UNF Hispanic Health Issues Seminars: Brief Review Dr. Judith Rodriguez, RD Daniel Santibanez, MPH, RD University of North Florida Department of Public Health This is part 8 of an 8 part series of seminars on Hispanic Health Issues brought to you by the University of North Florida’s Dept. of Public Health, College of Health, a grant from AETNA, and the cooperation of the Duval County Health Department.

Regional Distribution Puerto Rican Dominican Central American South American Cuban Central American South American Puerto Rican Mexican Central American South American US Census Bureau 2003 14% 33% 45% 8%

Puerto Rican

Dominican

Central American

South American

Cuban

Central American

South American

Puerto Rican

Mexican

Central American

South American

Hispanic Demographics The largest minority group Hispanics are a young, fast growing population Larger families Lower high school graduation rates

The largest minority group

Hispanics are a young, fast growing population

Larger families

Lower high school graduation rates

Self identity differs Discrimination: One in three (31%) Latinos report they or someone close to them has suffered discrimination in the past five years; more (45%) report experiencing more subtle forms Hispanic Demographics (cont.)

Self identity differs

Discrimination: One in three (31%) Latinos report they or someone close to them has suffered discrimination in the past five years; more (45%) report experiencing more subtle forms

Hispanic Behaviors and Diversity Demographic Complexity Nativity status US Born vs. Foreign Born Hot – cold theory of disease Spiritualism, Santeria and Fatalism

Demographic Complexity

Nativity status

US Born vs. Foreign Born

Hot – cold theory of disease

Spiritualism, Santeria and Fatalism

Hispanic Behaviors and Diversity (cont.) Problems spiritual in nature are treated with prayer and ritual Influence of luck and God

Problems spiritual in nature are treated with prayer and ritual

Influence of luck and God

Discussion What information about demographics and/or regional distribution was new to you? What information have you used/has been especially helpful?

What information about demographics and/or regional distribution was new to you?

What information have you used/has been especially helpful?

Lifespan Latino children in the U.S. are at extremely high risk for adverse health effects Latino women have the highest birth and fertility rates of any other group in the U.S. and are faced with many challenges Latino elders are more likely to report being in poor health, experience more restricted activity, and have more difficulty performing ADLs

Latino children in the U.S. are at extremely high risk for adverse health effects

Latino women have the highest birth and fertility rates of any other group in the U.S. and are faced with many challenges

Latino elders are more likely to report being in poor health, experience more restricted activity, and have more difficulty performing ADLs

Obesity Obesity prevalence is higher among: African-American Females, Hispanic Americans (esp. Mexican-Americans and Puerto Ricans), Native Americans and Asians/Pacific Islanders The associations of poverty, acculturation, exercise, and diet to BMI implicate societal as well as individual contributors to obesity among U.S. Latinos.

Obesity prevalence is higher among:

African-American Females, Hispanic Americans (esp. Mexican-Americans and Puerto Ricans), Native Americans and Asians/Pacific Islanders

The associations of poverty, acculturation, exercise, and diet to BMI implicate societal as well as individual contributors to obesity among U.S. Latinos.

Obesity (cont.) Hispanics in Florida: Prevalence of Overweight 58.1 Prevalence of Obesity17.1 Longer duration of residence in U.S. is associated with higher BMI

Hispanics in Florida:

Prevalence of Overweight 58.1

Prevalence of Obesity17.1

Longer duration of residence in U.S. is associated with higher BMI

Diabetes Complications (heart disease, stroke, hypertension, blindness, kidney disease, nervous system, amputation, dental disease, pregnancy) Prevalence of Type 2 diabetes is 1.5 times higher in Latinos than non-Latino whites Two million or 8.2% of all Latino Americans aged 20 years or older have diabetes

Complications (heart disease, stroke, hypertension, blindness, kidney disease, nervous system, amputation, dental disease, pregnancy)

Prevalence of Type 2 diabetes is 1.5 times higher in Latinos than non-Latino whites

Two million or 8.2% of all Latino Americans aged 20 years or older have diabetes

Diabetes (cont.) In the United states among those between ages 45 – 74: 24% of Mexican Americans have diabetes 26% of Puerto Ricans have diabetes 16% of Cuban Americans have diabetes

In the United states among those between ages 45 – 74:

24% of Mexican Americans have diabetes

26% of Puerto Ricans have diabetes

16% of Cuban Americans have diabetes

Cardiovascular Disease Heart disease the primary cause of mortality/death among Latinos Heart disease and stroke claims the lives of 30% or more Latinos each year. Total deaths rates for Mex Am: about 29% for men about 27% of women

Heart disease the primary cause of mortality/death among Latinos

Heart disease and stroke claims the lives of 30% or more Latinos each year.

Total deaths rates for Mex Am:

about 29% for men

about 27% of women

Cardiovascular Disease (cont.) Risk factors and facts MA men have higher TG & lower HDL Genes account for 30-45% of difference in lipid profiles Sedentary lifestyles (exercise & diet) More years of immigration = more obesity

Risk factors and facts

MA men have higher TG & lower HDL

Genes account for 30-45% of difference in lipid profiles

Sedentary lifestyles (exercise & diet)

More years of immigration = more obesity

Cancer Hispanics’ risk of cancer can differ based on whether they are U.S. born or foreign-born, country of origin or heritage, degree of acculturation, and socioeconomic status Hispanics/Latinos tend to underutilize cancer screening procedure for several reasons

Hispanics’ risk of cancer can differ based on whether they are U.S. born or foreign-born, country of origin or heritage, degree of acculturation, and socioeconomic status

Hispanics/Latinos tend to underutilize cancer screening procedure for several reasons

Cancer (cont.) Compared to rates in the U.S: Lower incidence rates of breast, colon and rectum, lung, and prostate cancers in Puerto Rico, Cuba, and Central and South American countries than in the U.S. Higher incidence rates of cervical, liver, and stomach cancers

Compared to rates in the U.S:

Lower incidence rates of breast, colon and rectum, lung, and prostate cancers in Puerto Rico, Cuba, and Central and South American countries than in the U.S.

Higher incidence rates of cervical, liver, and stomach cancers

Discussion What interrelationships do you see among obesity, diabetes, cardiovascular disease and cancer? Is there one “take home message” about these conditions that you think you can use in your work with Hispanics?

What interrelationships do you see among obesity, diabetes, cardiovascular disease and cancer?

Is there one “take home message” about these conditions that you think you can use in your work with Hispanics?

HIV/AIDS 20% cases of AIDS cases are Latinos (8,000+) This percentage has increased from 18% in 1993 19% of deaths within Latinos are due to AIDS

20% cases of AIDS cases are Latinos (8,000+) This percentage has increased from 18% in 1993

19% of deaths within Latinos are due to AIDS

HIV/AIDS (cont.) HIV is the 2 nd cause of death for Latino males 35-44 (5 th for White men) Latino teens account for 21% of new AIDS cases AIDS rate is five times more for Latinas than for White women

HIV is the 2 nd cause of death for Latino males 35-44 (5 th for White men)

Latino teens account for 21% of new AIDS cases

AIDS rate is five times more for Latinas than for White women

HIV/AIDS (cont.) Transmission in Latinos Males 42% men who have sex with men 34% contaminated syringes 8% heterosexually Females 38% contaminated syringes 47% sex with HIV positive male

Transmission in Latinos

Males

42% men who have sex with men

34% contaminated syringes

8% heterosexually

Females

38% contaminated syringes

47% sex with HIV positive male

Environmental Health Latino children disproportionately exposed to toxins, air pollutants, hazardous chemical waste, pesticides, and lead In 2002, over 1.7 million Latinos reported that they currently have asthma High risk due to overrepresentation of Latino workers in the more hazardous occupations and industries

Latino children disproportionately exposed to toxins, air pollutants, hazardous chemical waste, pesticides, and lead

In 2002, over 1.7 million Latinos reported that they currently have asthma

High risk due to overrepresentation of Latino workers in the more hazardous occupations and industries

Substance Abuse Smoking and Hispanics/Latinos Lower rates of smoking than other groups, but Asian Americans Hispanic women: Smoking rates were much lower than those among females of other races Smoking by gender In 2002: 10.8 % women / 22.7 % men

Smoking and Hispanics/Latinos

Lower rates of smoking than other groups, but Asian Americans

Hispanic women: Smoking rates were much lower than those among females of other races

Smoking by gender In 2002: 10.8 % women / 22.7 % men

Substance Abuse (cont.) Smoking and Hispanics/Latinos Variations in smoking rates among Hispanic subgroups. In 2002: 27.2 % Puerto Ricans (highest), 10.7 % of Central-South Americans (lowest) In 2002, 9.1 percent of Hispanic middle school students smoked. Relatively equal to other racial/ethnic groups Hispanics were less likely to attempt to quit

Smoking and Hispanics/Latinos

Variations in smoking rates among Hispanic subgroups. In 2002: 27.2 % Puerto Ricans (highest), 10.7 % of Central-South Americans (lowest)

In 2002, 9.1 percent of Hispanic middle school students smoked. Relatively equal to other racial/ethnic groups

Hispanics were less likely to attempt to quit

Substance Abuse (cont.) Alcohol and Hispanics/Latinos Hispanic young people are more likely to drink and to get drunk at an earlier age Alcohol use contributes to the three leading causes of death among Hispanic 12-20-year-olds: unintentional injuries, homicide and suicide Hispanic high school students are more likely to report riding in a car with a driver who had been drinking

Alcohol and Hispanics/Latinos

Hispanic young people are more likely to drink and to get drunk at an earlier age

Alcohol use contributes to the three leading causes of death among Hispanic 12-20-year-olds: unintentional injuries, homicide and suicide

Hispanic high school students are more likely to report riding in a car with a driver who had been drinking

Mental and Emotional Health Latinos living in their countries of origin have less rates of mental disorders than those that migrate to the US (due to strong social networks) Acculturative stress a factor for immigrants Barriers to care include stigma, language, and access to mental health services

Latinos living in their countries of origin have less rates of mental disorders than those that migrate to the US (due to strong social networks)

Acculturative stress a factor for immigrants

Barriers to care include stigma, language, and access to mental health services

Infectious Diseases Latinos are twice as likely to have gonorrhea or syphilis Among minorities, Latinas report the second highest number of cases of gonorrhea Latinos are at High-Risk of contracting the hepatitis C virus

Latinos are twice as likely to have gonorrhea or syphilis

Among minorities, Latinas report the second highest number of cases of gonorrhea

Latinos are at High-Risk of contracting the hepatitis C virus

Discussion Which of these issues (environmental health, substance abuse, mental and emotional health, infectious diseases) is most relevant to your work? What information about any of those presentations did you find most useful?

Which of these issues (environmental health, substance abuse, mental and emotional health, infectious diseases) is most relevant to your work?

What information about any of those presentations did you find most useful?

Next Steps What do you think would be most helpful now for you – in terms of seminars, information, programmatic approaches? If we were to develop a follow up to this project (seminars) what do you think it should include?

What do you think would be most helpful now for you – in terms of seminars, information, programmatic approaches?

If we were to develop a follow up to this project (seminars) what do you think it should include?

References The references for the information provided on this summary is in the earlier presentation packets.

The references for the information provided on this summary is in the earlier presentation packets.

Thank you! Aetna University of North Florida, Dept. of Public Health Duval County Health Department Northeast Florida AHEC Mr. Daniel Santibanez Mr. Juan C. Henao You – the attendees!

Aetna

University of North Florida, Dept. of Public Health

Duval County Health Department

Northeast Florida AHEC

Mr. Daniel Santibanez

Mr. Juan C. Henao

You – the attendees!