Monday, October 15, 2012
(HealthDay News) -- Language barriers may help explain why Hispanic women in the United States are less likely than white women to receive an epidural for pain relief during childbirth, a new study finds.
Epidurals are the most effective way to manage pain during labor and delivery, but past studies show that Hispanic women have the lowest rates of epidural use.
For the new study, Northwestern University researchers analyzed the medical records of more than 1,400 Hispanic women who gave birth at a large urban maternity hospital. Spanish-speaking Hispanic women were less likely than English-speaking Hispanic women to receive an epidural (66 percent versus 81 percent, respectively), the investigators found.
In addition, the findings showed that 96 percent of all women who requested an epidural received one, which suggests that the hospital system is not responsible for the lower epidural rate among Spanish-speaking Hispanic women.
The findings are scheduled for presentation Saturday at the annual meeting of the American Society of Anesthesiologists in Washington, D.C.
"The study is important because it reveals a health care delivery disparity among Hispanic women based on spoken language," study author Dr. Paloma Toledo, of the department of anesthesiology and program for health equity at Feinberg School of Medicine, Northwestern University, said in a society news release.
"These findings, along with future research, will help us identify and target interventions, whether they are at the system, provider or patient level, to better educate Spanish-speaking Hispanic women about their pain relief options during labor," she added.
The data and conclusions of research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed journal.
SOURCE: American Society of Anesthesiologists, news release, Oct. 13, 2012
Thursday, October 11, 2012
(HealthDay News) -- Hispanic Americans are diagnosed with HIV infection nearly three times as often as whites, but rates and causes differ by region, a new study finds. HIV is the virus that causes AIDS.
For the study, researchers analyzed 2010 data from 46 states and Puerto Rico and found that the rate of HIV diagnoses among Hispanics in the Northeast (55 per 100,000 people) was more than twice that of any other region in the United States.
The investigators also found that the largest percentage of HIV diagnoses among Hispanics occurred in the South (35.4 percent).
Male-to-male sex was the primary method of HIV transmission among Hispanics overall, but those living in the Northeast were more likely to have been infected through injection drug use than Hispanics with HIV in other regions, the study authors noted in a news release from the U.S. Centers for Disease Control and Prevention.
Hispanics in the Northeast were also more likely to be of Puerto Rican descent, while those in other regions of the country were more likely to be of Mexican or Central American descent, according to the report published in the Oct. 12 issue of the CDC's Morbidity and Mortality Weekly Report.
When compared with Hispanics in the 46 states included in the study, those in Puerto Rico diagnosed with HIV were more likely to have contracted the virus through injection drug use or sexual contact with a member of the opposite sex.
These regional differences require that HIV testing, prevention and treatment efforts be tailored to the different needs of these regions, concluded researcher Qian An of the division of HIV/AIDS prevention at the CDC National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, and colleagues.
SOURCE: U.S. Centers for Disease Control and Prevention, news release, Oct. 11, 2012
Hispanics Heart Disease and StrokeHeart disease is the No. 1 killer for all Americans and stroke is the fourth leading cause of death. Hispanics and Latinos, however, face even higher risks of cardiovascular diseases because of high blood pressure, obesity and diabetes.
There is good news in the fact that a few simple lifestyle changes can reduce the chances of getting these diseases. Yet at the same time, Hispanics and Latinos face hurdles when it comes to making those changes and accessing health care, including language barriers, lack of transportation and lack of health insurance.
Those factors can make early diagnoses and management of risks difficult, said Martha L. Daviglus, M.D., Ph.D., a cardiovascular epidemiologist at Northwestern University and University of Illinois and an American Heart Association volunteer.
“Hispanics are more likely to delay care, drop out of treatment when symptoms disappear and avoid visits to the doctor,” Dr. Daviglus said.
High Blood Pressure
Hypertension, the medical term for high blood pressure, is a major risk factor for heart disease and stroke among Hispanics. Among Hispanics who experienced a stroke, 72 percent had high blood pressure, compared to 66 percent in non-Hispanic whites.
Checking your blood pressure regularly is an important first step for understanding your risks. If it’s high, work with your doctor to create a treatment plan. If it’s normal, be sure to keep checking it a couple times a year.
“If you do these things and are still unable to control your blood pressure, you will need to consult your physician and follow advice regarding medications to help lower blood pressure,” Dr. Daviglus said.
Obesity Is More Prevalent
Carrying extra weight is also a key risk factor for Hispanics. Seventy-five percent of Mexican-American men and 72 percent of women age 20 and older are overweight or obese.
That’s partly because of cultural influences, Dr. Daviglus said, pointing to popular fatty foods such as refried beans and sour cream.
But environmental factors also play an important role. Both parents work in many Hispanic families, which means it can be hard to find time to prepare healthy meals, Dr. Daviglus said.
“Any family with two working parents may find that $5 can get several hamburgers, but fruits and veggies are more expensive and take more time to prepare,” she said. “It’s an issue of time and money.”
Watching portion size, even for seemingly healthy foods, is important as well.
Getting plenty of exercise is also important. The National Health and Nutrition Examination Survey reported that 65 percent of Mexican-American men and 74 percent of Mexican-American women did not participate in leisure-time physical activity.
Dr. Daviglus said many Hispanics find it difficult to exercise because they work multiple jobs, or they live in areas lacking in safe walking areas or health clubs. In such cases you have to try to be creative to squeeze in 30 minutes of daily physical activity. Learn the American Heart Association's Guidelines for Physical Activity.
“If you can’t walk outside in your neighborhood, perhaps the area where you work is a safer choice,” she said. “Perhaps there is a nearby park with an indoor or outdoor track that can provide a secure area for walking.”
Diabetes Is Growing
An estimated 30 percent of adult Hispanics have diabetes, but as many as half don’t realize it. Untreated, diabetes can lead to serious complications, including cardiovascular disease and renal failure.
The prevalence of diagnosed diabetes in Mexican-Americans and Puerto Ricans between the ages of 24 and 74 was 2.4 times greater than in non-Hispanic whites.
“We’re seeing diabetes even in children and in much higher proportion than other communities,” Dr. Daviglus said. A family history of diabetes can be an important red flag signaling increased risks, but many of the risks for type 2 diabetes can be lowered with lifestyle changes and proper medical care.
“Make every effort to make healthy lifestyle changes,” Dr. Daviglus said. “Family history is important, but even if your parents or other family has diabetes, you can eat right and exercise and not get it.”
References and abstracts from MEDLINE/PubMed (National Library of Medicine)