Abstract
There are many health issues that confronts the Hispanics/Latino elderly population in the United States. Among them are diabetes and dementia.
This paper will deal with the various issues that have an effect on the Hispanic/Latino elderly population in the United States.
Issues the Impact Hispanic/Latino Elderly Population
During the last decade, the Latino community has grown twice as much in terms of size and has made its presence felt in nearly all sector from music to food, apparels, books, and movies. As the number of Hispanic/Latinos continue to increase, more and more establishments are beginning to understand the importance of having Spanish-English bilingual speakers in their fold (Credit Union National Association, n.d).
Since 1990, Hispanic/Latino population originating from Central or South America in the United States has gone up 5.6 percent with Mexicans, Puerto Ricans, and Cubans still comprising more than fifty percent of the Hispanic population (Credit Union National Association, n.d).
Here are some facts and figures about this group of people:
An estimated 27 million Hispanics/Latinos live in the United States and the number continues to grow. Hispanic/Latinos are the second largest minority group in the United States (Oak Ridge Institute, 1997).
Mexican-Americans comprise the largest Hispanic/Latino population in the United States making up 64% followed by Puerto Ricans, Central and South Americans, and Cubans in that order (Oak Ridge Institute, 1997).
Most Hispanic/Latinos reside in 20 urban areas in 10 states namely California, Texas, Florida, Illinois, New York, Arizona, Massachusetts, New Jersey, Colorado, and New Mexico (Oak Ridge Institute, 1997).
Hispanics have Indian, European, and African origin. They are culturally diverse (Office of Minority Health, 1997).
Puerto Ricans are regarded as American citizens. “Operation Bootstrap” paved the way for annual migrations of thousands of Puerto Ricans to agricultural farms in the Northeast. From 1970 to 1990, many Hispanics returned to Puerto Rico because of decreasing economy in the United States (Office of Minority Health, n.d).
Colombians have been flocking to the United States since 1950s due to economic reasons. Meanwhile, Dominicans have been migrating in the United States since the 1960s after the latter supported a military coup in the Dominican Republic (Office of Minority Health, 1997).
On a national level, Hispanics are four to six times more likely to read English below fourth grade than the entire US population. They have low literacy rate when it comes to Spanish as the rate of literacy would depend on the socioeconomic background and education of the individual (Office of Minority Health, 1997).
Issues Surrounding Hispanic/Latino Elderly Population
Health Issues
While the Hispanics/Latinos are the largest minority group in the United States, they continue to face a wide range of challenges that have an impact on their lives. One of the most crucial challenges is the aspect of health especially since Latinos only consult their doctors when they are really ill or when they are in a vulnerable position (Rios-Ellis, 2005).
Diabetes.
Diabetes ranks seventh among the leading causes of death among the Hispanic/Latino Americans and the fourth leading cause of mortality among women and elderly. Compared to other populations, Hispanic/Latinos registered the second highest number of Non-Insulin Dependent Diabetes (NIDDM) (Oak Ridge Institute, 1997).
Among the Hispanic population, the percentage of NIDDM is 110% higher in Mexican-Americans and 120% greater in Puerto Rican Americans compared to non-Hispanic whites. A study revealed that the incidence of NIDDM in poverty-stricken Mexican Americans residing in transitional income communities is four times greater than in wealthier Mexican Americans as well as non-Hispanic white population (Oak Ridge Institute, 1997).
In addition, the study likewise revealed that in Hispanic-Latinos aged 45 – 74 years old, the likelihood of diabetes is two to three times higher in Mexican Americans as well as Puerto Ricans than in Cuban Americans and non-Hispanic whites. The reason for this is that Mexican Americans show some level of biological resistance to the normal effect of insulin in the body, when combined with high level of fat and high blood pressure, can lead to higher rate of morbidity due to NIDDM (Oak Ridge Institute, 1997).
Diabetes manifests itself early in Hispanics/Latinos than in non-Hispanic whites, showing itself ten years earlier in Hispanics/Latinos (50-59) compared to non-Hispanic whites (60-69), and much earlier in Puerto Rican Americans and Mexican Americans, which is the most endangered population group (Oak Ridge Institute, 1997).
In contrast with other population, Hispanics/Latinos are not only in greater danger from diabetes but also likely to suffer from the side effects of diabetes. There are various risk factors playing a vital role in the prevalence and effect of diabetes among Hispanic/Latinos:
Overweight is a vital risk factor for incurring diabetes in all populations, especially for minorities. According to a HHANES survey conducted in 1984, overweight Hispanics/Latinos are at greater risk of suffering from diabetes than overweight non-Hispanic whites and blacks. In Mexican Americans, approximately 30% of men and 39% of women are overweight. The trend is similar among Cuban and Puerto Rican population (Oak Ridge Institute, 1997).
Hispanic/Latino Americans have a sedentary lifestyle compared to non-Hispanic whites. It seems that the therapeutic advantages of exercise is not clearly understood. Some respondents to focus groups likewise have the belief that exercise is only for the affluent who have the money to pay for health club memberships (Oak Ridge Institute, 1997).
The prevalence of diabetes among Mexican American families with a background of diabetes is high, as 72% of parents, 37% of siblings, and 11% of offsprings are affected, compared to Mexican American families with no history of diabetes in their families (Oak Ridge Institute, 1997).
The number of Hispanic/Latino elderly who have not consulted a doctor because it is expensive is twice as much than non-Hispanic/Latinos. They are more likely to have insufficient health insurance or to be uninsured compared to other ethnic groups in the United States (Oak Ridge Institute, 1997).
According to a study involving low-income Mexican Americans in California, emotional stress plays a role in the occurrence of diabetes. Many of them doubted or concurred that injecting insulin can have harmful effects. It was likewise revealed that only 38% felt that diabetes cannot be treated (Oak Ridge Institute, 1997).
In addition, the study likewise revealed that Latinos who have lived in the United States for a long time would be more knowledgeable about diabetes. However, many people had no qualms about being screened for diabetes (Oak Ridge Institute, 1997).
Moreover, diabetes is an issue that needs to be discussed with the family. This is because it is the tradition of Hispanics not to burden their families with matters concerning diabetes. Thus, it is unlikely for a diabetic Latino to discuss this issue with their family or follow a diet regimen and lifestyle change without getting encouragement and support from the members of their family (Oak Ridge Institute, 1997).
Dementia
Dementia is emerging as one of the most unrecognized public health issues facing the Hispanic/Latino communities in the United States. Prior to the first half of the twenty first century, the percentage of Hispanic elders with Alzheimer’s and related dementias could go up more than six times, from less than 200,000 currently to 1.3 million come 2050 (Novak & Riggs, 2004).
Although research is just starting to unfold the effect of Alzheimer’s disease among Hispanics, present data reveals that this population is at a much greater risk of suffering from this disease. The most prone individuals to be inflicted with dementia is the women because of their strong sense of filial love and the role that the female population have in the Hispanic/Latino population as well as the absence of responsive health and community services (Novak & Riggs, 2004).
Dementia is likewise prominent because of the heterogeneous nature of the Hispanic/Latino population. Thus, when addressing the problem of dementia among the Hispanics, it is important to consider their language, culture differentiation, and policy. Here is a breakdown of the most common risk factors for Alzheimer’s disease (Novak & Riggs, 2004):
Age is the greatest risk factor for Alzheimer’s disease among Hispanics, as its prominence on elders more than 65 years old increases by twice as much every 5 years and 47 percent of persons who are more than 85 years old. By 2050, the total life span of Hispanics would reach 87 years, which exceeds all other minority groups in the United States. By this time, the population of the elderly among the Hispanics would increase from the current 5% to 16% (Novak & Riggs, 2004).
Education seems to be an effective protection against Alzheimer’s disease. The Hispanic population has the lowest level of education in any group in the United States. One out of ten Hispanic elders have no formal education. More than half of them have less than 8 years of schooling (Novak & Riggs, 2004).
Increasing number of evidence points to vascular diseases as potential risks for Alzheimer’s and stroke-related dementia. The incidence of these two risk factors are very high among Hispanics. In a study conducted on elder Mexican Americans, it was discovered that type 2 diabetes as well as hypertension can lead to dementia. 43% of those with dementia suffered from diabetes, stroke, or both (Novak & Riggs, 2004).
Unfortunately, it is only now that research is starting to get a clearer picture of dementia among the elder people with Hispanics/Latino origin. Limited data obtained from research indicates that differences within the groups may have an impact on the prevalence of dementia. However, there is still much work to be done in order to determine an effective method of treatment, management, and prevention of dementia among the Hispanic/Latino population (Novak & Riggs, 2004).
Research likewise indicates that Alzheimer’s disease seems to be caused by genetic risk factors that has the same impact in non-Hispanic whites. Additional research has found proof that Hispanics are susceptible to genetic risk factors which are connected to insulin metabolism, thereby proving the fact that there are vascular and metabolic pathways that may contribute to Alzheimer’s both (Novak & Riggs, 2004).
When it comes to treatment and management of dementia, Hispanics/Latinos are not getting sufficient health care needed to lower the complications of dementia. Clinical experience as well as a huge body of evidence proves that Hispanics/Latinos are minimal users of formal services. It is unlikely that non-Hispanics would consult a physician or take advantage of services provided by other health professionals. Among the population with diabetes, high blood pressure, or cardio-vascular diseases, it is unlikely for Hispanics to take advantage of services that will facilitate the monitoring and control of these factors. As a result, the risk of dementia may be greater in Hispanics and Latinos both (Novak & Riggs, 2004).
There are several factors that contribute to the poor care of dementia among Hispanics/Latinos. Here are the obstacles to efficient dementia care among this population:
Most of the Hispanic elders are first generation immigrants who are uncomfortable with English or are awkward with a health care system. The failure of most health and community care systems to communicate in Spanish as well as their cultural apathy is a major factor why Hispanics are not at all comfortable with health care both (Novak & Riggs, 2004).
Elder Hispanics have fewer health insurance compared to their non-Hispanic counterparts. More than 25 percent of 50-64 year old Hispanics suffering from a chronic condition do not have insurance. Hispanics who are more than 65 years old depend on public insurance such as Medicare and Medicaid both (Novak & Riggs, 2004).
Cultural Issues
The cultural orientation of the Hispanics serves as a barrier on why Hispanics refuse to avail of formal treatment method. For Hispanics, their religion has something to do on how they view diabetes as well as their openness to accept treatment plans. For them, they have a fatalistic view of diabetes (Oak Ridge Institute, 1997).
For the Hispanics, God has a positive or negative influence in personal health. According to a National Council of La Raza report, the strong religious beliefs of the Hispanics/Latinos may be one factor why they have an ambivalent attitude towards the prevention, treatment, and control of diabetes among their ranks (Oak Ridge Institute, 1997).
For most Hispanic elderly, any change in diet or lifestyle required to prevent diabetes can be a source of depression. They view diabetic diets as limited and boring because it does not allow the patient to enjoy a variety of foods. They cannot bear the burden of eating these diets while the other members of the family continue to enjoy traditional foods (Oak Ridge Institute, 1997).
In addition, majority of Hispanics/Latinos have the belief that an individual sees the doctor only when they are really sick and it is unlikely for them to consult a physician for screening or preventive procedures. Playing a crucial role in this aspect are lack of a health plan, availability of culturally compatible health care system, and finances. Since diabetes does not manifest signs or symptoms, most Hispanics would only consult a doctor when the situation is already very critical (Oak Ridge Institute, 1997).
Aside from that, reports have indicated a strong sense of filial piety for their older relatives, particularly among Hispanic daughters. This is an indication that it is unlikely for Hispanics to reside in a long term care facility and would prefer to live with kins compared to other groups except Asian Americans. If they do agree to live in a nursing home, it is likely that they would experience cognitive and functional impairments compared to non-Hispanic whites (Oak Ridge Institute, 1997).
Other studies have also revealed that, aside from their filial piety, other reasons for the reluctance of Hispanics/Latinos to use formal treatment includes distrust of outsiders, recognition that stress is a part of familial responsibility, and resistance to sharing familial concerns with other people (Oak Ridge Institute, 1997).
Other Key Issues Affecting Hispanics/Latinos
Aside from health concerns, Hispanic/Latinos likewise face the problem of language barriers. For Hispanics who have minimal knowledge of English, they are prone to having difficulties availing of medical care as well as face the prospect of greater difficulty with communicating with their health care provider concerning their medical issues. According to a study by the Commonwealth Fund, almost half of Spanish-speaking Latinos encountered difficulties relating their problem with their physician as well as difficulty understanding directions for prescription medicines and written information from a physician’s office (Rios-Ellis, 2005).
Immigration Issues
Most Latinos in the United States are native born but there are immigrants as well. When it comes to immigration and acculturation issues, immigrants perform better than the non-immigrant ones. Factors such as isolation due to absence of health insurance, minimal or zero knowledge of the health care system, and insufficient Spanish-speaking providers, have a role in the difficulty of Latinos in acculturation (Rios-Ellis, 2005).
Realizing the immigration issues that Hispanic/Latinos face, the Center for Human Services (CHS) implemented the new Hispanic-Latino initiative in 2007 in order to address these concerns. The CHS is aware that the lack of understanding and increasing concern about immigration issues are crucial because they can bring about economic and social concerns. Aside from that, the Hispanic-Latino Initiative likewise aims to bridge the language and cultural gap between Hispanics and service providers in the United States (Center for Human Services, n.d).
Under the new initiative, Latinos will have more access to services which focuses on behavior change, education, and skill development. Likewise, the Hispanic-Latino initiative aims to strengthen community awareness and participation of Hispanic Latinos (Center for Human Services, n.d).
The initiative will focus on vital issues in the field of health and education. The projects for the former include addressing the problem of obesity, diabetes, nutrition, HIV/AIDS, and lifestyle. When it comes to the latter, the Hispanic-Latino Initiative will provide services on English as Second Language (ESL), High School Equivalency (HEP), and vocational training (Center for Human Services, n.d).
Conclusion
While the Hispanics/Latinos are the largest minority group in the United States, they continue to face a wide range of challenges that have an impact on their lives. One of the most crucial challenges is the aspect of health especially since Latinos only consult their doctors when they are really ill or when they are in a vulnerable position.
Diabetes ranks seventh among the leading causes of death among the Hispanic/Latino Americans and the fourth leading cause of mortality among women and elderly. Compared to other populations, Hispanic/Latinos registered the second highest number of Non-Insulin Dependent Diabetes (NIDDM).
Dementia is emerging as one of the most unrecognized public health issues facing the Hispanic/Latino communities in the United States. Prior to the first half of the twenty first century, the percentage of Hispanic elders with Alzheimer’s and related dementias could go up more than six times, from less than 200,000 currently to 1.3 million come 2050.
Aside from health concerns, Hispanic/Latinos likewise face the problem of language barriers. For Hispanics who have minimal knowledge of English, they are prone to having difficulties availing of medical care as well as face the prospect of greater difficulty with communicating with their health care provider concerning their medical issues. According to a study by the Commonwealth Fund, almost half of Spanish-speaking Latinos encountered difficulties relating their problem with their physician as well as difficulty understanding directions for prescription medicines and written information from a physician’s office.
References
Hispanic/Latino Americans and Diabetes. Oak Ridge Institute. Retrieved September 9 2008 from
http://www.orau.gov/cdcynergy/demo/Content/activeinformation/resources/DB_Hispanic_Latino_and_Diabetes-Audience_Profile.pdf
Hispanic-Latino Initiative. Center for Human Services. Retrieved September 9 2008 from
http://www.chs-urc.org/CHSHLINITIATIVE.html
Latino/Hispanic Culture & Health. Office of Minority Health. Retrieved September 9 2008 from http://www.health.state.ri.us/chic/minority/lat_cul.php
Novak, K., & Riggs, J (2004 March 18). Hispanics/Latinos and Alzheimer’s disease. Alzheimer’s Organization. Retrieved September 9 2008 from http://www.alz.org
Rios-Ellis, B (2005). Critical Disparities in Latino Mental Health: Transforming Research into Action. National Council of La Raza. Retrieved September 9 2008 from
http://www.depressionisreal.org
What the Hispanic Population Looks Like. Credit Union National Association. Retrieved September 9 2008 from http://www.cuna.org
