January 8, 2007
Via
Hispanic babies are 1.5 to 2 times more likely than others in the U.S.

to be born with a neural tube defect (NTD), according to national statistics. The National Council on Folic Acid (NCFA) will recognize National Folic Acid Awareness Week, January 8 - 14, 2007, with a concentrated effort to inform Latinas about how to minimize these conditions, including increasing their folic acid consumption.
Statistics show that in the U.

S., there is a higher prevalence of Latinas delivering babies with NTDs, serious birth defects of the brain and the spine, than non-Hispanic white women. However, the Centers for Disease Control and Prevention (CDC) reports that Latinas consume the least amount of folic acid and have the least knowledge about folic acid than other racial or ethnic groups.

“Helping Latinas and their families understand the role folic acid can serve in reducing neural tube defects is a priority,” says Adriane K. Griffen, NCFA chair. “We need to educate all women, especially Latinas, that folic acid can help prevent birth defects such as Spina Bifida, the most common and permanently disabling birth defect.

”
Research indicates that consumption of folic acid before and during early pregnancy can lower the rate of NTDs by up to 70 percent. The U.S.

Public Health Service recommends 400 micrograms of B vitamin folic acid daily for women of childbearing age. Women are recommended to take multivitamins and consume fortified grains as part of a healthy diet. Increasing consumption of folic acid among Latinas may be the easiest way to decrease pregnancies affected by NTDs.

Studies show that Latinas have the lowest reported folic acid consumption of any racial or ethnic group in the U.S., and NTDs occur more often among Latinas.

According to Alina Flores, Health Education Specialist at the CDC’s National Center on Birth Defects and Developmental Disabilities, “Informing Latinas about the benefits of folic acid is a valuable effort that needs to extend beyond National Folic Acid Awareness Week. With additional research and public support we can have a profound impact on countless Latino families.”
The National Council on Folic Acid is a partnership of national organizations, associations and state folic acid councils reaching over 100 million people a year with the folic acid message.

For more information about folic acid and National Folic Acid Awareness Week, visit http://www.folicacidinfo.org.

Posted by Juan G. Tornoe on January 09, 2007 at 21:58 in | December 31, 2006
By Mary Ann Roser and Tiffany Erickson
A new national study — touted by the authors as the first to examine obesity in 3-year-olds — found that Hispanic children are twice as likely to be overweight or obese as black or white children.
The study focused on urban, low-income children and found that overall, 35 percent were overweight or obese.

The researchers followed 1,976 children from birth in 20 U.S. cities.

Their work, funded by the nonprofit Robert Wood Johnson Foundation, was published online this past week in the American Journal of Public Health. It will appear in the journal's print edition in February.
I hope that people will take seriously the problem of childhood obesity, said Rachel Kimbro, the study's lead author and the Robert Wood Johnson Health and Society Scholar at the University of Wisconsin-Madison.

I think it startles people to hear that 3-year-olds are obese ...

and the problem gets magnified as children age.
It's a concern that has not escaped leaders at Salt Lake City's Guadalupe School, an elementary and pre-kindergarten school that serves disadvantaged children, many of them Hispanic immigrants with non-English-speaking parents.
Guadalupe parent-educators coach parents on how to read with their children as well as on good nutrition and health — how to prepare healthy snacks and encourage healthy eating and activity.

Patty Walker, principal at Guadalupe, said that as part of the school's preschool curriculum, children are taught how to kick, throw and catch a ball, pump a swing and run, skip and hop to ensure they learn to be active early on.
I am amazed at how many 3-year-olds I see that can't pedal a tricycle, Walker said.
Childhood obesity is a growing public health worry, and the new study is significant because it is among the first that looks at the problem's origins, said Dr.

Daniel Hale, a pediatric diabetes specialist and a professor of pediatrics at the University of Texas Health Science Center at San Antonio.
I'm seeing 10- and 11-year-olds who weigh over 200 pounds, Hale said. This is absolutely becoming routine in our practice.

Overweight and obese children are far more common among low-income families, the researchers said. Among the general population, about 10 percent of children ages 2 to 5 are believed to be overweight (defined as weighing more than 85 percent of other children of the same age and sex) or obese (weighing more than 95 percent of children of the same age and sex), Kimbro said.
For the study, the researchers chose children more likely to be low-income, with two-thirds born to unwed mothers.

About 20 percent were not low-income, Kimbro said.
The study found that 32 percent of the urban black and white children were overweight or obese compared with 44 percent of Hispanic children. Although Kimbro said the researchers can't explain those differences, they have some ideas.

Hispanic children ate more fatty foods and were far more likely to be put to bed with a bottle, they said. Fourteen percent of Hispanic children in the study took a bottle to bed, compared to 6 percent of white children and 4 percent of black children, the study said.
The researchers said bottle-to-bed kids were nearly twice as likely to be overweight or obese at age 3.

At Salt Lake City's Guadalupe School, Walker said that putting babies to bed with bottles could be easier for low-income parents working multiple jobs with busy schedules.
Plus, she said low-income families also tend to buy high-starch and high-preservative foods because they hold longer and are less expensive.
The healthier the food the more you are going to pay, she said.

Researchers also found that children with an obese mother had nearly twice the risk of being overweight or obese than children with normal-weight moms.
Children who were breast-fed for at least six months were much less likely to be overweight, the study said. White women were the most likely to breast-feed for six months or more, at 30 percent, compared with 21 percent for Hispanics and 13 percent for blacks.

Of the three groups, Hispanic mothers may be more likely to hold the common cultural belief that chubby children are healthier, the paper says. This value could lead these mothers to provide more food and encourage their children to eat more, resulting in the greater prevalence of overweight in this community. Hispanic mothers are also more likely to worry when their children say they are not hungry and to continue to pressure their children to eat.

In Austin, low-income preschool Hispanic children follow the trend the researchers found, said Dr. Melissa Smith, a pediatrician and medical director of the Seton Community Health Centers, which serve large numbers of low-income, minority families.
I definitely see children that are overweight at that age group .

.. but it's a little surprising that it is twice as much for Hispanics, Smith said.

Hispanics face many barriers to good health, including poor access to care and a diet lacking in sufficient fresh fruits and vegetables, she said.
Instead of letting children watch TV, which was high across all three study groups, Smith recommended that parents emphasize play, exercise and family outings.
In her practice, she sees increasing numbers of children with type 2 diabetes, which used to called 'adult-onset diabetes' and is related to obesity.

Texas doesn't have data on type 2 diabetes in children, but the rate for adults is slightly higher than the national average.
Dr. Larry Deeb, president of medicine and science at the American Diabetes Association, said the study is sobering.

I have now given up being astounded, he said. Every time the new data comes out, it's more than I ever would have believed.
The study, he said, points to the impending disaster we have with diabetes that's looming over America.

Researchers cite poverty, isolation
December 5, 2006
By Stephen Smith
Puerto Ricans in Greater Boston are in the midst of an epidemic of depression, researchers reported yesterday, with 58 percent of middle-aged women and 38 percent of middle-aged men diagnosed with the condition.
The findings emerged from a major ongoing study of Puerto Rican health conducted by researchers at Tufts and Northeastern universities who are using four-hour, in-person interviews and blood and urine tests to look at a range of health issues in the state's largest Hispanic group. The study, the most elaborate portrait ever of the medical status of Puerto Ricans in the Boston area, has also found alarmingly high rates of diabetes and obesity.

But researchers said it was the findings on depression that especially stunned them -- more than two-thirds of the Puerto Ricans who said they were diagnosed with depression reported taking medications to control the disease.
Researchers and specialists in the study of health disparities attribute the high rate of depression to the stress of poverty, social isolation, chronic disease, and poor diet.
The levels of depression among Puerto Ricans were higher than what the researchers had found in an earlier study, which also included white, non-Hispanics from the same neighborhoods.

In that study, only 22 percent of the whites reported ever having been diagnosed with depression. The current research project is looking exclusively at Puerto Ricans, who number more than 27,000 in Boston alone.
Previous large studies have shown that depression is more common among members of ethnic and racial minority groups than among white, non-Hispanics.

We were shocked when we looked at this data, said Katherine L. Tucker , the Tufts professor directing the research. It's an epidemic, it's a crisis.

The findings spurred an immediate call to action by local Hispanic leaders, with one state representative promising to share the research on Beacon Hill. The executive director of a leading Hispanic social service agency, where clients regularly report struggling with depression, said the study provides statistical proof of something long recognized anecdotally.
It is a wake-up call, said Janet Collazo , chief of La Alianza Hispana .

Now, we have facts that are showing a reality.
That reality is also evident to a physician at Massachusetts General Hospital not involved with the study. Dr.

Joseph Betancourt , director of the hospital's Disparities Solutions Center , said that half of the Hispanic patients at the hospital's Chelsea diabetes clinic report bouts of depression.
An increasing body of medical evidence suggests that diabetes and depression are frequently linked, making it imperative to address both conditions, Betancourt said -- especially among Puerto Ricans, who face a daunting host of social, economic, and health woes.
If you look at this population, they really have what I would consider the perfect storm for disparities for health and health care, said Betancourt, who spent five years of his childhood in Puerto Rico.

The health status of Hispanics has historically received scant attention from researchers, who have more often examined the divide between whites and blacks, said Betancourt, who is involved in a citywide drive to better understand racial and ethnic disparities in health. And on those few occasions when Latinos have been classified as a separate group by national researchers, those studies have rarely differentiated among different segments of the Hispanic community.
The preliminary results released yesterday include more than 1,000 Puerto Ricans between the ages of 45 and 75.

The participants have lived in the mainland United States for an average of 36 years, and have a median income of $10,200. And a significant proportion said that they felt they had not adapted to the dominant, English-speaking culture.
Their depression, they said, was often fueled by the sight of relatives departing Boston for warmer climes.

They constantly referred to their social networks being undermined by people picking up and leaving, said Northeastern researcher Luis Falcón .
The study also looked beyond depression at other health measures, including obesity, diabetes, and indicators of stress in the bloodstream, such as nutrient deficiencies.
The researchers found that 66 percent of the women in the study and 44 percent of the men were obese, compared, according to previous research, with 18 percent overall statewide.

In a related finding, 41 percent of study participants said they had been diagnosed with diabetes; a 2006 state study reported that 6.4 percent of adults statewide indicated they suffered from the condition.
And Hispanic diabetics are three times more likely than the average diabetic to end up on dialysis, said Dr.

Francisco Trilla , who practices at a clinic in Jamaica Plain.
Let's try not to continue on the same path, Trilla said. Let's take important data, let's be shocked by it.

We need to do better.
The researchers at Tufts and Northeastern are trying to do exactly that.
To help address the underlying stress-related nutrient deficiencies, researchers are mailing vitamins and other supplements to 135 of the participants.

Researchers will follow them -- as they will all of the study participants -- for two years to see if their health changes.
Hoping to relieve depression, researchers also have a pilot study designed to encourage Puerto Ricans to gather for social activities. But participants have dropped out in significant numbers, citing poor health, family emergencies, and difficulties communicating with taxi drivers.

Jenny Cintron , who participated in the study, is not depressed herself, but traces rampant depression in her community, in part, to a reluctance to leave the familiar confines of home.
In the Puerto Rican community, I know people who don't go outside of the house -- they're taking care of the kids, their parents, their grandparents, the household chores, said Cintron, 46, who lives in Dorchester. Who wouldn't go crazy?

Raymond Rassi , then nearly 50, decided to participate in the study in 2005, after spying a poster advertising it at his local library. Though he does not suffer diabetes or other chronic conditions, he knew, as a Puerto Rican, that he is genetically at risk for them.
And if I'm going to be predisposed to this, I wanted to know: 'What can I do to prevent it?

' said Rassi, who lives in Chelsea.
So the researchers started asking him questions about what he ate and how often he exercised. In a week, how often do you eat fruit?

Once, he told them. What about vegetables? Twice.

That told me something, he recalled. And I found that doing simple things like changing a tire was exhausting me.
He was so sobered by the questioning that he decided to forgo trips to fast-food joints while adding more fiber to his diet.

He increased his physical activity, too.
The result: Rassi, now 51, weights 178 pounds, down from 208. And he's training for the Boston Marathon.

November 16, 2006
By LAUREL NAVERSEN GERAGHTY
THE light-brown complexion of Vilda Vera Mayuga glows in a way that suggests she devotedly visits a dermatologist, sits for facials or drowns her skin in expensive creams and serums. But Ms. Mayuga, 30, a lawyer and native Puerto Rican who lives in Manhattan, hasn’t been to the dermatologist in more than five years.

Instead, she relies on remedios caseros — home remedies that the women in her family have used for generations — as the cornerstone of her otherwise spare skin-care regimen.
“I like to use the cream that comes out of the cactus,” she said, referring to sabila, or aloe vera, which she uses for dry skin, dark spots and scars, her most common problems. “You cut it and you squeeze it out and you boil it, and then you put it against your skin.

”
It is no secret among physicians that natural remedies like these are popular among Hispanics in the United States. But skin care companies with products to sell are nonetheless setting their sights on Latinos — the nation’s fastest-growing ethnic group, which the United States Census Bureau projects will make up one-fifth of the population by 2030 and one-quarter by 2050.
“I don’t think it’s lost on anyone that our population is shifting,” said Margo Weitekamp, vice president for new ventures at Johnson Johnson Consumer Products Company.

That’s why, in 2004, her company bought AMBI Skincare, a brand made for black women, and has since adapted it to appeal to women of Hispanic and Asian descent, too. Their products include fade creams, a moisturizer with sunscreen and an acne-clearing treatment to help reduce the dark marks that pimples can leave behind.
Neutrogena and Aveeno Active Naturals, also owned by Johnson Johnson, now offer a scrub, a peel, a night treatment, an eye cream and moisturizers to even the skin’s tone or erase lingering acne marks — common concerns among Hispanics.

Meanwhile, Avon, which has a devoted Latina following, allocated nearly 15 percent of its media expenditures to Hispanic-specific ad campaigns in 2004, the last year tracked, and Procter Gamble spent nearly $150 million on Hispanic-geared media, according to the market research firm Mintel International Group.
But even as marketers try to develop new products and appeal to the needs of the Hispanic community — a multitude of ethnicities — a larger question remains of whether Hispanic skin differs among its subgroups and from other ethnicities and if so, how.
“The answer is that no one really knows for sure,” said Dr.

Jeffrey Dover, an associate clinical professor of dermatology at the Yale University School of Medicine, who licenses his line, Skin Effects by Dr. Jeffrey Dover, to CVS.
Dr.

Roopal V. Kundu, director of the Center for Ethnic Skin at Northwestern’s Feinberg School of Medicine in Chicago, said she believes that there could be qualities and characteristics shared by many Hispanics that are not common to non-Hispanics. But the research is thin.

“As a scientist-dermatologist, it would be nice to know if there was actually some sort of structural or biological difference” among ethnicities, Dr. Dover said. “We’d understand the mechanism of disease better, and we’d find treatments better, and we wouldn’t be just guessing with ones that really don’t work very well.

”
In a comprehensive review of scientific studies that have been conducted on ethnic skin, Naissan O. Wesley and Dr. Howard I.

Maibach of the University of California, San Francisco, found few studies devoted to Hispanics. But writing in 2003 in the American Journal of Clinical Dermatology, they examined objective data for 10 characteristics aside from pigmentation and concluded that the evidence for nonpigment distinctions between Hispanics and others was “contradictory” and “inconclusive.”
THE problem is compounded by the fact that Hispanic is a broad category.

“Basically people have been doing these studies in ‘Hispanics,’ in quotation marks, and I say, ‘Well, who was your group — Mexican-Americans, Puerto Ricans?’ ” said Dr. Miguel Sanchez, an associate professor of dermatology at New York University School of Medicine, who lectures on Latino skin.

Academic centers like the Center for Ethnic Skin are hoping to further the research devoted to Latinos. Physicians, too, who are seeing more Hispanic patients, are striving to learn how to better treat their skin.
Nowadays dermatologists recognize that there are variances, differences in the way that ethnic skin behaves,” Dr.

Sanchez said of pigmentation, “and so they have actually been flocking to courses at conferences.”
Dr. Gary Brauner, associate clinical professor of dermatology at Mount Sinai School of Medicine in New York, said that because “descriptions of all classic dermatologic diseases are descriptions on white people,” dermatologists often find it difficult to discern harmful conditions in patients who have skin that’s medium-brown or darker.

“You may see black lesions growing all over the place and you think, ‘My God, do they have melanomas all over?’ ” he said. “When in fact, they are just ordinary moles or very dark seborrheic keratoses, just spots you get as you get older.

”
Other skin issues also stand out among people of Hispanic descent. Inflammatory conditions like acne or eczema can leave lasting dark marks, Dr. Kundu said.

Melasma, dappled pigment across the forehead, cheeks and upper lip, is common in women. There’s also ashy dermatosis — grayish blotches on the limbs and trunk — and vitiligo, a disease of pale patches of skin.
Such pigmentary disorders can be so severe that they “ruin some women’s lives,” Dr.

Dover said.
Hispanic women said that even a mild injury to the skin — a nick, a burn, an hour in the sun or an adverse reaction to a drug — may contribute to hyperpigmentation that lasts for weeks or even months. “If I even have a scratch, it will turn a little dark,” said Damarys Vargas, 42, a portfolio manager at Citicorp in Manhattan.

Still, the biggest concern of many dermatologists is not appearance but rather that their Hispanic patients are facing an increased risk for skin cancer. The disease is on the rise among Hispanics in the United States, and diagnosis is often made weeks or months later than it is for Caucasians, Dr. Sanchez said.

“We think because we have a better ability to tan, we don’t need to wear sunscreen, and then when we start getting skin cancer, we’re shocked,” said Dr. Flor A. Mayoral, a Miami dermatologist who has lectured or done research for a few pharmaceutical and dermatology companies.

Dermatologists recommend that even Latinas with dark skin guard against the sun by wearing sunscreen with S.P.F.

15 or higher. Doctors also urge Latinas to seek medical treatment if a mole bleeds or looks uneven, or if skin changes become distressing.
“Folk remedies that are so common in the Hispanic communities are wonderful things,” Dr.

Sanchez said. “We just want people to remember that should not be a substitute for traditional medicine when things are not going well.”
A Californian nutrition council has published guidelines for Hispanic consumers in an effort to encourage good nutrition amongst the nation’s most unhealthy population.

November 15, 2006
By Lorraine Heller
The nutrition information, published by the Dairy Council of California, places strong, but not exclusive, emphasis on dairy products.
The industry body said it aims to help families make good food choices even when limited by busy time schedules. The recommendations could further prompt the dietary supplement industry to follow suit and target the specific needs of the Hispanic population.

With today's families having less time together due to more mothers in the workplace and busier schedules overall, making every effort to have family meals at home will allow parents to not only watch what their kids eat, but also give parents the opportunity to act as role models, which can be a very effective tool in keeping kids healthy, said Monica Montes of the Dairy Council of California.
The group yesterday announced that its website MealsMatter.org provides nutritional tips in Spanish as well as English, to cater for the nation’s growing Hispanic population.

Latin foods are full of flavor, and making simple changes to traditional recipes will significantly improve the nutrition content of the dishes. Cooking with low-fat milk and reduced-fat cheeses keeps the flavor while eliminating extra fat, said Montes.
Other suggestions include baking or grilling meats and vegetables instead of frying them, or serving kids low-fat milk instead of soda to boost nutrients and help eliminate extra sugar in their diets.

Indeed, with the buying power of Latinos last year totaling $768bn, the growing importance of this consumer segment has resulted in a stream of new foods and flavors appearing on the US market, designed specifically to appeal to Hispanic tastes.
And this consumer group is only set to grow further.
According to estimates by Hispanic Telligence, based on an analysis of US Bureau of Economic Analysis figures, the Hispanic purchasing power between 1994 and 2004 revealed a compound annual growth rate of 7.

7 percent- nearly three times the 2.8 percent total US rate of disposable income.
But Hispanics are twice as likely as Caucasian Americans to develop diabetes, according to the American Diabetes Association.

Two million Hispanics currently suffer from diabetes, while over 60 percent are classed as overweight.
This “genetic predisposition” to health has prompted a number of nutrition groups to encourage good eating habits designed specifically for this segment of the population.
Indeed, one nutrition organization, the Latino Nutrition Coalition (LNC), recognized the need for separate guidelines for this group as early as 1996, when it established a dietary pyramid for Latinos.

Set up by nutrition advocacy group Oldways and sister group to the Whole Grains Council, the LNC this year introduced a booklet designed to back up the pyramid, which was based on the concept of the US Department of Agriculture's original model of a dietary pyramid.
Available in supermarkets, the guide provides visual and easy-to-understand dietary guidelines and also recommends certain product brands belonging to members of the coalition when these fit in with the diet plan.
Because of an elevated and potentially more risky use of personal audio technology, Hispanic adults appear to be more at risk for hearing loss and may already be experiencing hearing problems at a higher rate than adults, Hispanic teens, and teens in general.

Even though Hispanic adults in many cases are less likely to use personal electronic devices (they are less likely than adults overall to use cell phones, Walkman/portable CD players, and portable television/DVD players) they use these products less safely than adults in general. In addition, they are more likely than adults in general to use iPods and MP3 players, which are generally used with earphones.
Teens overall tend to use the cell phone at higher rates that the other groups, however, very few use cell phones with earphones, thereby eliminating some of the risk to hearing involved in using cell phones.

Looking at the typical length of use for each of the electronic devices tested, Hispanic adults are nearly always more likely to use these devices for longer periods of time and they are in every case except for cell phones, more likely than adults overall to have the volume turned loud. For many of the devices, nearly half of Hispanic adults use them for one hour or more during a typical session. Teens in general are more likely than adults in general to use most of these products for longer periods of time and at higher volume.

Hispanic teens, when comparing their use of iPods and other MP3 players with teens in general, use these devices for longer periods and at higher volume. Among Hispanic teens, boys are more likely to use iPods for longer periods than girls and at higher volumes, but for other MP3 players, the reverse is true — Hispanic girls are more likely than boys to listen for longer periods at higher volume.
In addition to playing most of these personal devices louder than adults in general, Hispanic adults are slightly less likely to have purchased specially-designed earphones for use with these electronic devices.

While both Hispanic teens and teens in general tend to play their electronic devices at higher volume, they are also slightly more likely than adults, both Hispanic and in general, to have purchased specially-designed earphones to lessen the risk of hearing loss.
Hispanic adults are more likely than adults in general to say they are concerned about hearing loss (67% vs. 58% all adults) and they are more concerned than all adults with hearing loss due to the use of earphones (49% vs.

33% adults). They are also much more likely than adults overall to be concerned about hearing loss in their children (77% vs.59%).

In keeping with their deeper concern about hearing loss, they are more likely than adults in general to say they are likely to turn down the volume, to cut down on the length of time they listen, and to purchase specially-designed earphones.
Equal percentages of adults in general and teens in general (48% each) say they are not concerned about hearing loss from use of these products, while teens in general (52%) are much more likely than adults (33%) to say they are concerned. Hispanic adults (49%) and Hispanic teens (58%) are much more likely than adults and teens overall to express concern about hearing loss.

Despite this concern, more than half (58%) of teens in general and 44% of Hispanic teens say they are not likely to cut down on the time they use these devices and three in ten of both sets of teens are not likely to turn down the volume. A majority of both Hispanic and all teens say they are not likely to purchase specially designed earphones to prevent hearing loss.
It is disturbing that just half of teens overall (49%) and Hispanic teens (51%) say they have experienced none of the symptoms that can be associated with hearing loss, compared to 63% of adults overall and 53% of Hispanic adults who say this.

And perhaps more disturbing is that Hispanic teens (19%) and teens in general (17%) are more likely than their adult counterparts to have experienced tinnitus.
Television appears to be the best way to reach both Hispanic adults and their children. Half say television is the best way to reach children with a message about the risk of hearing loss, compared to one in three adults in general who feel this way.

When asking Hispanics which Spanish media they watch, more than half say Spanish-language television programs and finally, when asking what is the most effective means of reaching them, 57% say English-language television.
Finally, for all four groups, television is the best way to reach children, teens, and young adults about the possible risk of hearing loss associated with using these devices. Hispanic adults and teens in particular (50% each) say television is the best way to go.

For all adults, disseminating the information through family and friends is nearly as effective as through television (29% and 32%, respectively). Teen magazines could play a role in informing teens as they were more than twice as likely as adults to say this was a good way to contact them, especially the girls in both teen groups.
Clearly there is an interest and a need for outreach to teens in general and to both teens and adults in the Hispanic community on this issue.

These three groups are more likely than adults in general to engage in risky behavior regarding their hearing. This, of course does not mean there is not a problem among all adults. All four groups indicate some level of risky behavior and a concern about hearing loss, but less willingness to engage in behaviors that cut the risk like turning down the volume or purchasing specially-designed earphones.

Television is clearly the media to use to reach the greatest number of people and using English-language media, especially television, to reach Hispanics of all ages could be beneficial.
Posted by Juan G. Tornoe on November 15, 2006 at 16:51 in | November 7, 2006
By ASHIMA SINGAL
Linda Landaverde loves beans.

She eats them almost every day.
Unfortunately, she has to count how many she eats to limit her intake of starchy carbohydrates.
Ms.

Landaverde of Orlando, Fla., has type 2 diabetes, an illness she's been living with for almost eight years.
Until about a month ago, she says, she managed the disease poorly.

Her food choices, based on Latino tastes, weren't the most diabetic-friendly meals. But she just couldn't stomach the foods her doctors and nutritionists recommended, such as salads and fruits. They weren't staples of her ethnic menu.

I'm not a very big salad eater, says the 55-year-old court interpreter.
Ms. Landaverde, who is from Puerto Rico, would eat her traditional meals and sometimes suffer from widely varying glucose levels as a result.

Chronic dry mouth, lightheadedness, cold and hot sweats, and sometimes even vertigo are a few of the symptoms caused by low or high blood sugar.
After she attended a diabetes seminar for Spanish-speaking residents recently, Ms. Landaverde learned more about her illness and how to maintain her glucose levels.

About 20.8 million Americans have diabetes, which was the sixth-leading cause of death in 2002, according to the American Diabetes Association.
Diabetes disproportionately affects Hispanics and blacks.

Mexican-Americans, for example, are 1.7 times more likely to get diabetes than non-Hispanic whites, according to the diabetes association.
Some researchers attribute the disparity in these minority groups to genetics, along with lack of exercise, obesity and diet.

Retired dietitian Dolores Rosario, 73, says she also sees lack of money for more healthful foods and proper health insurance as a barrier.
And because of that, Hispanics become more obese, and that makes the condition more difficult, she says.
In North Texas, registered dietitian Zela Daniel addresses economics with Hispanic families in a pilot program for the Garland Independent School District.

The bilingual nurse-specialist and diabetes educator for the district works with the parents of children who may have the precursors of diabetes to improve the whole family's diet.
Parents have to change the groceries they buy, she says. I usually ask for their income so I can help them prepare a meal that's not going to break the bank.

We work with the whole family.
Besides looking at what families can afford, she looks at where they buy groceries and how to get the most for their budget.
Josephine Mercado, director of Hispanic Health Initiatives in Florida, says, The idea is to empower the patient so that they could do something for themselves.

Most of the people don't know the resources that are out there for them.
The initiative is being funded by a $60,000 grant, given in July by the Blue Foundation for a Healthy Florida, a charity branch of Blue Cross and Blue Shield of Florida.
Locally, the Dallas Concilio of Hispanic Service Organizations sponsors several programs that teach Hispanics about diabetes and diet, says health outreach specialist and American Diabetes Association volunteer Cynthia Villalobos.

Although the programs most often contact Hispanics through schools or community clinics, any group can request a presentation, in Spanish or English.
Wherever we're able to do it and give classes, Ms. Villalobos says, we will.

Hispanic food brands are taking notice of the growing health concerns.
Popular Latino brands, including Iselitas and Goya, are adding whole grain, light versions, sugar-free, no cholesterol, reduced fat, zero grams trans fat, and low-carb choices to their product lines.
The so-called Latino paradox puzzles medical experts, who seek the answer in diet, lifestyles and support networks.

August 28, 2006
By Juliet Chung
Thousands of Latino patients stream though the East Los Angeles practice of Dr. Hector Flores and his partners each year.
The older ones go to the family practice with arthritis and hypertension, the younger ones with diabetes and asthma.

What surprises Flores, however, is not how sick they are, it is how sick they are not.
Overall, Flores said, his patients are much healthier than one would expect given their low levels of income and education, factors epidemiologists long have known are linked to poor health.
You can predict in the African American population, for example, a high infant mortality rate, he said recently, so we would think a [similarly] poor minority would have the same health outcomes.

But they don't. They're not there, he said, referring to outcomes among Latinos.
Why Latinos aren't sicker — a phenomenon known to health experts as the Latino paradox — is puzzling to public health experts, given the link between disadvantage and high disease and mortality rates.

In overall mortality rates and infant mortality rates, two standard measures of a population's health, Latinos' numbers approach and sometimes surpass those of whites.
In Los Angeles County in 2003, the age-adjusted mortality rate for Latinos was 535 per 100,000, 33% less than for non-Hispanic whites and 52% less than for blacks, according to the most recent data from the county's Department of Public Health.
Nationally that year, Latinos' mortality rate was 621, 25% less than whites' and 43% less than blacks', according to National Vital Statistics Reports, published by the Centers for Disease Control and Prevention.

Latinos' infant mortality rates reflect a similar pattern. Locally, the rate was 5.2 per 100,000 in 2003, 16% higher than whites' and 57% less than blacks'.

The national rate was 5.7, about the same as whites' and 58% less than blacks'.
It violates one of the most predictable patterns we see in most areas of the world and for most diseases, said Dr.

Paul Simon, chief epidemiologist for the county's Public Health Department.
The question is, 'What is the Latino population doing right?'
The reasons for the paradox are a matter of some debate.

Some scholars attribute it to immigration, which may draw selectively from the ranks of the hale and hardy.
Another possibility is that many immigrants return to their home countries when seriously ill, skewing mortality statistics in this country.
But increasingly, researchers are suggesting that such factors as diet, lifestyle choices and strong social support networks are the key to Latinos' better-than-expected health.

They're not taking some secret Aztec herb they didn't tell you about, said David Hayes-Bautista, an early observer of the Latino paradox who directs UCLA Medical School's Center for the Study of Latino Health and Culture.
It's worth figuring out what is making the difference, he added, because we could all be better off for it.
As the immigration debate heats up and the cost of healthcare soars, the phenomenon is attracting attention from social scientists and public health officials.

It was first noticed, though, in the 1970s and 1980s by researchers looking at infant and overall mortality rates in Texas and California.
Scholars tended to view the findings as wrong or anomalous, assuming that Latinos' relatively disadvantaged socioeconomic status put their health status more on par with blacks'.
As data accumulated, covering broader swaths of the country and longer periods, skepticism turned to curiosity.

Kyriakos Markides, who in 1986 coined the term Hispanic epidemiological paradox, described scholars' shift in recent years as remarkable.
Nobody talked about it then, said Markides, a professor of socio-medical sciences at the University of Texas Medical Branch, speaking of a generation ago. People just ignored the data or assumed that disadvantaged populations have high mortality.

Now, it's the leading theme in the health of the Hispanic population in the United States.
The paradox remains controversial, in part because its first-blush message — that Latinos are less ill than expected — might lead people to believe that the group doesn't need scarce healthcare dollars.
Hayes-Bautista recalled an incident in the 1990s when a colleague he had just briefed on the paradox asked him to keep the data to himself, saying she feared services for Latinos could be cut.

I guess it's the triumph of — I hate to say — of ideology over data, he said.
In addition, some doctors and other medical professionals aren't familiar with the concept, which is a broad statistical phenomenon, not necessarily true in individual cases or practices.
Even some who are aware of the phenomenon question its significance, saying they still must focus on treating individuals.

Somebody at 36,000 feet can stand back and say this is all true and verified, but I still have a clinic full of diabetics, hypertensives, people with high cholesterol, said Dr. Felix Nuñez, the medical director of South Central Family Health Center, a Los Angeles clinic that serves a large Latino population.
Scholars also note that it seems to apply more to some diseases than to others.

Data suggest Latinos experience less lung and breast cancer than whites, but they also are more likely to have diabetes, cervical cancer and AIDS.
The paradox's power appears variable, too, waning by some measures with each generation and fluctuating by place of origin. Some researchers say that, for unclear reasons, it is most apparent among Mexicans and less so among Puerto Ricans.

You never get a complete picture of what's going on, said Alberto Palloni, a sociology professor at the University of Wisconsin and president of the Population Assn. of America. You get patches, halfway photographs of what is happening.

Studies have indicated, however, that Latinos drink less alcohol and smoke less than their white counterparts, although their healthful behaviors appear to wane with greater acculturation in the United States.
Several studies have found that the children and grandchildren of foreign-born Latinos tend to smoke, drink and use illegal drugs more than their parents and grandparents. And some research suggests that they are less likely to breast-feed or stick to the healthier diets of their forebears.

You can see it in obesity rates; they're very high in Mexican children, said Dr. Leo Morales, an associate professor of medicine and public health at UCLA who has written about the paradox.
That portends high disease rates for cardiovascular disease, diabetes, all the obesity-related complications.

Ana F. Abraido-Lanza, an assistant professor at Columbia University's Mailman School of Public Health, cited a greater availability of fast food in the United States and social factors, including a more relaxed attitude toward drinking.
Another possible culprit is stress.

A 1999 study published in the journal Social Forces found that Puerto Rican women who had recently moved to the mainland United States reported fewer stressful life events than mainland-born peers, such as being physically abused or being close to someone with a serious drug or alcohol problem.
Strong social networks could be helping them.
A strong family and social network can reduce stress and can provide emotional support during difficult periods, Simon said.

All those things translate into people living longer and living healthier.
A yet-to-be-published study of Chicago neighborhoods found that in enclaves with high numbers of Latino immigrants, 5% of such immigrants had asthma, a lower percentage than for whites, blacks and U.S.

-born Latinos in the same area.
That figure jumped to 22%, higher than for all other groups, among Latino immigrants when they lived in neighborhoods with few of their immigrant peers, even when such factors as health insurance and poverty were accounted for.
There seems to be something about neighborhood social context that matters, said Kathleen Cagney, a University of Chicago assistant professor and lead author on the study, which is to be published in the American Journal of Public Health.

In this case, Cagney said, she believes the trust and solidarity in their neighborhoods led foreign-born Latinos outdoors and away from indoor irritants such as mold and cockroach infestations.
No expert offered a comprehensive explanation of the paradox, and some wondered whether one was possible.
In some ways, it's like the more you get into it, the more complex it seems, said Dr.

Elena Fuentes-Afflick, a professor of pediatrics at UC San Francisco.
Like Flores, she believes the truth ultimately will involve a combination of factors.
UCLA's Hayes-Bautista believes the answer exists, if only health experts look hard enough.

There must be an explanation, he said. We just need to put the time in to understand.
August 5, 2006
Source:
Hispanic and African American working-age adults in the U.

S. are at greater risk of experiencing gaps in insurance coverage, lacking access to health care, and facing medical debt than white working-age adults, according to a new report from The Commonwealth Fund.
Sixty-two percent of Hispanic adults ages 19 to 64--an estimated 15 million adults--were uninsured at some point during the year, a rate more than three times as high as that for white working-age adults (20%).

Uninsured rates for working-age African-American adults are also high, with one-third (33%)--more than 6 million adults--uninsured or experiencing a gap in coverage during the year.
Uninsured rates for low-income Hispanics are exceptionally high: three-quarters (76%) of Hispanic adults with incomes below 200% of the federal poverty level had a time uninsured, compared to 44% of African Americans and 46% of whites with low incomes. Disparities persist across income levels--forty percent of Hispanic adults with incomes over 200% of poverty were uninsured during the year, compared to about one-quarter (23%) of African American adults and 12 percent of white adults in that income group.

The report, Health Care Disconnect: Gaps in Coverage and Care for Minority Adults, by Commonwealth Fund researchers Michelle M. Doty and Alyssa Holmgren, analyzes data from the Commonwealth Fund 2005 Biennial Health Insurance Survey.
These findings are extremely troubling, and indicate missed opportunities to ensure a healthy and productive workforce, said Commonwealth Fund President Karen Davis.

Minority Americans face persistent disparities in rates of health care coverage, as well as cost and access barriers to care even when they do have health insurance.
Survey results reveal that a high proportion of Hispanics are disconnected from the health system, and uninsured Hispanic adults are at especially high risk for not getting needed care. More than one-fourth (27%) of uninsured Hispanic adults with health problems had no doctor's visit in the past year, compared to 17 percent of African American and white adults.

Hispanics are also least confident about being able to self-manage chronic diseases or health problems. Thirty-one percent of uninsured Hispanic adults with health problems said they were not too or not at all confident about managing health problems, compared to 16 percent of African American adults and 17 percent of white adults with health problems.
African American adults have higher rates of health problems among both lower and higher income groups.

Sixty-three percent of African American adults under 200% of poverty reported they had one of four chronic diseases (hypertension, heart disease, diabetes or asthma) or a disability, compared to half of low-income whites and 39 percent of low-income Hispanic adults. Forty-five percent of African American adults over 200% of poverty report health problems, compared to 32 percent of whites and 23 percent of Hispanics in the higher income group.
Sixty-one percent of African American adults who were uninsured during the year reported medical bill or debt problems, compared to 56% of uninsured white adults and 35% of uninsured Hispanic adults.

* About one-third (36%) of African American adults visited an emergency room for a condition that could have been treated by a regular doctor if one had been available, compared to 19% of Hispanics and 19% of whites.
* Just three-quarters of Hispanic adults had their blood pressure checked in the past year, compared to 94 % of African American adults and 90% of white adults.
* Half (51%) of Hispanic adults had a dental exam in the past year, compared to 60% of African American adults and 65% of white adults.

The authors conclude that insurance plays an important role in reducing racial and ethnic disparities in access to care. However, expanding insurance coverage among African Americans and Hispanics, alone, will not ensure equal access and equal care. Policies that seek to improve the availability of on-going care relationships with health care providers and promote continuity in care would also benefit minority Americans and improve access and quality of care.

Posted by Juan G. Tornoe on August 07, 2006 at 23:09 in | July 28, 2006
By CHRISTINA KRISTOFIC
Hanover Hospital is making changes.
And hospital officials hope other local organizations join them in doing what it takes to make local Hispanics feel at home.

Flavius Lilly, vice president of organizational and community development for the hospital, said the hospital and Adams-Hanover Counseling Services decided last year they needed to develop a better understanding of the Hispanic community.
The two agencies hired Dr. Carol Vidal, a Spanish psychiatrist, to study the Hispanic community in Hanover, identify the community's needs and recommend ways to address those needs.

Vidal interviewed Hispanic community leaders and focus groups of local Hispanics from January through April. And Hanover Hospital and Adams-Hanover Counseling Services released her report today.
The report reveals that many of Hanover's Hispanics are undocumented workers who live underground for fear of being deported.

Lilly said it's a difficult thing for hospital officials to reconcile – helping people who are obviously breaking federal laws.
I think most people would agree that if somebody is ill and they need medical care, Hanover Hospital's going to be there to provide it, whether or not you're documented, he said.
Our mission statement says we serve all people regardless of their backgrounds and ability to pay for medical services.

And before the hospital and Adams-Hanover Counseling Services can minister to the needs of local Hispanics, they must understand those needs, he said.
Vidal's report shows: The Hispanic populations has limited access to social, public and health-education services; English proficiency, work hours and illegal-immigrant status are barriers to health and wellness; Prejudice, discrimination and cultural misunderstanding make it difficult for Hispanics to call America home; Hispanic youths are at high risk for unhealthy behaviors.
To address those needs, Vidal has suggested the hospital offer English classes for Spanish speakers, provide educational and wellness programs in Spanish, improve translation services at the hospital and affiliated facilities, and plan community events to foster cultural understanding.

Lilly said the hospital is already working on following several of Vidal's recommendations, including offering Spanish classes for local Hispanics at the Wellness Center.
The hospital is also trying to identify bilingual staff members who could help translate until it can implement a more permanent solution.
July 21, 2006
Via
Obesity is a chronic disease that currently affects nearly one-third of the adult American population, 15.

5% of adolescents ( ages 12-19), and 15.3% of children ( ages 6-11). Obesity in children and adolescents has many health and social consequences that often continue into adulthood; the increase in obesity rates for children has been especially significant, rising from 5-7% to more than 15% in just two decades.

Latinos and their children have been particularly affected by the growing prevalence of
overweight and obesity. In 2005, at least one in four Hispanic adults living in the U. S.

was obese (having a Body Mass Index of 30 or more). More than one in six (16.8%) Hispanic high school students in overweight.

Hispanics' rates of being overweight are significantly higher than White high schoolers (11.8%) and about the same as Blacks ( 16.0%) of the same age.

An additional 16.7% of Hispanic high school youth are at risk of b becoming overweight. This trend continues among even young Latinos.

Mexican American children ( ages 6-11) are more likely to be overweight than non-Hispanic Black children and non-Hispanic White children (24%, 20%, and 12% respectively). Even at the preschool level, Mexican Americans are more likely to be overweight ( 11%) than their non-Hispanic Black ( 8%) and White (10%) counterparts.
As the largest racial and ethnic minority population in the United States, Latinos are also the youngest; more than 34% of the U.

S. Latino population in 2004 were under the age of 18. As Latino children are a major segment of the Latino population and make up a significant portion of obese or overweight children in the U.

S., this problem is widespread and must become a major focus for the community and the nation.
The majority of national data measuring prevalence of overweight and obesity in the Latino population, collect data among the Mexican American community, the largest subgroup of Latinos in the United States.

While these data can be used to roughly note trends in the Latino community, they do not reflect the full diversity of the Latino population in the United States.
Who is at risk of obesity?
Obesity rates tend to follow a socioeconomic slope and have a greater effect on people with limited resources, racial-ethnic minorities, and the poor.

Genetics: Children of obese or overweight parents are at greater risk of becoming obese or overweight. Hispanic adults experience high rates of obesity and their children are likely to be obese, as well.
Diminished physical activity: Nearly half ( 47.

6%) of all Hispanic live in central city households which often lack opportunities to be physically active and lack resources for proper wellness care. Many poor urban families typically live in neighborhoods where getting exercise and being able to play outside is less feasible and even dangerous.
Greater reliance on high-calorie and high-fat foods generally associated with poverty and food insecurity: Food insecurity affects 21.

7% of Latino households compared to 8.6% of non-Hispanic White households. Access to quality foods and nutrition is important in overall health and nutritional well-being; many families with lower incomes and food insecurities purchase and consume foods with lower nutritional value and higher calories and fat content.

With less security of adequate nutrition, Latino adults and children are more at risk of being overweight or obese.
What are the effects of obesity on the community?
The health risks that result from overweight and obesity can significantly contribute to rising costs in health care.

Obesity is a risk factor for many health complications, including low self-esteem and depression, type 2 diabetes, pulmonary complications such as asthma, sleep apnea, hypertension, cardiovascular disease and conditions, some cancers, and arthritis. In 2003, the estimated costs of health complications that resulted from obesity were $75 billion and continue to grow.
Teenage weight is often predictive of adult weight; it is thus important to begin addressing overweight and obesity issues at an early age.

Children are at higher risk of a variety of adverse health effects associated with being overweight and obese, including:
* Asthma
* High blood insulin levels leading to type 2 diabetes
* Elevated blood pressure levels
* Increased stress on bones and cartilage resulting in poor development of each one, as well as cause pain and limit range of motion
* Sleep apnea
* Psychosocial consequences, including low self-esteem.
What can be done to help prevent obesity?
It is important to teach healthy eating behaviors and exercise models early in a child's life since what we experience as children often contributes significantly to our habits as adults.

However, as long as Latinos continue to face challenges accessing quality, affordable, and healthy foods, in conjunction with limited opportunity to be physically active, it will be difficult to fight the growing epidemic of obesity and decrease the health risks that are associated with being overweight. Policies which shore up access to food assistance, break down enrollment barriers, enhance culturally-competent nutrition counseling and encourage physical activity all play an important role in ensuring that Latino households can greatly enhance their health and well-being.
June 22, 2006
BY NANCY MCVICAR
They share the same socioeconomic disadvantages as other minority groups, but Hispanic women have fewer low-birth-weight babies and lower rates of premature births than black and white mothers, South Florida researchers have found.

An 11-year study by Dr. Victor Hugo Gonzalez-Quintero and colleagues at the University of Miami Miller School of Medicine reviewed more than 80,000 deliveries at Jackson Memorial Hospital, and found Hispanic mothers had the lowest rate of low-birth-weight infants, 9 percent, compared with 18 percent for non-Hispanic black mothers and 11 percent for non-Hispanic white mothers.
Researchers say they are not sure why, but suspect family and cultural influences may be key factors, with many Hispanic families providing care, attention and support for women during pregnancy.

The study, the largest ever done at a single institution to examine the issue, compared the maternity experiences of South Florida women from the Caribbean and Central America and South America with non-Hispanic blacks and whites from Jan. 1, 1989, to Dec. 31, 1999.

During that time, 50 percent of the deliveries in Miami-Dade occurred at Jackson, the principal hospital providing care to the indigent population.
The findings, published in The Journal of Reproductive Medicine, echo previous studies in border states such as Texas and California, where 70 percent of the Hispanic new moms in the studies were of Mexican heritage, Gonzalez-Quintero said.
He wanted to see whether the phenomenon held true across other Hispanic groups, and it did.

South Florida is the ideal place to look at this, Gonzalez-Quintero said. It is fascinating. I think if we could find out why they do better, this could be used to address disparities for other minorities, which should be one of our number one goals of public health.

The study was not an attempt to determine why the Hispanic outcomes were generally better, but there are a number of possible explanations, he said, including family and cultural influences.
They have their ideas about nutrition from their home country, and they may have a higher respect for maternal role. The woman is the center of the household, so when someone is pregnant in the family they are taken care of more cautiously, he said.

Jane Delgado, president of the National Alliance for Hispanic Health, suggested other factors may also play a role.
We know [from earlier studies that] Hispanic women are less likely to smoke or use alcohol, she said. They eat more fruits and vegetables and less processed food, and we welcome babies into our families.

They focus the family resources to help. A baby is considered a gift. It's a very positive thing.

Ada Gonzalez, 38, of Miramar, whose first child, Alana Rosalie, was born at Memorial Hospital West almost 10 months ago, said she got advice and lots of support during her pregnancy from her mom, her aunt and her sister, her husband's family and the neighbors in her largely Latin neighborhood.
They were constantly saying, `Rest,' and they {ellipsis} called a lot. They wanted to help with the cleaning up, and the cooking, and wanted the renovations for the baby's room done early, said Gonzalez, who was born in Puerto Rico.

They told me to make sure to eat a lot of fruit, all the veggies, and the root vegetables. The neighbors brought over plantains to make sure I was getting enough potassium.
Melissa Vazquez, 30, who is second generation Cuban-American, had a similar experience before her baby boy was born a month ago at Holy Cross Hospital.

Both my brothers are in town, and my parents live in Hollywood. They were always telling me to rest and relax, and calling to ask if I'd eaten and what I was eating. I've always eaten healthy, said Vazquez, who lives in Fort Lauderdale.

Thelma O'Connor, 34, of Pompano Beach, went through the pregnancy for her son James, 1, without having her big family around her because most of them are still back in Mexico, she said. But her neighbors, a French couple and a Hispanic mom with a 4-year-old son, looked in on her often and brought food to make sure she ate right, she said.
And my mom is here visiting right now from Mexico, so that's good, O'Connor said.

A Palm Beach County study on access to prenatal care released two years ago showed there are other roadblocks preventing women from getting early prenatal care.
Some did not understand the benefits of early care, and those who had lived in this country for less than five years were unclear about how to get insurance. Other difficulties included a lack of transportation and overbooked and understaffed public health clinics.

But the study, done by a Johns Hopkins University researcher for the Maternal Child Family Health Alliance of Palm Beach County, also found that when pregnant women, whether Hispanic, black or white, were part of a small, tight-knit community, they were likely to get advice on the importance of seeing a doctor early and help in seeking early prenatal care.
June 9, 2006
By Esmeralda Servin
Mexican women are often seen as the family anchor; taking care of the children, husband and, sometimes, parents.
But what happens when a Mexican woman’s health is jeopardized as a result of her caring nature.

“Latina women are always left last on the list. We care for others before we take care of ourselves,” said Irene Lopez, Vice Chair of the “Why Me” program in San Diego.
The Centers for Disease Control and Prevention reports that Hispanic women, particularly those who live in countries along the U.

S Mexico border are less likely to undergo regular screenings for breast cancer.
The “Why Me” program is hoping to change some of those cultural barriers and make a difference in the health of Latina women.
Upbringing is a large factor in how Mexican women care for themselves.

“It’s partly cultural that you don’t touch your body or look in the mirror,” said Lopez.
That notion is a huge barrier in breast care.
“It’s important for women to know their bodies, examine their breasts and be aware of any changes,” said Lopez.

Women can begin monthly breast self-exam at age 20. From ages 20-39 women should have a clinical breast exam by a health professional every three years. Women 40 and older should have a clinical breast exam every year and also begin having annual mammograms.

According to the American Cancer Society (ACS), being a woman is the main risk factor for breast cancer. The chance of getting breast cancer also goes up as women get older.