Minority health

Hispanic seniors less likely to receive necessary immunizations

Although elderly individuals have a high risk of complications from flu or pneumonia, a study recently reported in the journal Archives of Internal Medicine indicates that significant racial and ethic disparities exist for immunizations.  Hispanic seniors are less likely to be immunized than non-Hispanic White seniors, with an especially striking difference for pneumococcal immunizations.  The authors suggest several factors for these disparities:

  • language preference is an important factor for immunization, with considerably larger disparities for Spanish-preferring than English-preferring Hispanic seniors
  • geographic factors that determine whether Spanish-preferring seniors live in large Hispanic communities or in linguistically-isolated “new communities”
  • type of available Medicare or managed care plan with respect to uniform preventive care

In terms of increasing immunization among Hispanic seniors, the article states that the findings “have important implications for increasing immunization among Hispanic seniors, suggesting that further efforts are needed to improve cultural and linguistic access to care. In particular, geographic targeting of the subgroups at greatest risk, in combination with surname lists and health literacy mapping, may help optimize outreach and targeting of vaccine resources.”

Haviland AM, Elliott MN, Hambarsoomian K, Lurie N.  Immunization disparities by Hispanic ethnicity and language preference.  Arch Intern Med. 2011, Jan. 24; 171(2): 158-65.

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Hispanic Teen Parents and Intimate Partner Violence

Dr. Janna Lesser and others at UTHSC San Antonio recently published a study of teen parents’ experience managing intimate partner violence:

“At a young age they develop strategies to manage violence, but new challenges with violence manifest themselves as they enter into intimate partner relationships. For some of these youth, parenthood is perceived as a transforming experience that offers an opportunity for a positive change in their life trajectory.”

(Issues Ment Health Nurs. 2010 Feb;31(2):96-102)

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How Will Health Care Reform Affect the Use of Curanderismo?

Will easier access to health care affect the use of complementary and alternative medicine in the Valley?  With changing health care reform, only time will tell whether it will have an effect on the use of folk healers among the Valley population.  While some may use Curanderismo because they can’t afford conventional treatment, others choose this method of treatment because they don’t trust conventional doctors, or because of tradition.  Still many, according to Albert Salinas, a curandero in Edinburg, see clients who use Curanderismo in conjunction with conventional treatments.  Complementary use of the traditional healing arts may be the best way to take advantage of modern medicine while not abandoning one’s beliefs.   According to Antonio Zavaleta, director of the Texas Center for Border and Translational Studies at the University of Texas-Brownsville, “We don’t want to discourage people from visiting curanderos.  We only want them to stop if we see they are being harmed”.

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Immigrants less likely to report family history of cancer

A new study indicates that immigrants are less likely to report family histories of cancer, and therefore might be missed by screening and prevention efforts that could otherwise benefit them. The study will appear in the 15 January issue of Cancer but is now online (see citation below). It is based on analysis of data from over 5000 respondents to the 2005 Health Information Trends Survey (HINTS). The analysis found that foreign-born respondents were two-thirds less likely to report a family history of cancer than US-born respondents — and that rate was consistent among immigrants regardless of the amount of time they had lived in the US or their degree of acculturation. Possible contributing factors discussed included:

  • Lower incidence of cancer in countries of origin: “Lower incidence rates of cancer outside of the United States are thought to be attributable to younger age structures in these countries, behavioral and environmental exposures, and a pattern of underdiagnosing and under-reporting cancers in under-resourced countries.”
  • Immigrants may have fewer opportunities to learn about family histories of cancer; distance from relatives, and some cultural beliefs (i.e. stigma) may inhibit exchange of information about cancer history.
  • Immigrants may be less likely to have experienced medical care that emphasized knowing and reporting family history of illnesses — not just cancer, but other family history as well.

Here’s a summary of the study from HealthDay/MedlinePlus — and here’s the same summary in Spanish. The full citation is as follows:

Orom H, Coté ML, González H, Underwood W, Schwartz AG. Family History of Cancer: Is it an Accurate Indicator of Cancer Risk in the Immigrant Population? Cancer [forthcoming 2008-01-15]. doi:10.1002/cncr.23173. http://dx.doi.org/10.1002/cncr.23173

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Importance of Promotores de Salud in Fight Against Diabetes

The use of community health workers (promotores de salud) to better reach the Hispanic population in the fight against diabetes is being investigated in a study being conducted in San Antonio.  These  health educators can be found in a wide variety of locations such as community-based organizations, clinics, churches and schools.  Therefore,  it is easier for those in the most need to bypass some of the barriers (language, economics, and access to health care) that might keep them from obtaining the assistance they need in a more “conventional” health setting.

A partnership between Humana and the National Council of La Raza is behind the research.  According to Dr. George Smith, president of Humana Senior Products in Texas, “There is evidence that community health workers can effectively engage, educate, and activate individuals with chronic diseases in ways that the formal health system cannot.”

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Increase in Hypertension Seen in Older Mexican-Americans

Researchers at the University of Texas Medical Branch at Galveston recently conducted a study which showed an increase in the prevalence of hypertension in older Mexican-Americans living in the Southwest  region (Texas, New Mexico, Arizona, California, Colorado) of the United States.  It is believed the increase is due, in part, to the increase of diabetes and obesity in the population.  While awareness of hypertension was greater at the end of the study, the likelihood of study participants being hypertensive was also greater.  According to Kyriakos S. Markides, co-author and principal investigator of the study, “More effort should be targeted to reverse trends of both obesity and diabetes as potential causes of hypertension.”

The results of the study, which included almost 4,000 participants and was conducted between 1993 and 2005 , can be seen in the January issue of Annals of Epidemiology.

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Increasing Enrollment in Clinical Trials

Monday’s issue of the San Antonio Business Journal reports on a National Cancer Institute-sponsored program at UT HSC’s Regional Academic Health Center (RAHC) to increase the number of Hispanic children enrolling in clinical trials for leukemia. Dr. Amelie G. Ramirez is the principal investigator for this study, which will place a promotora at the RAHC with the goal of increasing awareness of clinical trials among families as well as clinicians. The promotora will also work to address barriers that may prevent participation in clinical trials.

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International Study of Breast Cancer in Latinas to be Launched This Year

The largest study ever conducted of breast cancer in Latin American women is being spearheaded by the National Cancer Institute (NCI) Office of Latin American Cancer Program Development, in partnership with the Susan G. Komen for the Cure cancer organization.  The international study will be conducted in Argentina, Brazil, Chile, Mexico and Uruguay, while supporting the development of programs for cancer research, clinical trials, training programs, and technology and capacity building within the participating countries.  Research information will be  linked between the study countries and the United States.  According to Nancy G. Brinker, founder and CEO of Komen for the Cure, “This landmark collaboration between Komen, NCI, and five Latin American countries will help us get to answers about genetics, environment and social issues that contribute to breast cancer deaths in Latinas.”

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January is National Birth Defects Prevention Month

According to the March of Dimes website, Hispanics are the largest and fastest growing ethnic group in the United States. Hispanic woman of childbearing age (15-44 years) give birth to nearly one-quarter of the babies born in the United States each year. The March of Dimes also reports that nearly one out of every eight Hispanic babies is born too soon. While the preterm birth rate for Hispanics is similar to rate for the general population, it has grown more than 8 percent in the last decade.

Prematurity is the leading killer of newborns in America and babies who survive often face the risk of lifelong disabilities such as cerebral palsy and mental retardation, chronic lung disease, and vision and hearing loss, as well as other developmental problems.

The March of Dimes works to improve the health of babies by preventing birth defects, premature birth and infant mortality. For more quick reference information and fact sheets go to March of Dimes site for professionals.

The March of Dimes website is also available in Spanish: http://nacersano.org/.

Promotional materials (in English & Spanish) for 2008 Birth Defects Prevention Month may be found at the National Birth Defects Prevention Network (NBDPN) website.

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June 3 Workshop in El Paso: Turning Scientific Knowledge into an Effective Action Plan for Human Security

The US-Mexico Border Virtual Health Library is organizing a workshop in El Paso on June 3. From the workshop announcement: “Using a hands-on approach, this workshop will train participants on how to use the online tools available through the U.S.-Mexico Border Virtual Health Library (Border VHL), as well as from the National Library of Medicine (NLM) Online Databases, effectively. Furthermore, the workshop will highlight other Web resources tailored to the public health workforce.”

The workshop will be offered as part of the US-Mexico Border Health Association’s annual meeting. Space is limited and pre-registration for the meeting is required. The workshop will be led by the National Network of Libraries of Medicine – South Central Region and the Pan American Health Organization/WHO US-Mexico Border Office.


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