aetna presentation life cycle
DESCRIPTION
Latinos and the Life CycleDr. Judith C. Rodriguez, RD, UNFMr. Daniel Santibanez, MPH Candidate, UNFApril 22, 2005 - UNF Hispanic Health Issues SeminarsThis 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.TRANSCRIPT
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.