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Stanford Report, August 20, 2003

Interventions critical to Mexican immigrant health Outreach programs should focus on diet, weight control, study finds


By SARA SELIS

A medical center study has cast light on the health risks and behaviors of women and men from Mexico who have lived in the United States for many years. This rapidly growing segment of the U.S. population, whose health needs are often misunderstood or neglected, would benefit from improved nutrition, weight reduction and colorectal cancer screening, the study revealed. It also indicated that certain aspects of life in the United States may actually increase health risks for immigrants from Mexico.

Past studies have examined the health behaviors of Latinos in the United States but have considered Latinos as one large group, said Marilyn Winkleby, PhD, associate professor of medicine at the Stanford Center for Research in Disease Prevention and senior author of the paper published in the summer issue of Ethnicity and Disease.

In reality, the U.S. Latino population consists of important subgroups with different health risks and needs. In California, the largest subgroup is people from Mexico. Furthermore, Winkleby noted, many studies have missed some subgroups, such as farmworkers in labor camps, because they often don’t have a permanent residence or regular contact with health-care providers.

"Given that Latinos are this country’s fastest-growing ethnic group, we don’t know nearly as much as we should about their health needs," she said. The study, conducted in late 2000 in collaboration with public health officials, surveyed nearly 1,000 women and men living in California’s Monterey County and close to 200 male farmworkers living in labor camps in that county.

Respondents were asked about health behaviors including diet, exercise, alcohol use and cancer screening. The survey was conducted by phone for the community sample and in person for the labor-camp sample. It achieved an unusually high response rate: 87 percent for the community sample and 98 percent for the labor-camp sample.

The survey revealed an increasingly stable population of Latinos in California. While most respondents were born in Mexico and spoke primarily Spanish, 80 percent of the community sample and almost 50 percent of the labor-camp sample had lived in the United States for at least 10 years.

The good news from the survey included low smoking rates (more than 80 percent of the women and nearly half the men from the labor camps reported they had never smoked) and high rates of cervical and breast cancer screening (87 percent of the women had a Pap test within the past three years and 69 percent of women over age 40 had a mammogram within the past two years).

The bad news included poor nutrition and high rates of obesity, even among the farmworkers. Also troubling was the screening rate for colorectal cancer: 70 to 80 percent of the community sample and 100 percent of the labor-camp sample had never been screened.

One significant finding concerned the negative impact of living in the United States. The survey revealed that for every five years the respondents had lived in this country, the odds of obesity increased 25 percent for women, and the odds of high fat/fast food intake and high alcohol use increased 35 percent and 50 percent, respectively, for the labor-camp men.

Winkleby said the results showed that interventions are needed for Mexican immigrants in the United States, with a focus on obesity, nutrition, screening for colorectal cancer, and high alcohol use for men. Even simple, low-cost strategies can be effective, she explained, citing efforts by agricultural employers in Monterey County to provide healthy foods for farmworkers in cafeterias and on field trucks.

The survey also demonstrated the need to expand Latinos’ access to health insurance and routine medical care. About 30 percent of the community sample and 65 percent of the labor-camp sample had no health insurance, and more than 25 percent of the labor-camp sample had not seen a doctor for five years or more.

A program for which Winkleby is seeking funding in conjunction with the Monterey County Health Department would improve Latinos’ access to health-care services and cancer information by keeping community clinics open on weekends and evenings and establishing partnerships with fast-food restaurants to provide culturally appropriate, Spanish-language cancer information.

Winkleby noted that among Latino communities, "there are strong barriers to cancer detection and treatment and a lack of awareness about the benefits of early detection." She also cited poor access to health-care services, language barriers and a medical system that can seem intimidating to this group.



New studies suggest United States falls short on Mexican-American health (5/12/99)

Life in poor neighborhoods may signal greater mortality risk (7/23/03)