beatriz sosa-prado, m.s.(c) physicians for a national health program – california outreach...
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Beatriz Sosa-Prado, M.S.(c)Physicians for a National Health Program – California
Outreach SpecialistJuly 8, 2012
Summer Conference
LATINOS IN THE UNITED STATES AND IN CALIFORNIA
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Latino Population in the U.S.
50.7 million Latinos 15.4% total U.S. population Not including undocumented
By 2050, the Latino population is set to triple to 132.8 million¹
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Latino Subpopulations in the U.S.
2 largest Latino subpopulations: Mexicans & Puerto Ricans
65% Mexican 9% Puerto Rican
Other Latino subpopulations 3.5% Cuban 8.5% Central American 5.8% South American2
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Latino Population in California
13.7 million Latinos 37% of the total California population Not including undocumented Severe underreporting in census
The majority subpopulation in California is Mexican 11.5 million; 31.2%
2
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What does it mean to be a Latino in the U.S.? The answer may be very different if you
ask a black Dominican, a white Cuban, or a Panamanian, Colombian, Argentine, Honduran or Brazilian of any color (Andalo, 2004)
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Characteristics of Latinos in the U.S. and in California
CharacteristicsAge IncomeEducationEmployment
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Age-specific Characteristics
Median age of Hispanics in U.S. is 27.3 y/o 65.5 % is 18 y/o or older Median age of U.S.’s total population =
36.8
Median age of Hispanics in CA is 27 y/o 65.4 % 18 y/o or older Median age of CA’s total population =
34.9
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Poverty Rates
Latinos in U.S.: 23.5% American Indians &
Alaskan Natives: 27.3%
Blacks: 25.8% Native Hawaiians &
Other Pacific Islanders: 15.1%
Whites: 11.7% Asians: 11.4%
Latinos in CA : 20.6% American Indians &
Alaskan Natives: 22.9%
Blacks: 20.8% Native Hawaiians &
Other Pacific Islanders: 12.5%
Whites: 12.6% Asians: 10.4%
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Education-specific characteristics U.S.: 60.9% of Latinos have attained a
H.S. diploma or higher 39.1% have less than a H.S. diploma, compared
to 14.7% of the total U.S. population
CA: 56.7% have attained a H.S. diploma or higher 43.3% have less than a H.S. diploma, compared
to 19.4% of the total California population
U.S. Census Bureau. (2009). 2009 American Community Survey 1-year estimates [Data file]. Retrieved December 20, 2010, from http://factfinder.census.gov/servlet/DatasetMainPageServlet?_program=ACS&_submenuId=&_lang=en&_ts
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Employment-specific Characteristics
69% of Latinos in the U.S. 8.1%
unemployed; 31.1% not in formal labor force
68.5% of Latinos in CA 8.8%
unemployed; 31.5% not in formal labor force
2
In the labor force…
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Characteristics of Latinos in California and in the U.S.
Latinos in California
Latinos in U.S. Total Pop. in U.S.
Median Age 27 yrs 27.3 yrs 36.8 yrs
Median Income $45,655 $39,923 $50,221
Education(% with H.S. diploma)
56.7% 60.9% 85.3%
Employment(% in labor force)
68.5% 68.9% 65.3%
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Comparison Characteristics of Main Populations in California
Latinos Whites Blacks Asians
Median Age
27 yrs 37.5 yrs 33.8yrs 37.5 yrs
Median Income
$45,655 $61,382 $43,501 $73,227
Education(% with H.S. diploma)
56.7% 83.8% 87.4% 85.8%
Employment(% in labor force)
68.5% 64.7% 60.8% 65.2%
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Latino Cultural Values
Strong family ties Familismo
Values Respeto Confianza
Religion Espiritismo
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Life Expectancy of Latinos
For Latinos in the U.S., the life expectancy at birth is approximately 82 years. Compared to:
76 years in Mexico 78 years in Puerto Rico 77 years in Cuba
Average life expectancy for the general U.S. population as of 2007 is 77.9 yrs
(U.S. Census Bureau, 2008)
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Acculturation and Health Among Latinos
Acculturation: “the process by which an individual raised in one culture enters the social structure and institutions of another, and internalizes the prevailing attitudes and beliefs of the new culture” (Franzini et al., 2002)
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Effects of Acculturation
Acculturation in the U.S. has affected the lifestyle of Latino subpopulations Less fresh food Less vegetables and fruits Less exercise
The effects of acculturation on Latino health are complex and not well understood
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Acculturation and Health Among Latinos
Acculturation is associated with… negative health behaviors and outcomes:
Substance abusedietary practicesbirth outcomes
positive health outcomes:access to health care, use of preventive services, and self-perceptions of health
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Acculturation and Health Among Latinos
More acculturated Latinos see themselves as healthier than less acculturated Latinos despite tendencies toward worse health outcomes (Lara et al., 2005), indicating cultural effects on wellness and perceptions of health
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Leading Causes of Death among Latinos
As of 2006, the top 5 leading causes of death among Latinos: 1. Heart disease2. Cancer 3. Unintentional injuries4. Stroke5. Diabetes
(National Center for Health Statistics, 2009)
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Specific Health Issues among Latinos
Chronic Diseases Infectious Diseases Occupational Health Issues Environmental Health Issues Cultural, Linguistic and Literacy Level-
Specific Barriers to Care
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Occupational Health Issues Among Latinos
Jobs with high rates of unintentional injuries and exposure to health hazards
Among foreign-born Latinos, 59% higher work-related injury death rate than U.S.-born Latinos
(CDC, 2008)
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Migrant Health Issues
Occupational Health Exposure to pesticidesSkin disordersInfectious diseasesLung problemsHearingVision disordersStrained muscles and bonesUnsanitary conditions and lack of potable water.
Migrant LifestyleProcess of migrationOral HealthMental Health
3 NCFC. “Fact Sheet: Occupational Health and Safety.” http://www.ncfh.org/docs/fs-Occ%20Health.pdf
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Environmental Health Issues
A large percentage of Latinos live and work in urban and agricultural areas exposed to dangerous hazards: Air pollutants like ETS (environmental tobacco
smoke), CO (vehicle exhaust), and natural gases Pesticides Unsafe drinking water Lead and mercury
contamination
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Ways Ethnic/Racial Minorities are Disadvantaged in Health General health status, characterized by higher
rates of chronic/disabling illness
Lower likelihood of having health insurance
Linguistic barriers between the provider and patient
Racial attitudes and discrimination
Historical experiences, such as migration and segregation
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Cultural, Linguistic and Literacy Level-Specific Barriers to Care
Limited English proficiency may negatively affect use of health care services
Spanish-only speaking Latino parents often rely on their English-speaking children to translate and mediate between them and their doctors
Health care quality is rated lower when the patient and provider speak different languages. 3
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Cultural, Linguistic and Literacy Level-Specific Barriers to Care
Communicating directly with health professionals in a common language is associated with level of trust and confidence in medical settings.
When patients and providers speak the same language, foreign-born Latinos report that communication is improved and health care quality is perceived as better. 3
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Health Care Gaps for Latinos
Lower likelihood of seeking or receiving health care services
Employers do not offer coverage Thinking that one is healthy so we do not
need it Cultural lifestyle Barriers to access health care contributes to
lower health status and higher rates of morbidity and mortality
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Latino Access to Health Care
2 key components of health care access for Latinos:
Lack of medical insurance
Lack of regular health care provider
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Latino Access to Health Care
Latinos have lowest rates of health insurance coverage in the U.S. and in CA
Latino subgroups with the lowest rates of health insurance coverage Central Americans 39%; 42% Mexicans 29%; 42%
3
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Access to Health Care – Health Insurance Coverage in U.S.
Latinos Whites Blacks Asians Total U.S. population
No Health Insurance Coverage
31.0% 13.3% 18.1% 14.8% 15.1%
With Private Health Insurance Coverage
42.6% 72.1% 52.3% 70.8% 67.4%
With Public Health Coverage
30.5% 27.3% 37.6% 19.8% 28.5%
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Access to Health Care – Health Insurance Coverage
in CALatinos Whites Blacks Asians Total CA
population
No Health Insurance Coverage
28.9% 16.0% 16.1% 13.9% 18.0%
With Private Health Insurance Coverage
43.9% 66.4% 57.1% 69.7% 62.6%
With Public Health Coverage
30.7% 27.8% 35.6% 21.8% 27.7%
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Latino Access to Health Care
In a survey conducted by the Pew Hispanic Center (2007) with a nationally representative sample of 4,013 Latinos 60% non-citizens not legal permanent
residents lacked health insurance coverage 28% of citizens or legal permanent
residents lacked health insurance coverage
Livingston, G. (2009, September 25). Hispanics, health insurance, and health care access. Retrieved from http://pewhispanic.org/files/reports/113.pdf
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How do we improve access to care for Latinos?
Single payer (HR 676, SB 810) Change in public perceptions and policies that
facilitate access to health care among recent Latino immigrants
Health care for all Improving cultural competency among health
care Providers Utilizing and engaging Community Health
Workers (Promotore/as) Reforms to improve the social and physical
environments in which Latinos livePerez-Escamilla, R. (2010). Health care access among Latinos: Implications for social and health care reforms. Journal of Hispanic Higher Education, 9(1), 43-60.
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Why Minority Health is Important?
Explosion in Latino and Asian populations Increased immigration and increased
fertility By 2050, racial/ethnic “minorities” will be
the majority (LaVeist, 2002)
The health of U.S. racial/ethnic groups will inevitably reflect the health of the nation as a whole--“Their” health will be “our” health.
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¡Gracias!
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References
1. U.S. Census Bureau. (2009). Facts for features: Hispanic heritage month 2009: Sept. 15 – Oct. 15 [Fact sheet]. Retrieved March 17, 2010, from http://www.census.gov/Press-Release/www/releases/pdf/cb09ff-17_hispmonth09eng.pdf
2 U.S. Census Bureau. (2009). 2009 American Community Survey 1-year estimates [Data file]. Retrieved December 20, 2010, from http://factfinder.census.gov/servlet/DatasetMainPageServlet?_program=ACS&_submenuId=&_lang=en&_ts
Andalo, P. (2004). Health for one and all: Latinos in the USA. Perspectives In Health, 9(1), 2004
4. http://www.pewhispanic.org/2012/06/27/country-of-origin-profiles/