Meet Your New Clients: Hispanics/Latinos Webinar Presented by the National Hispanic and Latino Addiction Technology Transfer Center April 25, 2013 Presenter: Luis R. Torres, PhD University of Houston Graduate College of Social Work

Who is Hispanic/Latino A person of Mexican, Puerto Rican, Cuban, South or Central American, or other Spanish culture or origin, regardless of race. The term, “Spanish origin,” can be used in addition to “Hispanic or Latino” (OMB Definition) A person of Mexican, Puerto Rican, Cuban, South or Central American, or other Spanish culture or origin, regardless of race (Census Definition)

National Numbers 52 million (June 2012); 17% Population Median Age 27 47.5 % increase between 2000 and 2011 133 million by 2050 (30% of U.S. population) 63% are of Mexican American decent (2010) Other groups: Puerto Ricans, Salvadorans, Cubans, Dominicans, Guatemalans, Colombians, Hondurans, Ecuadorians, Peruvians (10 largest groups) http://www.pewhispanic.org/2012/06/27/the-10-largest-hispanic-origin-groups-characteristics-rankings-top-counties/ Source: U.S. Census Bureau, 2012

National Income, Poverty, and Health Insurance 2011 Median HH Income : $39K ($54.4K White) Native-born $42.4K, Foreign-born $35.9K 2011 Poverty Rate: 25.9% (11% White) Native-born 25.9%, Foreign-born 25.8% 2011 W/out health insurance: 30% (11% White) Native-born 18%, Foreign-born 51% Source: U.S. Census Bureau, 2012

National Families and Children 10.5 million Hispanic households in in 2011 63% married couples (2-parent homes) 39% consist of a married couple younger than 18 75% Speak language other than English at home Source: U.S. Census Bureau, 2012

National Education 27% of Hispanics 25 and older had at least a high school education in 2011 (29% White) 13% of Hispanics 25 and older had a bachelors degree or higher in 2011 (32% White) 20% of elementary and high school students are Hispanic 25% of Children enrolled in Head Start and Early Head Start are Hispanic

U.S. Hispanic Population Source: Source: Ennis, Sharon R., Merarys Ríos-Vargas, and Nora G. Albert. “The Hispanic Population: 2010”. U.S. Census Bureau. May 2011 “<http://www.census.gov/prod/cen2010/briefs/c2010br-04.pdf.>

New Destination States North Carolina Georgia Arkansas Tennessee Nevada South Carolina Kentucky Nebraska Alabama Utah

Why do the stats matter??? More than 60% of Latino youth live in low-income families, compared to 26% of non-Hispanic White children  Low socioeconomic standing makes it difficult for Latino children to receive the mental health care they need Hispanic children are the least likely of any minority demographic to receive mental health care services National Center for Children and Poverty, 2012

Case Vignette Latino/a Heterogeneity: Frieda What cultures, languages, faiths, and multigenerational issues are depicted in the vignette? What substance use and mental health issues are depicted? What strengths do you see that you can use in working with this family?

Hispanic Health Disparities: Risk Factors for Mental Health, Substance Abuse, Family Violence, And Other Health Issues

What are “health disparities”? Health disparities are differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the United States (NIH, 1999) A population is a health disparity population if there is a significant disparity in the overall rate of disease incidence, prevalence, morbidity, mortality or survival rates in the population as compared to the health status of the general population (Minority Health and Health Disparities Research and Education Act, United States Public Law 106-525 (2000), p. 2498)

Disproportionate Higher Rates: Health Conditions Diabetes Hypertension High Cholesterol Metabolic syndrome HIV Preventable and maintainable with proper preventive health care maintenance (DHHS, 2007)

Disproportionate Higher Rates: Mental Health Conditions Substance Abuse, Depression, Anxiety, Adolescent Suicide (Latinas) On the rise: Impulse Control Disorders, Dysthymia, PTSD, Eating Disorders High prevalence rates of substance abuse, depression, & anxiety (Burnam, Hough, Karno, Escobar, & Telles, 1987; Chun, Organista, & Marin, 2003). Other mental health conditions such as impulse-control disorders, dysthymia, and post-traumatic disorder are on the rise in Hispanics (Alegría, Mulvaney-Day, Torres, Polo, Cao, & Canino,2007; CDC, 2008).

Risk Factors Cultural values, beliefs, attitudes and traditions Acculturation Lack of insurance coverage Misdiagnosis Lower socioeconomic status Stigma and Discrimination Poverty Legal Status Hispanics are disproportionately impacted by many health and mental health disparities, among them substance abuse, depression, anxiety, and metabolic syndrome (Office of Minority Health, 2003). Hispanic female adolescents have among the highest suicide attempt rates of any group (Zayas, Lester, Cabassa, & Fortuna, 2005). Acculturation processes are impacted by many different factors, including pre-immigration societal and individual factors the immigration context itself individual and contextual factors in the new host society Thirty-six percent of Hispanics do not have insurance or a usual source of care (US Department of Health and Human Services, 2008). Hispanics are less likely to be properly diagnosed or to utilize mental health service. (Office of Minority Health, 2003).

Strengths of the Latino Population Deep religious faith and strong family orientation High value placed on children Extended family network High overall literacy rate Incomes among the Hispanic population have and tend to improve over the years Most Hispanics immigrants come to the United States because they are highly motivated to work and improve their lives

Thank You! Luis R. Torres, PhD LRTorres@uh.edu 17