Latino Health: An Evolving Health Matter

The current issue of Family & Community Health focuses on Latino health, which is an evolving public health matter in the United States, given the major shifts experienced by this population in the past decades. Latinos/Hispanics have become the largest racial/ethnic minority in the United States, comprising 17.3% of the total US population.1 Although a large percentage of this increase has been attributed to immigration that occurred in the past 4 decades, the number of foreign-born Latinos has actually declined in the past 10 to 15 years.1 However, the number of US-born Latinos has increased, making Latinos the youngest racial/ethnic group in the United States.1 In addition, Latinos have settled in new areas of the country, such as the US-South, which experienced the fastest-growing Latino population in the country in the 1990s and 2000s.2 However, new data have shown that, due to the economic recession, the 3 fastest-growing Latino counties since 2007 are in North Dakota.2 Finally, Latinos have become one of the most heterogeneous racial/ethnic groups in the United States from cultural, social, economic, and genetic perspectives.3

Contributing authors address some of the broad issues with regard to Latino health, such as the importance of understanding the heterogeneity of this population, acculturation, and assimilation. Zhen-Duan and colleagues examined the demographic factors associated with barriers to heath care among Mexican and Guatemalan immigrants in an emerging Latino destination (Cincinnati). In addition to the expected cultural differences of 2 populations emigrating from different countries, they called attention to the heterogeneity within each subpopulation and its relevance in the development of tailored interventions.

Although further studies are needed toward consistent assessment of acculturation and assimilation, some studies have shown these constructs to be relevant when working with immigrant populations. Garcia et al examined the association between language spoken at home (preferred language) and citizenship/nativity (acculturation indicators) and periodontitis among Mexican Americans, the largest subgroup of Latinos in the United States. Individuals who indicated Spanish as their preferred language were significantly more likely to have periodontitis than Mexican Americans who indicated English as their preferred language, after adjusting for a number of variables. On the contrary, Plasencia and colleagues obtained different results when examining acculturation and type 2 diabetes self-management among Mexican Americans. They found that acculturation was associated with less favorable diabetes control, fiber density, physical activity, and more physical disability. Although direct comparisons between these 2 studies cannot be made, given differences in sample size, acculturation assessments, and data analyses, these results show that acculturation may play different roles depending on the health outcome.

Florez and Abraido-Lanza went one step further to better understand how acculturation may play a role in health outcomes by focusing on obesity as an outcome. They posited that in the process of assimilation, immigrants follow different patterns and it is important to consider these patterns when developing strategies to promote health and prevent disease. They found segmented assimilation, characterized by rapid economic and educational advancement while intentionally maintaining ethnic values, to be protective with regard to obesity, compared with second and third generations.

Two of the articles in this issue indirectly address cervical cancer, a disease that disproportionally affects Latinas as compared with white women. Once it was established that cervical cancer is caused by persistent cervical infections with certain carcinogenic or high-risk human papillomavirus (HPV) genotypes, 2 approaches to cervical cancer prevention have emerged: HPV vaccination and HPV testing. Both are effective if administered in an age-appropriate manner.4-9 However, access to these technologies has not been equal across subpopulations, including Latinos.10 Morales-Campos and Parra-Medina examined factors associated with HPV vaccination initiation and completion among daughters aged 11 to 17 years of Latina mothers living in the Texas-Mexico border. Schiffner and colleagues conducted a qualitative study about Mexican American college men's understanding of HPV and cervical cancer. Given that HPV is sexually transmitted, it is critical to engage men in cervical cancer prevention (including HPV vaccination). Both studies provide preliminary data on the importance of engaging parents (HPV vaccination) and partners (sexual risk reduction) in cervical cancer prevention and control among Latinos.

The last 2 articles in this issue focus on youth, which is of great relevance, given that Latinos are the youngest racial/ethnic group in the United States. Both studies had Community-Based Participatory Research as their philosophical framework and addressed the importance of engaging youth, parents, and other stakeholders in the development of prevention strategies among Latino youth.

In summary, this issue provides a snapshot of the work ahead in health promotion and disease prevention among Latinos. As researchers, we have a great opportunity and responsibility. Latinos are young, and we have the opportunity to intervene early and prevent disease. We also have the responsibility of sharing our scientific knowledge with these communities and engaging them in finding solutions and strategies that meet their needs. We thank the contributing authors for the thoughtful research.

-Isabel C. Scarinci, PhD, MPH

Associate Director for Faculty Development

Division of Preventive Medicine

Associate Director for Globalization and Cancer

Comprehensive Cancer Center

University of Alabama at Birmingham

-Mercedes Morales-Aleman, PhD

Assistant Professor

Community and Rural Medicine

The University of Alabama

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