aetna presentation life cycle

Latinos and the Life Cycle

Dr. Judith C. Rodriguez, RD, University of North Florida

Mr. Daniel Santibanez, MPH Candidate, University of North Florida April 22, 2005

This is part 3 of an 8 part series of seminars on Hispanic Health Issues brought to you by the University of North Florida’s Dept. of Public Health, College of Health, a grant from AETNA, and the cooperation of

Duval County Health Department. For more information or register for the seminars, please call 620-1289.

The Early Years

General info

Beliefs and Practices

Issues

Recommendations

The Early Years – 0-5 Years

General info Mental –

Sense of security and bonding determined by care given

Physiological – First year is the fastest rate of growth of entire

life; growth slows after first year Breast feeding –

has physiological and mental benefits

Beliefs and Practices Children are a gift from God Early introduction of solids common

practice A “fat baby is a healthy baby”

The Early Years – 0-5 Years

http://www.tdh.state.tx.us/tbdmd/risk/risk7-NTDS.htm

Issues Inadequate access to or insufficient use of

health care In US NTD prevalence highest among

Hispanics High level of nutrient needs relative to size and

iron-deficiency anemia Inappropriate bottle feeding practices

The Early Years – 0-5 Years

http://www.tdh.state.tx.us/tbdmd/risk/risk7-NTDS.htm

Issues Immunization rates need improvement High levels of dental caries Nearly one in four cases of AIDS reported in

children under the age of 13 is among Latinos. http://www.ashastd.org/news/hisp.html

The Early Years – 0-5 Years

The Early Years – 0-5 Years Recommendations Promote prenatal care Promote breastfeeding Provide information on

introduction of and benefits of appropriate infant feeding practices

Provide information about free and reduced health care options

General info

Beliefs and Practices

Issues

Recommendations

School Age – 6 - 13

School Age – 6 - 13

General info Nutrient needs are relatively stable, but

may vary a bit during growth spurts Sense of self and identity are being formed Many health care values and habits are

being developed/learned Body must be prepared for upcoming

growth and physical changes Physical activity is important

Beliefs and Practices Children’s food preferences/ idiosyncrasies

need to be met “Milk” is good – but in excess may displace

other foods and nutrients Children are allowed to eat unlimited, what

they like

School Age – 6 - 13

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

School Age – 6 - 13

School Age – 6 - 13

http://www.cdc.gov/nchs/products/pubs/pubd/hestats/asthma/asthma.htm

School Age – 6 - 13

“One in three Latino children with a family history of diabetes suffers from pre-diabetes….. this condition does not seem to be associated with the child's weight”

Cruz, M. Journal of Clinical Endocrinology & Metabolism. Jan. 2004

School Age – 6 - 13

Recommendations Determine child rearing values of/and caregivers

and use such in health promotion strategies Educate parents on benefits of preventive

practices Help children develop/learn coping strategies

that promote health in an appropriate cultural, social, and educational context

Adolescence 13-18

General info

Beliefs and Practices

Issues

Recommendations

Adolescence 13-18

General info Mental/emotional - increased awareness of

“sexual self,” body image Behavior standards set by peer group Physiological ranges of growth spurts and peaks,

(Females - menses create an increased need for some nutrients)

Secondary sex characteristics start to appear body is preparing for physiological changes

Limited self exploration, dating and intimacy

Adolescence 13-18

Beliefs and Practices Caregivers may not discuss sex,

reproduction; consider it “taboo” Males may be given more “liberty” and

freedom for sexual exploration than females

Modesty for women highly valued

Adolescence 13-18

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

Adolescence 13-18

Adolescence 13-18

Issues Study by Delva, et al found “Drug use was

significantly higher among boys and adolescents of almost all Hispanic ethnicities who did not live with both parents…(and) drug use differed according to ethnic group on language first spoken, parental education, urbanicity, and region.” (AJPH 2005)

Erratic or poor eating, iron deficiency anemia

Adolescence 13-18

Recommendations Emphasize how quality of health

behaviors and nutritional care now will greatly impact reproductive and later years

Interventions should tailored to Latino children and be done in school health and pediatric clinics

Reproductive Years

General info

Beliefs and Practices

Issues

Recommendations

Reproductive Years

General info Increased synchrony of physiological,

social, financial, and emotional maturity Social roles defined Sexual maturity reached; body in

maintenance, then slowing, mode Symptoms of some chronic diseases may

start to manifest

http://www.ashastd.org/news/hisp.html

Reproductive Years

General info Hispanics represent 12+% percent of the

population and 17+% percent of US AIDS cases Latinos are among the greatest risk for hepatitis

C virus. Hispanic women are 7X more likely to contract

AIDS and have higher rates of syphilis and the second highest number of cases of gonorrhea

Reproductive Years

Beliefs and Practices Variety of reasons may be ascribed to

illnesses Various practices during pregnancy –

“antojos” (cravings) must be honored Concepts of “marianismo” and

“machismo” will influence prevention and care seeking behaviors

Reproductive Years

Issues Lung cancer mortality is 3X higher for Hispanic men

(39.6 per 100,000) than for Hispanic women (14.9 per 100,000).

Lung cancer is one of the most common types of cancer in Hispanic men and women.

Lung cancer death rates are higher among Cuban-American men than among Puerto Rican and Mexican men

Latino women have higher rates of breast and cervical cancers

http://diabetes.niddk.nih.gov/dm/pubs/hispanicamerican/

Reproductive Years

Issues Diabetes is particularly

common among middle-aged Hispanic Americans

Diabetes is twice as common in Mexican American and Puerto Rican adults

04/11/23 Mokdad, AH et al JAMA, Oct/99 v282 i16 p1519 28

Health Issues - Obesity

Most Growth in Prevalence of Obesity:

Hispanic ethnicity (11.6% to 20.8% 1991-1999)

Obesity is 1.5 times more common in Mexican American women (reaching 52%) than in the general, female population. http://www.nlm.nih.gov/medlineplus/hispanicamericanhealth.html#children

http://www.ashastd.org/news/hisp.html

Reproductive Years

Recommendations - Women Encourage consumption of high folic acid

foods Promote wt. management and wt. loss

strategies Promote traditional network support systems,

especially for child rearing and prenatal care. Educate immigrant families on disease risk

http://www.ndep.nih.gov/diabetes/control/principles_Hisp.htm

Reproductive Years Recommendations

Promote Seven Principles For Lifetime Diabetes Control

Principio 1: Aprenda todo lo que pueda sobre la diabetes (learn all you can)

Principio 2: Reciba atención regular para la diabetes (get regular care) Principio 3: Aprenda cómo controlar la diabetes (learn to control)

http://www.ndep.nih.gov/diabetes/control/principles_Hisp.htm

Reproductive Years Recommendations

Principio 4: Cuide los factores clave de la diabetes (attend to factors that are important)

Principio 5: Vigile los factores clave de la diabetes (watch the key factors related to diabetes)

Principio 6: Prevenga las complicaciones de la diabetes (prevent complications)

Principio 7: Visite al médico para ver si tiene alguna complicación de la diabetes (see the physician if you have any complications)

http://www.ashastd.org/news/hisp.html

Reproductive Years Recommendations Increase early screening, prevention, and

treatment and access to health care services Minimize language and cultural barriers Use hotlines and bilingual referral services Resources: Protección Es Vida [a popular

bilingual fotonovela] and Paso A Paso [an in-depth resource guide for individuals living with HIV]

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

Later Years

General info

Beliefs and Practices

Issues

Recommendations

Later Years

General info Changes in family contacts, social roles,

and relationships Mental adjustment to new life status Work at maintaining optimal body

functions Some cognitive functions affected Increased sense of mortality

Later Years

Beliefs and Practices Elderly are to be respected and

honored Many families are extended – they care

for the elderly in the home or have them nearby

Later Years

Issues Chronic diseases manifested - heart

disease, osteoporosis, high blood pressure, diabetes.

For Hispanics aged 50 or older, about 25 to 30 percent have either diagnosed or undiagnosed diabetes.

Access to health care, financial security and mental adjustment

Later Years

Issues Activities of daily living likely to be affected. Family members experience conflict related

to “respecting” the elderly and getting them to adhere to dietary and medical treatments

Diet – coffee/chocolate and toast/cheese Undiagnosed osteoporosis risk Longer life span but in poorer health – and

describe health as fair or poor

Later Years

Issues Twenty-seven percent of Hispanic American

households provide informal caregiving to a friend or relative.

The typical Hispanic caregiver is a 40 year old female.

More than half of all Hispanic caregivers also has a child age 18 and younger living at home.

http://www.aoa.dhhs.gov/press/fact/alpha/fact_serving_hispanicamer.asp

Later Years

Recommendations Seek out community

networks e.g., transportation van, congregate meals, etc.

Teach simple self monitoring strategies

Help empower widows/elderly males living alone to select and prepare healthy foods

Provide support networks and strategies for caregivers of elders

Healthy People 2010

Recommendations

The National Alliance for Hispanic Health Reports Forty percent of Healthy People 2010 population-based

objectives/sub-objectives do not have Hispanic baseline data. Progress on these objectives cannot be measured for Hispanic

communities.

Recommendations Release a Hispanic Healthy People 2010 midcourse review to report

Hispanic baseline data and identify a tracking system Implement improvements in Hispanic data collection, analysis, and

reporting Ensure that baseline data and tracking systems are put into place

CDC Interactive Heart Disease Mortality Maps http://www.cdc.gov/cvh/maps/statemaps.htm

CDC Interactive Cancer Mortality Maps http://www3.cancer.gov/atlasplus/charts.html

Florida Department of Health http://www.doh.state.fl.us/

Florida Health Charts and Interactive Maps http://www.floridacharts.com/charts/chart.aspx

Duval County Health Department http://www.dchd.net/index.htm

City of Jacksonville Community Maps http://www.coj.net/default.htm

Resources: Data Web Sites

Extension - Spanish language materials http://www.extensionenespanol.net/contact.cfm

National Alliance for Hispanic Health www.hispanichealth.org

National Council of La Raza Institute for Hispanic Health www.nclr.org/policy/health.html

National Dairy Councilhttp://www.nationaldairycouncil.org/

Office of Minority Health http://www.omhrc.gov/omhrc

USDA Food and Nutrition Information Center, Ethnic and Cultural www.nal.usda.gov/fnic/etext/000010.html

Resources: Web Sites

Health Issues in the Latino Community. By M. Aguirre-Molina, C. Molina, R. E. Zambrana. 2001.

Latina Health in the United States. By M. Aguirre-Molina, C. Molina. 2003.

Hispanic foodways, nutrition, and health. By Diva Sanjur. 1995.

The Health of Latino Communities in the South: Challenges and Opportunities. Available at:

http://www.nclr.org/content/publications/detail/26898/ Contemporary Nutrition for Latinos. Judith C.

Rodriguez. 2004.

Resources: Books

Any questions?

Thank youThis seminar is part 3 of an 8 part series of seminars on Hispanic Health Issues brought to you by the

University of North Florida’s Dept. of Public Health, College of Health, a grant from AETNA, and the cooperation of Duval County Health Dept. For more information or register for the seminars, please call

620-1289.