THE HEALTH AGENDA “But when theoretical models that explain patterns and variations of illnesses and disease are developed on the basis of non-Hispanic while populations and then applied to Latino populations, the results are confusing, seemingly paradoxical, and of little use in creating policies and programs aimed at the Latino population.”

THE HEALTH AGENDA “…Latinos, nationally as well as in California, do not exhibit these adverse indicators; Latinos exhibit patterns that are not predicted by use of conventional metrics and models—e.g. Socioeconomic Status [SES] Models.”

THE HEALTH AGENDA “…this paper argues, the development of Latino-based metrics and models is crucial for the formulating of sound health policies that accurately address Latino health dynamics.”

THE HEALTH AGENDA Center for the Study of Latino Health & Culture, School of Medicine, UCLA: --Provide data on the dynamics of Latino health --Provide a conceptual model of Latino risk factors so that interventions can be developed --Develop educational curricula to train providers --Create policy models to better serve the needs of the Latino communities. --Facilitate improvements in the delivery of services

THE HEALTH AGENDA “A brief overview of the Latino health profile will illustrate: --The need to understand Latino health sui generis, as constituting a unique phenomenon in its own right. --The need for Latino-based norms of disease & behaviors --The need for conceptual models that delineate the relationship between health & culture.”

THE HEALTH AGENDA Maternal Education Less than 12-yrs. (percent of total giving birth) : Asian/Pacific Islander = 15.0% Non-Hispanic White = 21.6% African American = 28.2% Latina = 51.4%

THE HEALTH AGENDA “In the conventional wisdom, this combination of risk factors should lead to adverse birth outcomes-- specifically, to a high percent of low birth-weight babies and elevated infant mortality. However, the birth outcomes of Latina mothers do not fit this expectation.”

THE HEALTH AGENDA Low Birth Weight, 1996 (percent of live births) : Latina = 6.28% Non-Hispanic White = 6.34% Asian/Pacific Islander = 7.07% African American = 13.01%

THE HEALTH AGENDA Infant Mortality, ’89-’91 (deaths per 1,000 live births) : Non-Hispanic White = 7.4% Latina = 7.6% Asian/Pacific Islander = 6.6% African American = 17.1%

THE HEALTH AGENDA “If Latino health were no different from non-Hispanic white or African American health, this occurrence would be of little consequence. However, Latino health norms are distinctly at odds with the norms of those two populations.”

THE HEALTH AGENDA “Indeed, Latino health is so distinctive that it has received its own label: the Latino `epidemiological paradox’.”

THE HEALTH AGENDA “Question should not be, `Why are Latino children doing so well in spite of high risk factor?’, but instead, Why are non-Hispanic white children doing so poorly in spite of all of their advantages’?”

THE HEALTH AGENDA “Once Latino-based norms are understood, variations from the Latino norms can be understood, and Latino health can be understood on its own merits.”

THE HEALTH AGENDA Latino Age-Adjusted Death Rate, ’94-’96 (deaths per 100,000 population) : Asian/Pacific Islander = Latina = Non-Hispanic White = African American = 758.7

THE HEALTH AGENDA There are four causes of death for which the Latino rate is higher than for non-Hispanic white rate: --Diabetes, is 63.5 % higher than N-HW -HIV/AIDS, is 172% higher than N-HW --Homicide & Legal Intervention, is 254% higher than N-HW --Chronic Liver Disease & Cirrhosis, is 88% than N-HW, the Highest of ANY group

THE HEALTH AGENDA KEY EMERGING ISSUES: 1.) translators/interpreters 2.) lack of insurance 3.) lack of documentation 4.) accessibility 5.) health disparities 6.) lack of bilingual mental health professionals

THE HEALTH AGENDA SE WI Resources: 1.) Aurora Walkers Point Clinic 2.) Core El Centro 3.) Hispanic Community Health Resource Center, Waukesha 4.) Latino Health Coalition 5.) 16 th Street Clinic 6.) United Community Center [UCC]

Review Questions 1.) Why are health-related theoretical models based on non-Hispanic populations problematic when applying to Hispanics? 2.) What are “socioeconomic status [SES] models”? 3.) Why do we need Latino-based norms for disease & Behavior? 4.) Why are Latino-based norms for disease & behavior different than for other populations? 5.) For what disease is its incidence higher in than the Latino population than in other populations? 6.) What is meant by “health disparities” and what are implications for Latino community?