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La Raza Focuses On Disparities In Health Care…Hispanics Organize To Fight Diabetes

National Hispanic Conference Focuses On Disparities In Health Care

September 1, 2002
Copyright © 2002 Medical Letter on the CDC & FDA via All rights reserved.

2002 SEP 1 - ( & -- Health care disparities between Hispanics and whites, brought on by the absence of health insurance, the language barrier and other factors, are gaining attention among advocates who focused on the problems at the recent National Council of La Raza meeting.

La Raza, a Hispanic civil rights group, held at least one workshop a day on combating problems including high breast cancer rates, early diabetes and the spread of AIDS, then devoted an entire afternoon to health issues.

"We're able to evidence in black and white this gap, this disparity, between the Hispanic and non-Hispanic population," said Carlos Ugarte, La Raza's deputy vice president for health. "This is a reality. There's no denying it. We have to work toward changing it."

U.S. Centers for Disease Control and Prevention (CDC) statistics from 1999, the most recent available, spell out the differences between Hispanics and non-Hispanic whites. Hispanics are 1.7 times more likely to die of cancer, 1.4 times more likely to die of coronary heart disease and more than four times more likely to be diagnosed with AIDS.

The National Institutes of Health is conducting more research to identify disparities and what works in reducing them, said Nathan Stinson, a deputy assistant secretary for the U.S. Department of Health and Human Services.

"When we look back, historically, at the improvements in the health of everyone, there have been great strides," Stinson said.

But with minorities and certain diseases, the situation is just "abysmal," he added. "That, in our view, becomes a real drag on the vitality of this nation."

One reason the disparities exist is because more Hispanics lack health insurance. About 35% of Hispanics younger than age 65 did not have health insurance in 2000, compared with 13% of non-Hispanic whites, according to CDC statistics.

Some Hispanics work in the service industry and construction, where health insurance may not be offered, said Yanira Cruz, director of La Raza's Institute for Hispanic Health. Another problem is the lack of Spanish-language information and doctors who speak Spanish, she said.

With a clinic located three blocks from the United States-Mexico border in El Paso, Texas, Salvador Balcorta of the Centro de Salud Familiar La Fe, said ethnic health disparities can be particularly bad in regions like his.

"We still have the Third World diseases on the border with real high rates of hepatitis A, tuberculosis, things that the rest of the country at times think they're not in danger of," said Balcorta, executive director of the community health center.

Compounding the problem is a shortage of doctors and clinics in El Paso, he said. He thinks medical students should be offered an incentive: In exchange for working in a medically underserved area, they could receive help paying their medical school loans.

Hispanics also need to push for schools with health-related programs to admit more Latinos, he said.

Jovenes por la Salud, or Youth for Health is working to solve that problem. The East Los Angeles program, which enrolls about 260 students a year, encourages high school students to pursue careers in health care.

It provides tutoring in science and math courses, brings in doctors, nurses, pharmacists and physical therapists to speak to students and takes teens on field trips to universities in southern California. About 90% of the students graduate from high school and most choose to study biology, science or health in college.

"When you have professional staff in the medical health profession who are bilingual, and understand the culture the patients are coming from, they are able to communicate better with the patients," said Carlos Venegas, educational coordinator at the Multicultural Area Health Education Center, which runs the program.

Mindful of Hispanic health care concerns, Maria Huapaya pushed a stroller carrying her children - a 4-year-old and a 5-month-old - through the conference's health fair, hoping to get her cholesterol tested.

"I have two kids," said the 35-year-old Fort Lauderdale, Florida resident who is originally from Puerto Rico. "I want to live long to see them grow."

This article was prepared by Medical Letter on the CDC & FDA editors from staff and other reports.

Hispanics Organize To Fight Diabetes

By Kelly Brewington | Sentinel Staff Writer

August 20, 2002
Copyright © 2002 Orlando Sentinel. All rights reserved.

Enrique Segarra and his mother were diagnosed with diabetes five years ago. But Segarra's 16-year-old son is fighting to avoid the family legacy.

Since Segarra, 43, was diagnosed, the soda in the family fridge has been replaced with skim milk, and the teenager lost 42 pounds in the last year.

"My children see me inject insulin at home, and they see me poking my fingers with a lancet," said Segarra, a Puerto Rican who has been an Orlando pharmacist for 20 years. "They know this is what will happen if you keep eating junk food."

Segarra is working with Hispanic Health Initiatives, a Casselberry-based outreach agency, to confront the problem that has not only affected his family but is rampant in the Hispanic community.

Last month, Hispanic Health Initiatives received a $57,000 grant from the Blue Foundation for a Healthy Florida, the statewide fund-raising arm of Blue Cross and Blue Shield, to help Hispanics with type-2 diabetes. The money will go toward an education program in Osceola, Orange, Seminole and Volusia counties.

The need is there, considering that:

*?Hispanics are nearly twice as likely to have diabetes and to die from it as non-Hispanic whites of similar age.

*?Central Florida is home to nearly 20,000 diabetic Hispanics, but nearly 7,000 of them don't know they have the illness.

*?Osceola County, where the population is nearly 30 percent Hispanic, is among the top 12 counties in the state in diabetic death rates.

Hispanic Health Initiatives President Josephine Mercado hopes the project will make a small dent in the overwhelming problem.

Project to start in fall

The program will pair diabetics with an "amigo," or buddy, to help them follow a diet and exercise regimen the agency provides. The participants will meet weekly for the first 10 weeks then monthly for a year.

The program will start in November with a health fair conducted in Spanish, with an English translation. An advisory board including Segarra, other health-care professionals and a representative from Florida Hospital's Diabetes Center will address participants.

The personal touch works best, Mercado said.

"In the Hispanic culture, even when it's something beneficial to them, it requires that kind of friendliness," she said. "We do all our work in the community, at a time and place that is convenient for them with volunteers who they know."

The agency has a good track record with its initiatives. A program designed to help Hispanic women with early breast-cancer detection surpassed the expectations of the Florida Department of Health.

Hispanic Health Initiatives was supposed to provide referrals for 60 women and information to 600 between January and June of this year. It ended up referring more than 150 and reaching more than 3,000, Mercado said.

Blunt talk can help

Segarra, who volunteers with a church support group for diabetics, said he encounters people who are scared. Others are stubborn and refuse to change their diet. And still others, such as his 78-year-old mother, refuse to acknowledge they have the disease.

"I try to raise their self-esteem and let them know if you treat it now, you won't have any problems in the future," he said. "We need to educate Hispanics about their diet. Eating well can prevent a lot of other diseases, not just diabetes."

With his clients at the downtown Orlando pharmacy where he works, he's more blunt.

"I tell them if you let this go on for years, you will start getting a lot of pain in your legs, your nerves will die, you will get gangrene and they will start amputating some limbs," he said.

"If you survive that, you can go blind, your organs will fail, [and] then it's pretty much over."

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