas also have alarmingly higher rates of depression (27%). Latinas were the second highest ethnic group to report depressive symptoms. Acculturation stress due to conflictive gender roles in adolescent Latinas is believed to be the driving force of their higher rates of stress, depression and suicidality (National Coalition of Hispanic Health and Human Services Organization, 1999).

Although the reference list for the review article is impressive and very helpful, it also lays out a compelling case for a more comprehensive research agenda for studying issues such as intergenerational differences in acculturation and their effect on intrafamilial stress, differences between the mental and physical health of “acculturated” vs. “bicultural” Latino adolescents, and the relationship of gender differences in Latino adolescents to stressors, coping skills, resiliency, and mental and physical health.

Here’s an example of the Notimex coverage in Spanish: “Adolescentes hispanos afectados por el estrés” from MetroLatinoUSA, 2007-11-21; and here’s a blog post that reprints English-language coverage of the report from the 2007-11-09 issue of the Rio Grande Guardian (unfortunately, the original article does not appear on the Guardian‘s site now).

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Eye on Latinos

According to recent findings from the Survey of Public Knowledge, Attitudes, and Practices Related to Eye Health and Disease, most Americans do not know the risks and warning signs of eye ailments. This survey was sponsored by the National Eye Institute and the Lions Club International Foundation. It is interesting to note that Hispanic respondents:

  • reported the lowest access to eye health information,
  • knew the least about eye health, and
  • were the least likely to have their eyes examined among all racial/ethnic groups participating in the survey.

    Forty-one percent of Hispanics reported that they had not seen or heard anything about eye health or disease in the last year, compared with 28 percent of Asians, 26 percent of African-Americans, and 16 percent of Caucasians.

    This report supports the findings of the Los Angeles Latino Eye Study which was the largest, most comprehensive study of Latinos and visual impairment ever conducted in the United States. The study reported that Latinos had a high rate of visual impairment and most were not aware of their condition. Many things may contribute to under-diagnosis, including access to health care, availability of health services and demographic issues, factors that warrant further study. The study was funded by the National Eye Institute and the National Center for Minority Health and Health Disparities, part of the National Institute of Health, with additional support from Research to Prevent Blindness. Published results may be found in article: Causes of Low Vision and Blindness in Adult Latinos: The Los Angeles Latino Eye Study. Ophthalmology, Volume 113, Issue 9, September 2006, Pages 1574-1582.

    For more information on eye diseases and disorders, vision eye care resources, and información en español visit the National Eye Institute’s website. The National Eye Institute also offers a quick quiz (English & Spanish) to test your eye health.

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    Fatty Liver Disease in Children a Growing Trend

    A new obesity risk is now being addressed among children.  A condition known as fatty liver disease may be leading overweight children towards a future that could involve a liver transplant.  It is thought by experts that between 2 and 5 percent of American children older than 5, many obese or overweight, have the condition known as nonalcoholic fatty liver disease.  Fatty liver is a condition in which the liver can become inflamed and then scarred as fat buids up, possibly leading to cirrhosis.  If the point of cirrhosis has not been reached, the condition can be reversed through weight loss.  If cirrhosis develops, liver failure or liver cancer can follow. 

    “There are people in their 30s or early 40s that will require a liver transplant” from developing the condition as a kid, predicts Dr. Jose Derdoy, head of liver transplants at Cardinal Glennon Children’s Medical Center in St. Louis.  Unfortunately, early symptoms of the disease, such as fatigue and loss of appetite are not always noticed and the condition may worsen without anyone’s knowledge.  “The majority of children with this still go undiagnosed.” said Dr. Jeffrey Schwimmer, head of the Fatty Liver Clinic at Rady Children’s Hospital in San Diego.  “Some kids have died.”  The disease is most common in overweight children with belly fat and is associated with other risk factors such as elevated cholesterol, diabetes and heart problems.

    With genetics, diet and exercise all playing a role, this condition is most prevalent among Hispanics and more common in boys than girls.

    The American Academy of Pediatrics has recommended doctors do a blood test of liver enzymes every two years on obese children and overweight children with high blood pressure or cholesterol or family history of heart disease.

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