The document discusses Hispanic health issues across different life stages, including early childhood, school age, adolescence, reproductive years, and later years, highlighting beliefs, practices, issues, and recommendations for health promotion. It emphasizes the importance of culturally relevant health care access and preventive practices, especially in addressing conditions such as obesity, diabetes, and access to health care. The seminar, part of an 8-part series, aims to educate on these health concerns for improved outcomes in the Latino community.

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. The Early Years General info Beliefs and Practices Issues Recommendations

3. The Early Years – 0-5 Years General info Mental – Sense of security and bonding determined by care given Physiological – First year is the fastest rate of growth of entire life; growth slows after first year Breast feeding – has physiological and mental benefits

4. Beliefs and Practices Children are a gift from God Early introduction of solids common practice A “fat baby is a healthy baby” The Early Years – 0-5 Years

5. Issues Inadequate access to or insufficient use of health care In US NTD prevalence highest among Hispanics High level of nutrient needs relative to size and iron-deficiency anemia Inappropriate bottle feeding practices The Early Years – 0-5 Years

6. Issues Immunization rates need improvement High levels of dental caries Nearly one in four cases of AIDS reported in children under the age of 13 is among Latinos. http://www.ashastd.org/news/hisp.html The Early Years – 0-5 Years

7. The Early Years – 0-5 Years Recommendations Promote prenatal care Promote breastfeeding Provide information on introduction of and benefits of appropriate infant feeding practices Provide information about free and reduced health care options

8. General info Beliefs and Practices Issues Recommendations School Age – 6 - 13

9. School Age – 6 - 13 General info Nutrient needs are relatively stable, but may vary a bit during growth spurts Sense of self and identity are being formed Many health care values and habits are being developed/learned Body must be prepared for upcoming growth and physical changes Physical activity is important

10. Beliefs and Practices Children’s food preferences/ idiosyncrasies need to be met “ Milk” is good – but in excess may displace other foods and nutrients Children are allowed to eat unlimited, what they like School Age – 6 - 13

11. Issues High risk for behavioral and developmental disorders Dental caries Environmental hazards Overweight – but not perceived as an issue Diabetes Asthma Unintentional injuries Health care insurance/access School Age – 6 - 13

12. School Age – 6 - 13 http://www.cdc.gov/nchs/products/pubs/pubd/hestats/asthma/asthma.htm

13. School Age – 6 - 13 “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” Cruz, M. Journal of Clinical Endocrinology & Metabolism . Jan. 2004

14. School Age – 6 - 13 Recommendations Determine child rearing values of/and caregivers and use such in health promotion strategies Educate parents on benefits of preventive practices Help children develop/learn coping strategies that promote health in an appropriate cultural, social, and educational context

15. Adolescence 13-18 General info Beliefs and Practices Issues Recommendations

16. Adolescence 13-18 General info Mental/emotional - increased awareness of “sexual self,” body image Behavior standards set by peer group Physiological ranges of growth spurts and peaks, (Females - menses create an increased need for some nutrients) Secondary sex characteristics start to appear body is preparing for physiological changes Limited self exploration, dating and intimacy

17. Adolescence 13-18 Beliefs and Practices Caregivers may not discuss sex, reproduction; consider it “taboo” Males may be given more “liberty” and freedom for sexual exploration than females Modesty for women highly valued

18. Adolescence 13-18 Issues Overweight Substance abuse Gang violence Intergenerational and peer pressures Low high school completion rates Adolescent pregnancy Accidental deaths HIV/AIDS Mental health, depression, suicide

19. Adolescence 13-18

20. Adolescence 13-18 Issues 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) Erratic or poor eating, iron deficiency anemia

21. Adolescence 13-18 Recommendations Emphasize how quality of health behaviors and nutritional care now will greatly impact reproductive and later years Interventions should tailored to Latino children and be done in school health and pediatric clinics

22. Reproductive Years General info Beliefs and Practices Issues Recommendations

23. Reproductive Years General info Increased synchrony of physiological, social, financial, and emotional maturity Social roles defined Sexual maturity reached; body in maintenance, then slowing, mode Symptoms of some chronic diseases may start to manifest

24. Reproductive Years General info Hispanics represent 12+% percent of the population and 17+% percent of US AIDS cases Latinos are among the greatest risk for hepatitis C virus. Hispanic women are 7X more likely to contract AIDS and have higher rates of syphilis and the second highest number of cases of gonorrhea

25. Reproductive Years Beliefs and Practices Variety of reasons may be ascribed to illnesses Various practices during pregnancy – “antojos” (cravings) must be honored Concepts of “marianismo” and “machismo” will influence prevention and care seeking behaviors

26. Reproductive Years Issues Lung cancer mortality is 3X higher for Hispanic men (39.6 per 100,000) than for Hispanic women (14.9 per 100,000). Lung cancer is one of the most common types of cancer in Hispanic men and women. Lung cancer death rates are higher among Cuban-American men than among Puerto Rican and Mexican men Latino women have higher rates of breast and cervical cancers

27. Reproductive Years Issues Diabetes is particularly common among middle-aged Hispanic Americans Diabetes is twice as common in Mexican American and Puerto Rican adults

28. Health Issues - Obesity Most Growth in Prevalence of Obesity: Hispanic ethnicity (11.6% to 20.8% 1991-1999) Obesity is 1.5 times more common in Mexican American women (reaching 52%) than in the general, female population. http://www.nlm.nih.gov/medlineplus/hispanicamericanhealth.html#children

29. Reproductive Years Recommendations - Women Encourage consumption of high folic acid foods Promote wt. management and wt. loss strategies Promote traditional network support systems, especially for child rearing and prenatal care. Educate immigrant families on disease risk

30. Reproductive Years Recommendations Promote Seven Principles For Lifetime Diabetes Control Principio 1: Aprenda todo lo que pueda sobre la diabetes (learn all you can) Principio 2: Reciba atención regular para la diabetes (get regular care) Principio 3: Aprenda cómo controlar la diabetes (learn to control)

31. Reproductive Years Recommendations Principio 4: Cuide los factores clave de la diabetes (attend to factors that are important) Principio 5: Vigile los factores clave de la diabetes (watch the key factors related to diabetes) Principio 6: Prevenga las complicaciones de la diabetes (prevent complications) Principio 7: Visite al médico para ver si tiene alguna complicación de la diabetes (see the physician if you have any complications)

32. Reproductive Years Recommendations Increase early screening, prevention, and treatment and access to health care services Minimize language and cultural barriers Use hotlines and bilingual referral services Resources: Protección Es Vida [a popular bilingual fotonovela] and Paso A Paso [an in-depth resource guide for individuals living with HIV]

33. http://www.nhlbi.nih.gov/health/prof/heart/latino/foto_sp.pdf

35. Later Years General info Beliefs and Practices Issues Recommendations

36. Later Years General info Changes in family contacts, social roles, and relationships Mental adjustment to new life status Work at maintaining optimal body functions Some cognitive functions affected Increased sense of mortality

37. Later Years Beliefs and Practices Elderly are to be respected and honored Many families are extended – they care for the elderly in the home or have them nearby

38. Later Years Issues Chronic diseases manifested - heart disease, osteoporosis, high blood pressure, diabetes. For Hispanics aged 50 or older, about 25 to 30 percent have either diagnosed or undiagnosed diabetes. Access to health care, financial security and mental adjustment

39. Later Years Issues Activities of daily living likely to be affected. Family members experience conflict related to “respecting” the elderly and getting them to adhere to dietary and medical treatments Diet – coffee/chocolate and toast/cheese Undiagnosed osteoporosis risk Longer life span but in poorer health – and describe health as fair or poor

40. Later Years Issues Twenty-seven percent of Hispanic American households provide informal caregiving to a friend or relative. The typical Hispanic caregiver is a 40 year old female. More than half of all Hispanic caregivers also has a child age 18 and younger living at home. http://www.aoa.dhhs.gov/press/fact/alpha/fact_serving_hispanicamer.asp

41. Later Years Recommendations Seek out community networks e.g., transportation van, congregate meals, etc. Teach simple self monitoring strategies Help empower widows/elderly males living alone to select and prepare healthy foods Provide support networks and strategies for caregivers of elders

42. Healthy People 2010 Recommendations The National Alliance for Hispanic Health Reports Forty percent of Healthy People 2010 population-based objectives/sub-objectives do not have Hispanic baseline data. Progress on these objectives cannot be measured for Hispanic communities. Recommendations Release a Hispanic Healthy People 2010 midcourse review to report Hispanic baseline data and identify a tracking system Implement improvements in Hispanic data collection, analysis, and reporting Ensure that baseline data and tracking systems are put into place

43. CDC Interactive Heart Disease Mortality Maps http://www.cdc.gov/cvh/maps/statemaps.htm CDC Interactive Cancer Mortality Maps http://www3.cancer.gov/atlasplus/charts.html Florida Department of Health http://www.doh.state.fl.us/ Florida Health Charts and Interactive Maps http://www.floridacharts.com/charts/chart.aspx Duval County Health Department http://www.dchd.net/index.htm City of Jacksonville Community Maps http://www.coj.net/default.htm Resources: Data Web Sites

44. Extension - Spanish language materials http://www.extensionenespanol.net/contact.cfm National Alliance for Hispanic Health www.hispanichealth.org National Council of La Raza Institute for Hispanic Health www.nclr.org/policy/health.html National Dairy Council http://www.nationaldairycouncil.org/ Office of Minority Health http://www.omhrc.gov/omhrc USDA Food and Nutrition Information Center, Ethnic and Cultural www.nal.usda.gov/fnic/etext/000010.html Resources: Web Sites

45. Health Issues in the Latino Community . By M. Aguirre-Molina, C. Molina, R. E. Zambrana. 2001. Latina Health in the United States . By M. Aguirre-Molina, C. Molina. 2003. Hispanic foodways, nutrition, and health . By Diva Sanjur. 1995. The Health of Latino Communities in the South: Challenges and Opportunities. Available at: http://www.nclr.org/content/publications/detail/26898/ Contemporary Nutrition for Latinos. Judith C. Rodriguez. 2004. Resources: Books

46. Any questions? Thank you 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 .