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

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

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

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

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)

Characteristics of Latinos in the U.S. and in California

CharacteristicsAge IncomeEducationEmployment

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

2

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%

3

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

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…

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%

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%

Latino Cultural Values

Strong family ties Familismo

Values Respeto Confianza

Religion Espiritismo

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)

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)

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

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

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

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)

Specific Health Issues among Latinos

Chronic Diseases Infectious Diseases Occupational Health Issues Environmental Health Issues Cultural, Linguistic and Literacy Level-

Specific Barriers to Care

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)

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

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

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

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

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

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

Latino Access to Health Care

2 key components of health care access for Latinos:

Lack of medical insurance

Lack of regular health care provider

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

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%

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%

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

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.

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.

¡Gracias!

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/