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Transcript

  • 1. “ More research (and action) is needed”
  • 2. “Hispanic paradox”
    • Higher poverty, less formal education, less healthcare
    • Better health; lower mortality rates
  • 3. “Hispanic paradox”
  • 4. Hispanic paradox
  • 5. “Hispanic paradox”
    • “Healthy migrant” hypothesis
    • Barrio effect?
    • “Salmon bias”?
    • Acculturation risk?
  • 6. Not the end of story
    • Higher disability rates?
    • Higher diagnosed Type II diabetes over age 20 and mortality (Mexican Americans)
    • Higher obesity (Mexican Americans)
    • More stomach, liver, gallbladder and cervical cancers
    • Worse asthma (Puerto Ricans)
    • Less asthma (Mexican Americans)
  • 7. Hispanic paradox
    • Kyriakos S. Markides, University of Texas Medical Branch, Galveston
    • Jeanne Ruiz, Ph.D., R.N., assistant professor at The University of Texas Health Science Center at San Antonio (UTHSCSA)
    • Smith and Bradshaw, University of Texas School of Public Health
  • 8. Why are Latinos with diabetes twice as likely to die from it as non-Hispanic whites?
    • Genetics?
    • Culture?
    • Environment?
    • Less access to care?
    • Racism?
  • 9. Which Latinos?
  • 10. Which Latinos?
    • Mexican, Puerto Rican, Venezuelan, Cuban?
    • Immigrant or second-generation?
    • Wealthy or poor?
    • Urban or rural?
  • 11. Which Latinos?
    • Who decides?
    • Researchers don’t all agree
    • Self-ID can change
  • 12. Whose genes?
    • Studies to define “genetic ancestry”
    • Body composition (NY Puerto Ricans)
    • Asthma (SF Mexican-Americans, NY Puerto Ricans)
  • 13. Environment
    • NIEHS environmental genome project
    • - environmental conditions, plus
    • - genetic susceptibility
  • 14. Psychosocial factors
    • Work environment (job stress, shift work);
    • personality and negative emotions (anger, hostility, anxiety, and depression);
    • protective effects of social networks and support.
    • Hope and curiosity
    • (Ichiro Kawachi on heart disease)
  • 15. Social determinants
    • Income inequality
    • Social cohesion and mutual trust
    • Inequalities in political participation, civic engagement
    • Residential segregation
    • (Kawachi, Harvard University)
  • 16. Racism
    • Unequal treatment
    • -- Studies on unconscious decision-making
    • Racialized living
    • -- Allostatic load (stress response)
    • -- Social rank
  • 17. “More research is needed”
    • Countries of origin
    • Regional differences (multi-center studies)
    • Lengths of U.S. residence
    • Research in countries of origin
  • 18. Ichiro Kawachi Thomas A. LaVeist Brian Smedley, ed.
  • 19. Leading causes of death among Latinos (2003)
    • Diseases of heart 28,298
    • Malignant neoplasms 24,070
    • Unintentional injuries h 10,418
    • Cerebrovascular diseases 6,658
    • Diabetes mellitus 6,179
    • Chronic liver disease and cirrhosis 3,382
    • Homicide 3,355
    • Chronic lower respiratory diseases 3,174
    • Influenza and pneumonia 2,948
    • Certain conditions originating in the perinatal period 2,628
  • 20. Asthma
  • 21. Worst air pollution
    • SHORT-TERM PARTICULATES
    • (soot)
    • Los Angeles-Long Beach-Riverside
    • Bakersfield
    • Fresno-Madera
    • OZONE (smog)
    • Bakersfield,CA
    • Los Angeles-Long Beach-Riverside
    • Visalia-Porterville,CA
  • 22. Community stories
    • Community organizers
    • City and county health officers
    • Community food assessment (PolicyLink)
    • Center on Alcohol Marketing and Youth
    • Community Action to Fight Asthma
    • (regional project info)
    • http://www.calasthma.org/
  • 23. Asthma
    • Who is being counted?
    • Access to medications in school
    • School air safety
    • Air pollution regulations
    • Corporate responsibility
    • Land use laws
  • 24. AIDS/HIV
    • 14 percent of the population; 20 percent of AIDS diagnoses
    • 32 percent U.S. born; 18 percent Puerto Rican; 17 percent Mexican
  • 25. AIDS – issues
    • Transmission patterns
    • Education
    • Access to care
    • Community concern
  • 26. AIDS -resources
    • Kaiser Family Foundation
    • GLAAD
    • ( http://www.glaad.org/publications/resource_doc_detail.php?id=3101 )
    • Bienestar
    • ( http://www.bienestar.org )
    • Proyecto Contra SIDA Por Vida
    • San Francisco AIDS Foundation
    • (http://www.sfaf.org/beta/2005_win/mortality.html)
  • 27. How to find stories
  • 28. Evaluating stories
  • 29. Consider the source
  • 30. Evaluating a study
    • Who are the participants (subjects)
    • Number of participants (sample size)
    • Institution
    • P value
    • Standard deviation (SD)
    • Mean, median
  • 31. Examples
  • 32. SPJ Rainbow Sourcebook and Diversity Toolbox

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