| II.
About Hispanics
Understanding
the role of Hispanic migration patterns,
historical genetic/biological factors,
and health status
For
Hispanics in the United States,
history is a confluence of national
and social narratives that have
only recently merged into a powerful
river of common understanding.
An
historical perspective may be an
important precursor to understanding
the health status of Hispanics.
Understanding the migration patterns
and other environmental critical
events provides perspective to genetic/biological/environmental
interaction and helps to clarify
potential health behaviors. Current
theory states that major demographic
events (population migration, bottlenecks,
and expansions) leave imprints in
the form of altered gene frequencies
on the collective human genome.24
|
|
An
historical perspective may be an
important precursor to understanding
the health status of Hispanics.
|
The
majority of U.S. Hispanics have
a shared pre-colonization American
history that reflects a relatively
healthy group even though there
are high risk factors for some diseases
and a low propensity for certain
others.25
To some extent, the heterogenous
genetic characteristics of Hispanics
have been shaped by a number of
founder effects, such as migration
and invasion by Europeans. Socially
and culturally, the majority of
Hispanics have a shared historical
genetic family located in all of
the Americas — North, Central,
and South.26
History
of migration patterns and critical
events may differentiate one group
from another in addressing health
status, health behaviors, and health
beliefs.27
|
|
The
majority of Hispanics have a shared...historical
genetic family located in all of the
Americas... |
II.
About Hispanics Chapter Five: History
of Hispanics in the United States
Or
why the City by the Bay is not called
Saint Francis
Perhaps
the health status of Hispanics needs
to be further explored from it's
own migration patterns, the Americas.
As the history of Hispanics is examined
in the rest of the chapter, contemplate
the critical events before colonization.
In
1453, Constantinople fell to the
Ottoman Turks, cutting off Europe's
silk and spice trade with India
and Asia. Thirty-nine years later
an Italian named Christoforo Colombo
(Cristobal Colón in Spanish),
or Christopher Columbus, sailing
west for the Queen of Spain, first
reached the New World thinking he
had found a new route to the orient.28
His first landfalls included Juana
(Cuba) and the island of Hispaniola
(the Dominican Republic and Haiti)
whose natural wonders so amazed
him he declared his eyes, "would
never tire of beholding so much
beauty, and the songs of the birds
large and small."29
|
|
|
| Having
recorded their first impressions
of North America's natural wonders,
the early discoverers quickly set
about in search of gold and other
objects of value. The Conquistadors
were committed to expansion of the
Spanish empire and recovery of treasure
for the crown. Spanish Catholic
missions soon followed with the
goal of winning new religious converts.
Colonial administrators began spreading
Spanish culture from Mexico across
Central and South America.
Spanish
settlement of North America came
early and included the first permanent
European settlement of the New World
at St. Augustine, Florida in 1565.
In 1598, Don Juan de Oñate
colonized New Mexico.
Yet
almost all Hispanic immigration
to the United States may be linked
not only to the economic opportunities
that would attract European and
Asian immigrants, but also to U.S.
military actions linked to policies
of Manifest Destiny (that declared
the United States' "God-given
right" to all North American
territory) and the Monroe Doctrine
(which declared United States hegemony
over Mexico, Central, and South
America and warned European powers
not to intervene there). From the
Spanish American War that brought
Cuba and Puerto Rico under U.S.
administration in 1898, to various
invasions of the Dominican Republic,
Nicaragua, Honduras and other parts
of Central America, waves of immigration
followed on war, rebellion, and
occupation. This process has continued
as recently as the 1980s, when large
numbers of Guatemalans, Nicaraguans,
and Salvadorans fled to the United
States to escape civil wars. |
|
Spanish
settlement of North America came
early... St. Augustine, Florida
in 1565. In 1598 Don Juan de Oñate
colonized New Mexico.
...Hispanic
immigration to the United States
may be linked not only to the economic
opportunities that would attract
European and Asian immigrants, but
also to U.S. military actions...
|
| |
|
Mexican
Americans: "So far
from God, so close to the United
States," has been a proverb
in Mexico for generations, reflecting
the often turbulent relationship
between the two nations. Continuing
through the 1800’s Spain extended
its dominance across California
and the Southwest. Eventually the
goal of the church to convert the
indigenous inhabitants would lead
to conversions and intermarriage
and the survival of large numbers
of mestizo, or mixed blood people.
Today the California mission system
lives on in the names of its early
settlements that evolved into towns
and cities: San Diego, Los Angeles,
Santa Barbara, San Luis Obispo,
Monterey, San Jose, and San Francisco.
|
For
Mexicans living in the areas annexed
by the Treaty, the border had crossed
them adding new language and cultural
obstacles that still exist today.
Today,
Mexicans and Mexican Americans make
up over 57% of the U.S. Hispanic
population....
|
|
In
1821, Mexico fought to win its independence
from Spain. Mexico lost half its
northern territory to the United
States following the Mexican American
war through the Treaty of Guadalupe
Hidalgo. For Mexicans living in
the areas annexed by the Treaty,
the border had crossed them adding
new language and cultural obstacles
that still exist today.
With
close family and community ties
remaining on both sides of the frontier,
Mexican migration to and from the
United States has continued largely
uninterrupted since the Treaty of
Guadalupe Hidalgo. Today, Mexicans
and Mexican Americans make up over
57% of the U.S. Hispanic population
and include at least two million
seasonal migratory workers who spend
part of the year in the United States
and part in their native Mexico.30
|
| Puerto
Ricans: The second largest Hispanic
group (about 20%) in the United
States with some 3 million people
living on the U.S. mainland and
3.2 million more living on the island.31
Borinquen (the indigenous name for
Puerto Rico) was discovered by Columbus
in 1492 and conquered by Juan Ponce
de Leon in 1508. The Taino and Arawak
Indians who lived there were quickly
killed off through violence, starvation,
and forced labor. Yoruba African
slaves were then brought to the
island to work the sugar cane fields.
They eventually won their freedom,
intermarried, and incorporated their
culture and beliefs into the island
life.
In
1815, a second wave of Spanish settlers
known as the 'Real Cedula de Gracias'
were encouraged to emigrate to Puerto
Rico in order to "whiten"
its population. Instead, by defining
themselves as a new elite, they
exacerbated tensions between islanders
and their colonial administrators.
In 1897 Puerto Rican nationalists
declared themselves independent
from Spain. A year later, United
States forces landed in Puerto Rico,
Cuba, and the Philippines during
the Spanish-American War. But unlike
in Cuba and the Philippines, the
United States never gave up its
claim on Puerto Rico. In 1917, Puerto
Ricans were made United States Citizens
under the Jones Act and eligible
males were required to enlist in
the military. In 1952, Puerto Rico
was declared a Commonwealth of the
United States, although from within
the island there continues to be
movements for statehood and independence.
|
|
In
1917, Puerto Ricans were made United
States Citizens under the Jones
Act and eligible males were required
to enlist in the military. |
|
|
Economic underdevelopment on the island,
along with the United
States' expanding post-war industrial
base, and job opportunities led to
the migration of close to a million
Puerto Ricans to the mainland between
1945 and 1965. Large Puerto Rican
communities were established in New
York, other parts of the Northeast,
and Chicago. Half
a century later people on the mainland
continue to maintain close links
with their families at home through
the Puerto Rican "air bridge,"
of regular flights between the mainland
and Puerto Rico. At the same time
the cultural, political, medical,
and social needs of Puerto Ricans
on the mainland and on the island
have tended to diverge over time,
although key social agencies like
New York's Puerto Rican Family Institute
try to bridge that gap by maintaining
service centers in both locales.
|
| Cuban
Americans comprise about 4% of the
Hispanic population in the United
States. |
|
Cuban
Americans: Cuban Americans comprise
about 4% of the Hispanic population
in the United States.32
Even though they have the highest
level of education and income of
any Hispanic group, the median income
of Cuban Americans is nevertheless
25% less than that of non-Hispanic
whites. Cuba, only 90 miles from
Key West, Florida was visited by
Columbus in 1492 and colonized by
Spain in 1511, during which all
the native people were killed.
The
largest island in the West Indies,
Cuba, and its capitol port Havana,
became a major shipping and transportation
hub, as well as a key to the trade
in rum, sugar, cod, and slaves.
It's population was also a mix of
European settlers and African slave
laborers. Even before the Spanish-American
War of 1898, Cubans began emigrating
to the U.S..
In
1902, four years after annexing
Cuba in the Spanish-American War,
the U.S. granted it independence.
However, the U.S.
maintained a major influence in
Cuba over the next fifty years as
it became a popular resort destination.
|
The
Cuban Revolution of 1959 that overthrew
the regime of Fulgencio Batista
and brought Fidel Castro to power
drove close to half a million upper
and middle-class refugees to south
Florida. Later, waves of immigrants
from the communist island, such
as the "Marielitos" of
1980, included less-skilled people
along with some criminals and mentally
ill people, released from Castro's
jails and asylums.
Central
Americans: Since its early settlement,
Central America has had a history
of turmoil. The economies of Central
American countries tend to be unstable
because of their dependence on a
few agricultural export crops such
as coffee, sugar, bananas, and cotton
owned by a very small segment of
society. Because of the political
and economic struggles that the
nations of this region have endured,
many Central Americans have immigrated
to the United States, often in search
of refuge from violence and economic
instability created by civil wars
and other conflicts.
Central
Americans have settled in different
parts of the country. Salvadorans
have settled mainly in Los Angeles
and Washington D.C.; Guatemalans
in Los Angeles, San Francisco, and
Houston; and Nicaraguans in San
Francisco and Miami. Many suffer
from post traumatic stress problems,
relating to their countries' civil
wars.
Dominicans:
Discovered by Columbus in 1492,
the island of Hispaniola later divided
following a slave rebellion and
the establishment of the independent
nation of Haiti. The remaining eastern
two-thirds of the island would eventually
become the Dominican Republic, a
predominantly agricultural Spanish-speaking
nation with thick rain forests and
spectacular mountain
|
|
The
Cuban Revolution of 1959 that...brought
Fidel Castro to power drove some
half million upper and middle-class
refugees to south Florida. |
| ...
over half a million Dominicans and
their descendants have settled in
the United States, with 70% of them
located in New York City and adjacent
parts of New Jersey.
Although there are various reasons
for South American immigration to
the United States, two key causes
include political instability in
certain instances and the search
for economic opportunity or prosperity
in others.
|
|
ranges.
Since the U.S. invasion of the Dominican
Republic in 1965, during a period
of civil unrest, over half a million
Dominicans and their descendants have
settled in the United States, with
70% of them located in New York City
and adjacent parts of New Jersey.
South
Americans: Several hundred thousand
Colombians have also settled in
the U.S., mainly in Florida and
New York. Smaller numbers of Hispanics
have come to the United States from
Venezuela, Ecuador, and other Latin
American nations. Although there
are various reasons for South American
immigration to the United States,
two key causes include political
instability in certain instances
and the search for economic opportunity
or prosperity in others.
From
a psychosocial perspective the history
of Hispanics in the United States
clearly indicates that in dealing
with Hispanic populations in a medical
or social service context, one must
recognize the tremendous range of
historical experiences that exists
among the various sub-groups. Each
nationality has its own historical
perspective that affect how they
view themselves within the context
of living in the United States and
how the U.S. has treated them. In
fact, differences among subgroups
may be related to how they entered
the U.S., i.e., as legal immigrants,
legal refugees, undocumented workers,
or as a result of war.
|
II.
About Hispanics Chapter Six: Hispanic
Health Status
Understanding
the unique and unexpected Health Profile
of the Hispanic patient population you
serve.
To
date, the health profile of Hispanics
has not been fully available. The
lack of information is primarily
due to the historical lack of Hispanic
and Hispanic subgroup identifiers
in major data sets, including the
census, mortality, medical records,
the National Health Interview Survey,
and many others. Many national data
sets added Hispanic identifiers
by 1995. By 1996, all States has
added Hispanic identifiers to mortality
data. Still today, Hispanic identifiers
are absent from medical records
and many state disease/disorder
registries. Without this information,
it is difficult to know the complete
profile of Hispanic health.
Prior to 1995, the historical racial/ethnic
classifications often appeared as
white and nonwhite which masked
relevant information. The transition
to the categories of "white",
"black", and "others"
continued to camouflage pertinent
health information about Hispanics.
This labeling also contributed to
the notion that minority meant black
because the populations clustered
into "others" were fairly
invisible due to the fact that the
information was meaningless. Recognition
marks a struggle for Hispanics to
achieve official Government recognition.
This recognition uniquely identifies
Hispanic health issues, clearly
depicts an Hispanic health profile
and mandates a visible presence
in minority populations.
|
|
To
date, the health profile of Hispanics
has not been fully available....primarily
due to the historical lack of Hispanic
and Hispanic subgroup identifiers
in major data sets |
Another
issue which seems to confound the
collection of Hispanic information
is the misclassification of race/ethnicity.
When race/ethnicity is not self-identified,
up to one-third of data misclassification
has occurred mostly due to the heterogenous
phenotypes of the Hispanic population.
All Hispanics do not look alike. Some
misclassification occurs when those
who are asked to self-identify are
presented with "white,"
"African American," and
"Hispanic" options. Many
Hispanic ethnic groups identify with
their heritage or country of origin,
such as Mexican, Cuban, Salvadoran,
Chilean, etc.
|
...
Another issue which seems to confound
the collection of Hispanic information
is the misclassifiction of race/ethnicity.
|
Today
in the U.S., Hispanic is considered
an ethnicity with any racial background.
|
|
Today
in the U.S., Hispanic is considered
an ethnicity with any racial background.
Each racial category can be associated
with a specific migration pattern
and representative of clusters of
the population with a higher prevalence
of a particular disease. White is
associated with European descent and
migration patterns. Black is associated
with African descent and migration
patterns. Asians have Asian descent
and migration patterns – likewise
for American Indians, Alaska Natives,
Pacific Islanders and Native Hawaiians.
|
...Hispanic
is a U.S. government created term....this
labeling has to be both learned
and accepted as an identity for
those it is attempting to identify.
|
|
As
noted in Chapter 1, Hispanic is a
U.S. government created term; thus,
this labeling has to be both learned
and accepted as an identity for those
who it is attempting to identify.
Recognition of the misclassifications
has facilitated the Government to
partner with Hispanics to reduce mistakes
by adding the word "Latino"
and asking "Are you Hispanic/Latino?"
before asking the race question. However,
errors continue because many Hispanics
see themselves as a race, not just
an ethnicity. In this country, Hispanics
are not white nor black in their psychosocial
and cultural presentation and treatment.
|
As
science tries to unravel the answer
as to whether precursors of disease
within kinships are due to some
genetic/ biological factors or some
nonrandom force, the current social
labeling of race may confound the
answer. |
|
As
science tries to unravel the answer
as to whether precursors of disease
within kinships are due to some
genetic/biological factors or some
nonrandom force, the current social
labeling of race may confound the
answer. As mobilization and diversity
of the U.S. population increase,
understanding cluster variants and
changes in mixed migration patterns
will provide insight to engineering
and improving the health status
of Hispanics and all humans. This
understanding will enhance culturally
competent services.
An
examination of the classification/misclassification
is based on the hypothesis that
each sequence variant that confers
disease susceptibility must have
arisen in a particular individual
at some time in the past and must
have been inherited by his or her
descendants to create a disease
— associated polymorphism
prevalent in a population.33
The cluster could then be examined
for the genetic/biological mutations
that result from invasion, expansion,
and filtration of different migration
patterns such as the Spaniards (Europeans)
conquering of Mexico's indigenous
(Americas).
If this avenue of culturally competent
research is pursued, science may
be better able to determine whether
the pattern and magnitude of phenotypic
variation are consistent with random
evolutionary forces or whether a
more complex explanation is required.
|
To
fully present an Hispanic health profile,
specific or targeted research is needed
to augment the national depiction.
Yet, there is little to no information
which details Hispanic health information
and treatment outcomes. For example,
there is no information on cancer
treatment outcomes for Hispanic women
with breast cancer; on theoretical
models for health behavior changes;
on effective community-based alcohol
interventions; on pharmacological
treatments; etc. The list of inadequate
information is exhaustive and can
be experienced by each literature
search in any area or field. |
|
...there is little to no information
which details Hispanic health information
and treatment outcomes. |
As
a result of inadequate national data and
specific information, it is difficult
to fully determine Hispanic health status
and profile. The most recent changes indicate
potential shifts in current knowledge.
For example, SEER (the National Cancer
Institute’s Surveillance Epidemiology
and End Results project) expansion in
1995 repositioned Hispanic children with
brain cancer from third to first. It is
likely that similar shifts will be presented
as other data are analyzed and reported.
| Due
to the lack of information, cultural
competence should be practiced by
not identifying any one group as having
a lesser or greater health status
than another. |
|
This
incomplete determination of health
status makes it difficult to assess
the burden of disease and disorders
on Hispanics or in comparison to other
groups. Due to the lack of information,
cultural competence should be practiced
by not identifying any one group as
having a lesser or greater health
status than another. Cultural competence
should also be practiced in interpreting
data given the fact that Hispanics
are often classified as white or black;
yet, neither the white or black body
of information is fully applicable
to Hispanics. There are language,
psychosocial, cultural, and biological/genetic
differences that confound the application
of white and black prevention, intervention,
and treatment models and may not have
the same internal and external validity.
For instance, in genetic research,
the Genome project has identified
a marker for diabetes in Mexicans.
This marker does not appear in non-Mexican
whites or Japanese. As more information
unravels, Hispanic health status will
be clarified. The
Genome project, a major Federal
initiative to map genetic components,
has declared that genetic factors
contribute to virtually every human
disease, conferring susceptibility
or resistance, or influencing interaction
with the environment.34
The Genome project also has determined
that racial/ethnic groups are more
alike than different.35
However, clusters of the population,
often proxied by race/ethnicity,
may have a greater prevalence of
a particular genetic marker or set
of markers (codes for disease).36
Examples include diabetes in Mexicans
and Pima Indians, sickle cell anemia
in blacks, and Tay Sachs in Jews.
While
one cannot be expected to memorize
all the data that is provided in
this chapter, there are three key
points worth remembering in dealing
with the issue of Hispanic health
status: |
| Key
Facts
|
|
|
Hispanics
have lower mortality rates than
the overall population but are at
greater risk for number of chronic
illnesses and diseases. Mortality
is not a good measure for this population.
Hispanic
populations exhibit a number of
positive health indicators in terms
of diet; low levels of smoking and
illicit drug use; and a strong family
structure. However the longer each
generation has been in this county
these positive indicators tend to
deteriorate. Positive aspects of
traditional cultures need to be
reinforced.
There
is similarity, as well as, variability
among Hispanic subgroups. |
|
Mortality
is not a good measure for the population.
Positive
aspects of traditional cultures
need to be reinforced. |
Hispanics,
as outlined earlier, share a range
of sociocultural characteristics,
as well as national, experiential,
and in some instances genetic make-up,
that can impact their health status
within the United States. Certain
cultural factors, such as a more traditional
diet and lower rates of smoking among
women impact favorably on their health
status, while others, such as low-immunization
rates linked to low-economic status
and fear of authority among new immigrants,
have negative consequences. Unfortunately
acculturation among new immigrants
and their children seems to weaken
the positive health factors and lead
to the adoption of negative ones from
U.S. culture (such as smoking, alcohol
use, and early sexual activity).
When
politicians and policy-makers address
topics such as "black and minority
health," they're usually referring
only to issues and statistics dealing
with African-American health profiles
and then extrapolating from these,
even though Hispanics, with their
unique health needs, made up 12%
of the population in 1998.37
|
|
Unfortunately acculturation among
new immigrants and their children
seems to weaken the positive health
factors and lead to the adoption
of negative ones from U.S. culture.
|
...until
1989, the National Model Death Certificate
did not have an Hispanic identifier.
As data became more available an
Hispanic health profile emerged
which ran counter to....the “Minority”
health model.... |
|
The
major reason for this distortion,
is that until 1989 the National
Model Death Certificate did not
have an Hispanic identifier. This
prevented the emergence of an authentic
Hispanic health profile. As data
became more available, an Hispanic
health profile emerged which ran
counter to the prevailing models
of health. The “Minority”
health model did not explain the
state of Hispanic Health. |
Mortality
and Morbidity
In
1985, the Report of the Task Force on
Black and Minority Health of the U.S.
Department of Health and Human Services,
attempted to outline the disparities in
health status existing between the non-Hispanic
white population and the rest of the population.
However, it remained difficult to ascertain
the actual differences in health status
among "minority" populations
due to the fact that although mortality
data were available for blacks, Asian/Pacific
Islanders, Native Americans, and whites,
it was still not available for Hispanics.
Even
today the organization of reliable and
accessible data on Hispanic mortality
and morbidity lags behind that for other
racial and ethnic groups. Nonetheless
certain trends and statistical health
profiles have become clear, with the mortality
rates for Hispanics proving counter-intuitive
to the traditional view that the lower
economic status and educational attainment
of "minorities" dooms them to
a higher rate of mortality.
| Despite
having a lower income than white Americans,
Hispanics live longer than whites.
|
|
Despite
having a lower income than white Americans,
Hispanics live longer than whites.
Hispanics have an average life-expectancy
of 75.1 years for men and 82.6 years
for women.38
As a result, for the Hispanic community
the issues of morbidity rather than
mortality are of greatest concern.
These issues include lifestyle and
behaviors affecting health; environmental
factors such as exposure to pesticides,
unclean air and polluted water; and
the ongoing need for more effective
use of existing health services. Of
course many of these morbidity factors
also play a significant role in Hispanic
mortality rates. |
| The
top ten leading causes of death
for Hispanics of all age groups
are:
- Heart
disease
- Malignant
neoplasms,
- Accidents
and adverse effects,
- Human
immunodeficiency virus infection
(HIV),
- Homicide
and legal intervention,
- Cerebrovascular
diseases,
- Diabetes
mellitus,
- Chronic
liver disease and cirrhosis,
- Pneumonia
and influenza,
- Certain
conditions originating in the
prenatal period.39
|
|
Key
Concept
Top
Ten leading causes of death for
Hispanics of all age groups. |
| The
top two leading causes of death are
the same for the Hispanic and for
the non-Hispanic white population:
heart disease and cancer. However,
for Hispanics these two causes account
for 43% of deaths, whereas they accounted
for 59% of all deaths among non-Hispanic
whites in 1992.40 |
|
The
top two leading causes of death are
the same for the Hispanic and for
the non-Hispanic white population:
heart disease and cancer. |
Of
the ten leading causes of death for the
Hispanic population, two, "Homicide
and legal intervention," and "Certain
conditions originating in the prenatal
period," also reflect differences
in age composition between Hispanics and
other groups. The Hispanic community is
marked by its youthfulness. Its median
age is 26.3 years, compared to 36.6 years
for the non-Hispanic white population.41
Because the Hispanic population has a
greater proportion of young persons, it
also has a larger proportion of deaths
due to causes that are more prevalent
at younger ages, such as male violence
and female child birth.
Within
broad age categories the leading causes
of mortality are similar. However, some
differences still exist.
- Homicide
and legal intervention consistently
ranks higher for Hispanics than for
non-Hispanic whites for all age groups
between 15–24 years and 45–64
years.
- HIV
infection for Hispanics aged 1–64
years ranks consistently higher than
for non-Hispanic whites.
- Diabetes
mellitus and chronic liver disease and
cirrhosis also rank higher for Hispanic
populations aged 45–64 and 65
years and over than for non-Hispanic
whites of the same age groups.42
The
following sections provide some current
known and unknown information about incidence
and risk factors for disease. Much more
information is needed to fully determine
the health status of Hispanics.
Smoking
While
Hispanic adults have the lowest
rates of smoking, Hispanic eighth
graders now have the highest rates
of smoking among all their peers |
|
The
relationship between smoking and various
cancers, heart disease, and respiratory
disorders has been well and clearly
established. Lung cancer remains the
number one cause of death due to carcinomas
in both men and women. For the past
twenty years there has also been a
steady decline in the number of Hispanics
who smoke tobacco. By 1998, only 18.9%
of Hispanics smoked tobacco compared
to 26.5% of Non-Hispanic blacks and
25.9% of Non-Hispanic whites.43 |
While
Hispanic adults have the lowest rates
of smoking, Hispanic eighth graders now
have the highest rates of smoking among
all their peers. A recent survey found
that 51.1% of Hispanic eighth graders
had smoked within the previous 30 days
compared to 42.1% of non-Hispanic blacks
and 49.7% of non-Hispanic whites.44
In
addition, a recent survey in San Francisco
found that while only 15% of first-generation
immigrant Hispanic women reported smoking,
23% of second-generation Hispanic women
smoked. This was consistent with other
findings showing that as Hispanic women
acculturate to the United States they
tend to give up a number of their healthier
habits such as good nutrition.45
Diet
| Diet
has been shown to affect several cancers,
diabetes, and heart disease. The Hispanic
diet is high in fiber, relies on vegetable
rather than animal proteins, and includes
few dairy products and leafy green
vegetables. In cattle producing countries
however, diets tend to include a greater
amount of animal protein. |
|
The
Hispanic diet is high in fiber,
relies on vegetable rather than
animal proteins, and includes few
dairy products and leafy green vegetables.
|
Recent
studies also indicate that Mexican American
women report a higher intake of vitamins
A, C, folic acid, and calcium than do
non-Hispanic white women. Again, however,
these positive indicators tend to decline
with U.S. acculturated second generation
Mexican American women whose dietary intake
is the same as that for non-Hispanic white
women.46
Reflecting
differences among Hispanic sub-groups,
there are findings of both positive and
negative nutritional indicators for Hispanic
children. While mean iron intakes of Cuban
American and Puerto Rican children meet
the recommended level for iron, Mexican
American infants are below the recommended
level. While Hispanics consume less than
five fruits and vegetables per day, the
intake of chili peppers and tomatoes provide
much needed antioxidants. The majority
of Mexican American children also consume
less than the recommended servings of
fruits and vegetables, including fruits
and vegetables with high vitamin A and
C content. Also, after age 5, the majority
of Mexican American children consume less
than the recommended daily servings of
milk.47
| Although
Hispanic women are regarded as coming
from a breast-feeding culture, their
nursing rates begin to decline as
they acculturate to the United States.
|
|
In
terms of mother's milk, according
to 1990 statistics, 52% of Hispanic
women breast-fed their infants compared
to 59% of non-Hispanic white women
and 26% of non-Hispanic black women.
Although Hispanic women are regarded
as coming from a breast-feeding culture,
their nursing rates begin to decline
as they acculturate to the United
States. In addition, bottle-feeding
ad campaigns conducted in Puerto Rico
and throughout Latin America by corporations
that produce baby formula, has also
led to a steady decline in breast-feeding
in these areas.48 |
| ...
cholesterol levels are lower for Hispanics
than those reported for non-Hispanic
whites and non-Hispanic blacks. |
|
Cholesterol
Linked
to diet and nutrition, cholesterol
levels are lower for Hispanics than
those reported for non-Hispanic
whites and non-Hispanic blacks.
For all Hispanics, cholesterol levels
gradually increase with age. Hispanics
with high cholesterol levels tend
to be less aware of their situation
than their non-Hispanic white counterparts.
|
Mexican
American men are more likely than non-Hispanic
white adults to have high serum cholesterol
levels. However, Mexican American women
are somewhat less likely than non-Hispanic
black women and slightly more likely than
non-Hispanic white women to have high
serum cholesterol levels.49
The
traditional Hispanic diet includes
a carbohydrate staple (such as rice
or corn tortillas) with beans, which
together provide a balanced source
of protein without cholesterol. However,
as Hispanic immigrants and other groups
adapt to the dominant culture's diet
their serum cholesterol levels begin
to rise.
|
|
...
as Hispanic immigrants and other groups
adapt to the dominant culture's diet
their serum cholesterol levels begin
to rise. |
Weight
and Exercise
It
is estimated that approximately one-third
of all adults in the United States are
overweight with a greater prevalence among
Hispanics. Overweight percentages (based
on white standards of body composition)
for Mexican American males (39.5%) are
higher than for non-Hispanic whites (32.1%)
and non-Hispanic blacks (31.5%). A greater
percentage of Mexican American females
(47.9%) are overweight than non-Hispanic
white females (32.4%) but less than non-Hispanic
black females (49.5%).50
| Despite
evidence linking regular physical
activity to a range of health benefits,
millions of United States adults remain
essentially sedentary, a fact which
has generated the descriptive title
of "TV couch potatoes" (or
with the advent of the internet, "mouse
potatoes"). While there is a
woeful lack of data on Hispanic populations
and exercise, researchers report that
men are more likely than women to
participate in physical activity and
non-Hispanic whites more likely than
other ethnic groups. A CDC study of
high school students found that adolescent
males are about twice as likely as
adolescent females to report engaging
in vigorous physical activity.51
|
|
While
many Hispanics work in occupations
requiring heavy manual labor, many
of these activities do not contribute
to aerobic fitness |
While
many Hispanics work in occupations requiring
heavy manual labor, many of these activities
do not contribute to aerobic fitness.
A heart study conducted in San Antonio,
Texas, found that Mexican Americans engaged
in aerobic exercise less often than any
other group.
Alcohol
and Substance Abuse
Another
lifestyle issue facing the Hispanic community
is excessive alcohol use that can, over
time, cause serious medical problems,
as well as, increase the more immediate
risk of accidents and violence.
According
to SAMHSA's Prevalence of Substance Use
Among Racial and Ethnic Subgroups, Hispanics
vary markedly in their prevalence of substance
abuse, alcohol dependence, and need for
illicit drug abuse treatment. Relative
to the total population, Mexicans and
Puerto Ricans have high prevalence of
illicit drug use, heavy alcohol use, alcohol
dependence and need for illicit drug abuse
treatment. In contrast, Caribbeans, Central
Americans, and Cubans have low prevalence
and South Americans and other Hispanics
have prevalence similar to the total U.S.
population.
A
1992 survey found Hispanic males are far
more likely to have used alcohol (85.5%)
than Hispanic females (67.4%). Hispanic
males also report a higher percentage
of heavy alcohol use in the past month
(5.6%) than non-Hispanic whites |
