A new study coordinated by the Pan American Health Organization (PAHO) is the first to treat the US-Mexico border region as a single epidemiological unit. Examining the prevalence of diabetes, it found that rates of the disease as well as its risk factors are increasing. Diabetes is now Mexico’s leading cause of death. Among adults with type 2 diabetes living in the US-Mexico border region, approximately 22 percent were unaware that they had the disease.
Diabetes in US-Mexico Border Region
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:
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
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).
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:
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.
February 23: Release of 2010 Bexar County Health Assessment
On Wednesday, February 23, the Health Collaborative is hosting an event at TriPoint YMCA (3233 North St. Mary’s Street) to mark the release of the 2010 Bexar County Health Assessment. A presentation of key findings will be given from 8:00 to 9:30am.
From the announcement about the event: “The Health Collaborative quadrennial Health Assessment provides a comprehensive quantitative and qualitative community health report. The data is used to help organizations coordinate preventive care and community programs and shape policy decisions that contribute to a healthy, vibrant community.”
Feeling the Chill
A new report from the Pew Hispanic Center 2007 National Survey of Latinos: As Illegal Immigration Issue Heats Up, Hispanics Feel a Chill describes the effects of this year’s heightened attention to immigration on Hispanics around the country. Whether immigrants or native, legal or illegal, nearly two-thirds of Hispanic adults say that life has been made more difficult for all Hispanics because of Congress’s failure to pass a reform bill, and more than half worry that they or someone close to them could be deported.
Fitness can help a man’s heart
A study recently published in the Journal of the American College of Cardiology showed that men who are “highly fit” have less risk of dying from cardiovascular disease compared to men who have a “low level of fitness”. Researchers use this example. A 55-year old man who is considered to have a “low level of fitness” would require approximately 15 minutes to walk a mile. His fitness level would put him at a nearly 30 percent risk of dying from a cardiovascular disease. On the contrary, a “moderately fit” 55 year old man could walk a mile in 10 minutes. This man’s risk of dying from a cardiovascular disease would be 10 percent.
The purpose of the study, conducted at The Cooper Institute and the University of Texas Southwestern Medical Center in Dallas Texas, was to determine the relationship between fitness levels measured at ages 45, 55, and 65 and the lifetime risk of cardiovascular disease and death caused by cardiovascular disease. 11,049 men, ranging from 40 to 69 years of age, were included in the study. Their initial examination occurred before 1990 and they were subsequently followed up until death or until the age of 90. Participants had traditional risk factor measurement.
Lifestyle trends, such as poor diet and lack of exercise, can promote weight gain. In turn, weight gain can lead to diabetes mellitus, obesity and metabolic syndrome, which are all risk factors for cardiovascular disease.
Cardiovascular disease is the leading cause of death in Texas and the leading cause of death in Texas Hispanics, according to the Texas Department of State Health Services. In 2007, the prevalence of cardiovascular disease in South Texas was higher than the state rate.
To watch a video report on the study please follow this Health Day link: http://www.bing.com/videos/watch/video/outrunning-heart-disease/1d3afoy1b?from=
Berry, J, et al. (2011). Lifetime Risks for Cardiovascular Disease Mortality by Cardiorespiratory Fitness Levels Measured at Ages 45, 55, and 65 Years in Men. Journal of the American College of Cardiology 57 (15).
Forecast: 90% of Mexico’s population overweight/obese by 2018
A recent report by the Instituto Mexicano del Seguro Social (IMSS) indicates that if current trends continue over the next ten years, the percentage of the Mexican population considered overweight (BMI between 25 and 30) or obese (BMI over 30) could rise as high as 90% by 2018.
Although the press release indicates the percentage of Mexico’s population that is overweight or obese places it second only to the US in that category, that ranking may change soon if it has not already. The 2006 Encuesta Nacional de Salud y Nutrición placed that figure at nearly 70% for adults over age 20 in Mexico, compared with 66% for US adults over age 20 published in NCHS’s 2003-2004 National Health and Nutrition Examination Survey.
In the IMSS press release, specialists from the Department of Nutrition & Dietetics at the IMSS’s Centro Médico Nacional La Raza indicate that globalization has brought to Mexico not only lifestyle changes, but also changes in nutritional habits:
“We are suffering a dietary transition, in which we are changing our nutritional habits, leaving aside the traditional diet, which was based on grains, corn and … giving way to the culture of fast-food diets,” confirmed nutritionist Dr Georgina Nanclares Delgado.
Dr Rosa María Andrade García said Mexicans’ diets are becoming more and more like those of industrialized countries like the United States and China. At the same time, sedentary lifestyles are becoming strongly prevalent. “This transculturization is affecting us, we are taking on behaviors of other countries which really bring a certain type of diet which harms us, consuming large quantities of energy [calories], proteins and supersaturated fats, but with little fiber, vitamins and minerals,” she indicated.
Full Text of the Report on San Antonio Health Systems
Full text of the report on San Antonio health systems mentioned in the San Antonio Express News, “Urgent Matters: An Assessment of the Safety Net in San Antonio” is available online.