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10/29/91

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Health researchers explore trends in Latino communities

STANFORD -- Adopting American-style health behavior may not always be good for immigrants, those who study the health and well- being of Latino children and mothers said Oct. 25 at a conference hosted by the Stanford Center for Chicano Research.

Consider these research findings:

  • Babies of immigrant Latino mothers are larger at birth and survive infancy at a higher rate than babies of Latino mothers who were born in the United States, according to studies of birth certificates by Stephanie Ventura of the National Center for Health Statistics.
  • Even without professional prenatal care, the immigrant mothers tend to have healthier babies than their American-born counterparts.

Both trends were greatest within the Latino subgroup hailing originally from Mexico but also was present for Puerto Rican and Cuban American subgroups.

  • The infant-survival rate of Mexican-born immigrants would rank seventh in the world, just behind Germany and well ahead of the United States' overall ranking of 19th.

"We need to understand this. I can't tell you why [it is so]," David Hayes-Bautista, director of UCLA's Chicano Studies Research Center, said at the opening session of the two-day conference of researchers. The strength of the nuclear family among Latino immigrants may have something to do with it, he postulated.

Birth certificate studies of infant mortality and birth weight suggest that "acculturation may not be positive," Ventura said. Her analyses indicate that teenage Latino mothers who are American born tend to smoke and drink more, and they are more likely not to be married when they have their first child.

Sponsored by the national Inter-University Program for Latino Research and funded by the Ford Foundation, the working-group conference brought together about two dozen researchers to discuss how to better study the health and well-being of Latino children and mothers. The scholars formed three subgroups to design studies in the areas of the health and welfare of Latino women of child-bearing age, school readiness and adolescent risk.

Studies of Latino subgroups are important to everyone's health and well-being, researchers said, because they can help unravel genetic, behavioral and environmental contributors to health status.

For Mexican Americans, there is no consistent genetic profile, said Fernando Mendoza, a pediatrician who is director of the Stanford Center for Chicano Research.

Cultural practices - or the behavioral component of Latino health - he said, has been oversimplified in studies so far, which have primarily looked at language-use patterns as a rough indicator of "acculturation" to the United States.

"It may be that traditional [Latino] activities around pregnancy are very helpful," Mendoza said of the infant mortality and birth weight statistical patterns. "The idea that one has self-control over your health is very important in Latino culture."

Mothers less acculturated to American society express more concern for their children's health overall, he said. In one study that Mendoza and colleagues conducted, 26 percent of Spanish-speaking Mexican American mothers perceived their children's health as poor compared to only 8 percent of the English-speaking Mexican American mothers. The English-speaking mothers' perception was comparable to the perception of U.S. mothers overall, Mendoza said.

The Spanish-speaking parents also perceived more problems with their children's health than did doctors who made an assessment based on a one-time office visit.

"To me this says that either the children actually are in poorer health or the Spanish-speaking mothers have a different perspective on health," Mendoza said. "We don't understand why there is greater concern and what they do with that concern. Perhaps when you are less acculturated, you are doing things that are very helpful, things I call 'buffers of poverty.' "

In another study, Mendoza and colleagues found that Mexican American height does not appear to be related to genetic makeup. When controlled for poverty, Mexican American children grow as tall as others and even taller than middle-class Mexicans in Mexico City.

Height, generally used by researchers as an indicator of the overall nutrition of a population, may be inadequate for assessing health of subgroups in the United States, he said.

"Poverty is more associated with obesity in this country than with frank malnutrition, and poor nutrition leading to obesity can be as bad as malnutrition," Mendoza said. "Probably the biggest public health problem that Mexican American children have is obesity, which can lead to risk for adult-onset diabetes. The weight problems start as early as age 6."

It wasn't until 1976 that the U.S. government conducted a separate analysis of the U.S. Latino population. The first generation of socio-economic studies that followed documented basic demographic facts about subgroups that included Mexican Americans, Puerto Ricans and Cuban Americans, said Marta Tienda, a professor of sociology and public policy at the University of Chicago.

Now, a second generation of "cross-section" studies - such as those on infant mortality, birth weight and height - search for "not what is happening, but why," Tienda said. So far, she said, "it's not always obvious how health and economic well-being are linked." Some anomalies reported by ethnic groups, she said, may prove instead to be associated with economic stratification.

Some research findings may be based on inadequate study design, said Aida Giachello, a professor of social work at the University of Illinois-Chicago. She questioned whether substance abuse is, in fact, greater among Latinos who speak English and who are better educated, or if they are more likely to self report such use. "Somehow we have done a good job of collecting data so it does not fit with what we see in the barrio," Giachello said.

Giachello also complained that women are not being adequately treated for AIDS or included in clinical trials. Heterosexual transmission of AIDS predominantly affects Latino and African American women and children, she said, and statistics indicate the women are being diagnosed in late stages of the disease.

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