Aetna Presentation Life Cycle


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Latinos and the Life Cycle

Dr. Judith C. Rodriguez, RD, UNF
Mr. Daniel Santibanez, MPH Candidate, UNF

April 22, 2005 - UNF Hispanic Health Issues Seminars

This is part 3 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 Duval County Health Department.

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Aetna Presentation Life Cycle

  1. 1. Latinos and the Life Cycle Dr. Judith C. Rodriguez, RD, University of North Florida Mr. Daniel Santibanez, MPH Candidate, University of North Florida April 22, 2005 This is part 3 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 Duval County Health Department. For more information or register for the seminars, please call 620-1289.
  2. 2. The Early Years <ul><li>General info </li></ul><ul><li>Beliefs and Practices </li></ul><ul><li>Issues </li></ul><ul><li>Recommendations </li></ul>
  3. 3. The Early Years – 0-5 Years <ul><li>General info </li></ul><ul><li>Mental – </li></ul><ul><ul><li>Sense of security and bonding determined by care given </li></ul></ul><ul><li>Physiological – </li></ul><ul><ul><li>First year is the fastest rate of growth of entire life; growth slows after first year </li></ul></ul><ul><li>Breast feeding – </li></ul><ul><ul><li>has physiological and mental benefits </li></ul></ul>
  4. 4. <ul><li>Beliefs and Practices </li></ul><ul><li>Children are a gift from God </li></ul><ul><li>Early introduction of solids common practice </li></ul><ul><li>A “fat baby is a healthy baby” </li></ul>The Early Years – 0-5 Years
  5. 5. <ul><li>Issues </li></ul><ul><li>Inadequate access to or insufficient use of health care </li></ul><ul><li>In US NTD prevalence highest among Hispanics </li></ul><ul><li>High level of nutrient needs relative to size and iron-deficiency anemia </li></ul><ul><li>Inappropriate bottle feeding practices </li></ul>The Early Years – 0-5 Years
  6. 6. <ul><li>Issues </li></ul><ul><li>Immunization rates need improvement </li></ul><ul><li>High levels of dental caries </li></ul><ul><li>Nearly one in four cases of AIDS reported in children under the age of 13 is among Latinos. </li></ul><ul><li> </li></ul>The Early Years – 0-5 Years
  7. 7. The Early Years – 0-5 Years <ul><li>Recommendations </li></ul><ul><li>Promote prenatal care </li></ul><ul><li>Promote breastfeeding </li></ul><ul><li>Provide information on introduction of and benefits of appropriate infant feeding practices </li></ul><ul><li>Provide information about free and reduced health care options </li></ul>
  8. 8. <ul><li>General info </li></ul><ul><li>Beliefs and Practices </li></ul><ul><li>Issues </li></ul><ul><li>Recommendations </li></ul>School Age – 6 - 13
  9. 9. School Age – 6 - 13 <ul><li>General info </li></ul><ul><li>Nutrient needs are relatively stable, but may vary a bit during growth spurts </li></ul><ul><li>Sense of self and identity are being formed </li></ul><ul><li>Many health care values and habits are being developed/learned </li></ul><ul><li>Body must be prepared for upcoming growth and physical changes </li></ul><ul><li>Physical activity is important </li></ul>
  10. 10. <ul><li>Beliefs and Practices </li></ul><ul><li>Children’s food preferences/ idiosyncrasies need to be met </li></ul><ul><li>“ Milk” is good – but in excess may displace other foods and nutrients </li></ul><ul><li>Children are allowed to eat unlimited, what they like </li></ul>School Age – 6 - 13
  11. 11. <ul><li>Issues </li></ul><ul><li>High risk for behavioral and developmental disorders </li></ul><ul><li>Dental caries </li></ul><ul><li>Environmental hazards </li></ul><ul><li>Overweight – but not perceived as an issue </li></ul><ul><li>Diabetes </li></ul><ul><li>Asthma </li></ul><ul><li>Unintentional injuries </li></ul><ul><li>Health care insurance/access </li></ul>School Age – 6 - 13
  12. 12. School Age – 6 - 13
  13. 13. School Age – 6 - 13 <ul><li>“One in three Latino children with a family history of diabetes suffers from pre-diabetes….. this condition does not seem to be associated with the child's weight” </li></ul><ul><li>Cruz, M. Journal of Clinical Endocrinology & Metabolism . Jan. 2004 </li></ul>
  14. 14. School Age – 6 - 13 <ul><li>Recommendations </li></ul><ul><li>Determine child rearing values of/and caregivers and use such in health promotion strategies </li></ul><ul><li>Educate parents on benefits of preventive practices </li></ul><ul><li>Help children develop/learn coping strategies that promote health in an appropriate cultural, social, and educational context </li></ul>
  15. 15. Adolescence 13-18 <ul><li>General info </li></ul><ul><li>Beliefs and Practices </li></ul><ul><li>Issues </li></ul><ul><li>Recommendations </li></ul>
  16. 16. Adolescence 13-18 <ul><li>General info </li></ul><ul><li>Mental/emotional - increased awareness of “sexual self,” body image </li></ul><ul><li>Behavior standards set by peer group </li></ul><ul><li>Physiological ranges of growth spurts and peaks, (Females - menses create an increased need for some nutrients) </li></ul><ul><li>Secondary sex characteristics start to appear body is preparing for physiological changes </li></ul><ul><li>Limited self exploration, dating and intimacy </li></ul>
  17. 17. Adolescence 13-18 <ul><li>Beliefs and Practices </li></ul><ul><li>Caregivers may not discuss sex, reproduction; consider it “taboo” </li></ul><ul><li>Males may be given more “liberty” and freedom for sexual exploration than females </li></ul><ul><li>Modesty for women highly valued </li></ul>
  18. 18. Adolescence 13-18 <ul><li>Issues </li></ul><ul><li>Overweight </li></ul><ul><li>Substance abuse </li></ul><ul><li>Gang violence </li></ul><ul><li>Intergenerational and peer pressures </li></ul><ul><li>Low high school completion rates </li></ul><ul><li>Adolescent pregnancy </li></ul><ul><li>Accidental deaths </li></ul><ul><li>HIV/AIDS </li></ul><ul><li>Mental health, depression, suicide </li></ul>
  19. 19. Adolescence 13-18
  20. 20. Adolescence 13-18 <ul><li>Issues </li></ul><ul><li>Study by Delva, et al found “Drug use was significantly higher among boys and adolescents of almost all Hispanic ethnicities who did not live with both parents…(and) drug use differed according to ethnic group on language first spoken, parental education, urbanicity, and region.” (AJPH 2005) </li></ul><ul><li>Erratic or poor eating, iron deficiency anemia </li></ul>
  21. 21. Adolescence 13-18 <ul><li>Recommendations </li></ul><ul><li>Emphasize how quality of health behaviors and nutritional care now will greatly impact reproductive and later years </li></ul><ul><li>Interventions should tailored to Latino children and be done in school health and pediatric clinics </li></ul>
  22. 22. Reproductive Years <ul><li>General info </li></ul><ul><li>Beliefs and Practices </li></ul><ul><li>Issues </li></ul><ul><li>Recommendations </li></ul>
  23. 23. Reproductive Years <ul><li>General info </li></ul><ul><li>Increased synchrony of physiological, social, financial, and emotional maturity </li></ul><ul><li>Social roles defined </li></ul><ul><li>Sexual maturity reached; body in maintenance, then slowing, mode </li></ul><ul><li>Symptoms of some chronic diseases may start to manifest </li></ul>
  24. 24. Reproductive Years <ul><li>General info </li></ul><ul><li>Hispanics represent 12+% percent of the population and 17+% percent of US AIDS cases </li></ul><ul><li>Latinos are among the greatest risk for hepatitis C virus. </li></ul><ul><li>Hispanic women are 7X more likely to contract AIDS and have higher rates of syphilis and the second highest number of cases of gonorrhea </li></ul>
  25. 25. Reproductive Years <ul><li>Beliefs and Practices </li></ul><ul><li>Variety of reasons may be ascribed to illnesses </li></ul><ul><li>Various practices during pregnancy – “antojos” (cravings) must be honored </li></ul><ul><li>Concepts of “marianismo” and “machismo” will influence prevention and care seeking behaviors </li></ul>
  26. 26. Reproductive Years <ul><li>Issues </li></ul><ul><li>Lung cancer mortality is 3X higher for Hispanic men (39.6 per 100,000) than for Hispanic women (14.9 per 100,000). </li></ul><ul><li>Lung cancer is one of the most common types of cancer in Hispanic men and women. </li></ul><ul><li>Lung cancer death rates are higher among Cuban-American men than among Puerto Rican and Mexican men </li></ul><ul><li>Latino women have higher rates of breast and cervical cancers </li></ul>
  27. 27. Reproductive Years <ul><li>Issues </li></ul><ul><li>Diabetes is particularly common among middle-aged Hispanic Americans </li></ul><ul><li>Diabetes is twice as common in Mexican American and Puerto Rican adults </li></ul>
  28. 28. Health Issues - Obesity <ul><li>Most Growth in Prevalence of Obesity: </li></ul><ul><li>Hispanic ethnicity (11.6% to 20.8% 1991-1999) </li></ul><ul><li>Obesity is 1.5 times more common in Mexican American women (reaching 52%) than in the general, female population. </li></ul>
  29. 29. Reproductive Years <ul><li>Recommendations - Women </li></ul><ul><li>Encourage consumption of high folic acid foods </li></ul><ul><li>Promote wt. management and wt. loss strategies </li></ul><ul><li>Promote traditional network support systems, especially for child rearing and prenatal care. </li></ul><ul><li>Educate immigrant families on disease risk </li></ul>
  30. 30. Reproductive Years <ul><li>Recommendations </li></ul><ul><li>Promote Seven Principles For Lifetime Diabetes Control </li></ul><ul><li>Principio 1: Aprenda todo lo que pueda sobre la diabetes (learn all you can) </li></ul><ul><li>Principio 2: Reciba atención regular para la diabetes </li></ul><ul><li>(get regular care) </li></ul><ul><li>Principio 3: Aprenda cómo controlar la diabetes </li></ul><ul><li>(learn to control) </li></ul>
  31. 31. Reproductive Years <ul><li>Recommendations </li></ul><ul><li>Principio 4: Cuide los factores clave de la diabetes (attend to factors that are important) </li></ul><ul><li>Principio 5: Vigile los factores clave de la diabetes (watch the key factors related to diabetes) </li></ul><ul><li>Principio 6: Prevenga las complicaciones de la diabetes (prevent complications) </li></ul><ul><li>Principio 7: Visite al médico para ver si tiene alguna complicación de la diabetes (see the physician if you have any complications) </li></ul>
  32. 32. Reproductive Years <ul><li>Recommendations </li></ul><ul><li>Increase early screening, prevention, and treatment and access to health care services </li></ul><ul><li>Minimize language and cultural barriers </li></ul><ul><li>Use hotlines and bilingual referral services </li></ul><ul><li>Resources: Protección Es Vida [a popular bilingual fotonovela] and Paso A Paso [an in-depth resource guide for individuals living with HIV] </li></ul>
  33. 33.
  34. 35. Later Years <ul><li>General info </li></ul><ul><li>Beliefs and Practices </li></ul><ul><li>Issues </li></ul><ul><li>Recommendations </li></ul>
  35. 36. Later Years <ul><li>General info </li></ul><ul><li>Changes in family contacts, social roles, and relationships </li></ul><ul><li>Mental adjustment to new life status </li></ul><ul><li>Work at maintaining optimal body functions </li></ul><ul><li>Some cognitive functions affected </li></ul><ul><li>Increased sense of mortality </li></ul>
  36. 37. Later Years <ul><li>Beliefs and Practices </li></ul><ul><li>Elderly are to be respected and honored </li></ul><ul><li>Many families are extended – they care for the elderly in the home or have them nearby </li></ul>
  37. 38. Later Years <ul><li>Issues </li></ul><ul><li>Chronic diseases manifested - heart disease, osteoporosis, high blood pressure, diabetes. </li></ul><ul><li>For Hispanics aged 50 or older, about 25 to 30 percent have either diagnosed or undiagnosed diabetes. </li></ul><ul><li>Access to health care, financial security and mental adjustment </li></ul>
  38. 39. Later Years <ul><li>Issues </li></ul><ul><li>Activities of daily living likely to be affected. </li></ul><ul><li>Family members experience conflict related to “respecting” the elderly and getting them to adhere to dietary and medical treatments </li></ul><ul><li>Diet – coffee/chocolate and toast/cheese </li></ul><ul><li>Undiagnosed osteoporosis risk </li></ul><ul><li>Longer life span but in poorer health – and describe health as fair or poor </li></ul>
  39. 40. Later Years <ul><li>Issues </li></ul><ul><li>Twenty-seven percent of Hispanic American households provide informal caregiving to a friend or relative. </li></ul><ul><li>The typical Hispanic caregiver is a 40 year old female. </li></ul><ul><li>More than half of all Hispanic caregivers also has a child age 18 and younger living at home. </li></ul><ul><li> </li></ul>
  40. 41. Later Years <ul><li>Recommendations </li></ul><ul><li>Seek out community networks e.g., transportation van, congregate meals, etc. </li></ul><ul><li>Teach simple self monitoring strategies </li></ul><ul><li>Help empower widows/elderly males living alone to select and prepare healthy foods </li></ul><ul><li>Provide support networks and strategies for caregivers of elders </li></ul>
  41. 42. Healthy People 2010 <ul><li>Recommendations </li></ul><ul><li>The National Alliance for Hispanic Health Reports </li></ul><ul><li>Forty percent of Healthy People 2010 population-based objectives/sub-objectives do not have Hispanic baseline data. </li></ul><ul><li>Progress on these objectives cannot be measured for Hispanic communities. </li></ul><ul><li>Recommendations </li></ul><ul><li>Release a Hispanic Healthy People 2010 midcourse review to report Hispanic baseline data and identify a tracking system </li></ul><ul><li>Implement improvements in Hispanic data collection, analysis, and reporting </li></ul><ul><li>Ensure that baseline data and tracking systems are put into place </li></ul>
  42. 43. <ul><li>CDC Interactive Heart Disease Mortality Maps </li></ul><ul><ul><li> </li></ul></ul><ul><li>CDC Interactive Cancer Mortality Maps </li></ul><ul><ul><li> </li></ul></ul><ul><li>Florida Department of Health </li></ul><ul><ul><li> </li></ul></ul><ul><li>Florida Health Charts and Interactive Maps </li></ul><ul><ul><li> </li></ul></ul><ul><li>Duval County Health Department </li></ul><ul><ul><li> </li></ul></ul><ul><li>City of Jacksonville Community Maps </li></ul><ul><ul><li> </li></ul></ul>Resources: Data Web Sites
  43. 44. <ul><li>Extension - Spanish language materials </li></ul><ul><li>National Alliance for Hispanic Health </li></ul><ul><li>National Council of La Raza Institute for Hispanic Health </li></ul><ul><li>National Dairy Council </li></ul><ul><li> </li></ul><ul><li>Office of Minority Health </li></ul><ul><li>USDA Food and Nutrition Information Center, Ethnic and Cultural </li></ul>Resources: Web Sites
  44. 45. <ul><li>Health Issues in the Latino Community . By M. Aguirre-Molina, C. Molina, R. E. Zambrana. 2001. </li></ul><ul><li>Latina Health in the United States . By M. Aguirre-Molina, C. Molina. 2003. </li></ul><ul><li>Hispanic foodways, nutrition, and health . By Diva Sanjur. 1995. </li></ul><ul><li>The Health of Latino Communities in the South: Challenges and Opportunities.  Available at: </li></ul><ul><li> </li></ul><ul><li>Contemporary Nutrition for Latinos. Judith C. Rodriguez. 2004. </li></ul>Resources: Books
  45. 46. <ul><li>Any questions? </li></ul><ul><li>Thank you </li></ul>This seminar is part 3 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 Duval County Health Dept. For more information or register for the seminars, please call 620-1289 .