Black and Latino males twice as likely to have poor health

Given the inequality in healthcare in the United States, it's no surprise that some groups of people suffer far worse health outcomes than people with better resources. But if there is one group that has been especially overlooked in this equation, it's black and Latino boys. The major factor in their poor health, according to a new report by the California Endowment, is where they live. Growing up in poor and stressful neighborhoods with limited healthcare resources leads to poor health.

According to the findings in the report:

• The odds of poor health outcomes for boys and men of color are more than two times higher than for white boys and men in California.
• Latino boys are 4.1 times more likely than white boys to suffer from post-traumatic stress disorder.
• African-American boys are 2.5 times more likely.
• Latinos are 3.1 times more likely to have limited access to health care and 4.8 times more likely to lack health insurance.
• Asthma disproportionately affects children who live in poorer neighborhoods.
  Black young men have a homicide rate 16 times greater than that of young white men.
• African-American and Latino children are 3.5 times more likely to grow up in poverty compared to whites.

Poorer neighborhoods mean less access to stores selling health foods, fewer parks and safe places to run and play in and fewer social networks to promote health and safety.

The California Endowment has launched a 10-year initiative, called Building Healthy Communities, to improve the health of men and boys of color by making strategic improvements in the communities and neighborhoods in which they live. In the report, the group identifies a handful of successful programs to improve the lives of men of color already in place in the state that could be applied on a larger scale -- and why implementing these programs statewide cannot wait.
 
-- Shari Roan

Photo credit: Carlos Chavez  /  Los Angeles Times

Latinos found to have much higher rates of vision disorders

Visual impairment, blindness, diabetic eye disease and cataracts are the highest among Latinos compared with any ethnic group in the country, according to a series of new studies.

The findings were released Saturday as part of the Los Angeles Latino Eye Study, which is supported by the National Eye Institute. The study, which began in 2000, is the nation's largest and most comprehensive study of vision in Latinos. Most of the study participants are of Mexican descent living in La Puente.

The study found 53% of people in Los Angeles' Latino community have eye disease and 63% are undiagnosed. Many of the conditions can be treated to improve vision.

"These results underscore the importance of Latinos, especially those with diabetes, getting regular, dilated eye exams to monitor their eye health," said Dr. Rohit Varma, principal investigator of the study and director of the Ocular Epidemiology Center at the Doheny Eye Institute at USC. "Eye care professionals should closely monitor Latinos who have eye disease in one eye because their quality of life can be dramatically impacted if they develop the condition in both eyes."

The American Academy of Ophthalmology will launch a pilot program targeting Latinos this summer called EyeSmart EyeCheck. The first screening is scheduled for July 25. Details about the screenings will be posted on geteyesmart.org. Those interested can go to the site and click on the EyeSmart EyeCheck logo for more information on screenings in their area.

The studies are published in the May issue of the American Journal of Ophthalmology.

-- Shari Roan

Photo credit: Flickr

More from the week: Chlamydia, breast cancer, Hispanics in nursing homes

They may not have made headlines this past week, but these research developments are worth noting. So consider them noted (if not thoroughly developed in this space).

-- One might think that frequently screening and treating teenage girls for chlamydia would cut back on just how common the disease is in that age group. Not so.

Turns out there are a lot of reinfections. Here's the abstract, published in the Journal of Infectious Diseases, and here's the news release from Indiana University.

-- We can talk about quality-of-care standards, but that doesn't mean doctors will follow them. When it comes to procedures to ensure coordinated cancer care, for example, most breast cancer surgeons might just go their own way.

So suggests a survey of surgeons in Detroit and Los Angeles. Here's the abstract, published in the January issue of Medical Care, and the news release from the University of Michigan Health System.

-- As for nursing home quality, elderly Hispanic people are more likely to live in not-so-good ones, at least as compared to their white counterparts. The findings come as the percentage of Hispanics in nursing homes increases.

Here's the abstract, published in Health Affairs, and the news release from Brown University.

-- Tami Dennis

Spanking toddlers: Poverty, punishment and preparation for life?

There's no topic more incendiary than spanking. Add to that the spanking of very young children by  mothers in minority, low-income households and you have a minefield.

A group of Duke University researchers has not only ventured into that minefield; it has also set off a few bombs in the process. Published in this month's issue of the journal Child Development, their study of 2,573 toddlers enrolled in Head Start found that for poor children, early and frequent spanking -- by the age of 1 -- is not only very common, but it also makes their behavior at age 2 more aggressive and by age 3 appears to have slowed their socio-emotional development.

They also found that a low-income mother is most likely to start spanking a very fussy, irritable baby by the age of 1, and more likely still if the mother is depressed. Boys were spanked and yelled at more often than girls, and the poorer the family the greater the likelihood the kids would be physically and verbally punished at an early age.

The collective results suggest that the causes and effects of spanking are tightly bound together, making it difficult to tease out the influence of poverty, genetics, gender differences and cultural expectations when discussing the controversial practice.

The American Academy of Pediatrics in 1998 issued a recommendation that parents find means to correct children's behavior other than corporal punishment. A large body of evidence suggests the practice is seldom effective and may have negative effects. But some in the African American community have defended the practice, citing research showing that while spanking may make white children more aggressive, the practice makes African American children less so.

How common is it for low-income mothers to have spanked their children by the age of 1? One in three mothers told researchers that they or someone in their household had spanked their 1-year-old in the preceding week, on average doling out 2 1/2 spankings per week. By the time their children were 2 and 3, 49% of the moms in the study said they had spanked the child in the last week -- on average between 2 1/2 and three times.

Verbal punishment was less frequent than spanking: 17% of the mothers surveyed said they had yelled at a 1-year-old; 24% yelled at their 2-year-old, and 16% at their 3-year-old.

After stripping out the influence of income, African American children at all three ages were most likely to be spanked and to be verbally punished; low-income white mothers and Mexican American mothers who were more Americanized were about equally likely to spank their young children, and generally about equally likely to yell at the toddlers. Recently arrived Mexican American moms were least likely to spank a toddler, and less likely to verbally punish a 2-year-old than were other low-income moms.

The study's findings generally "paint a picture of spanking and verbal punishments as products of parental challenges (e.g., the many difficulties associated with being a young parent and/or living in poverty), and may also reflect a goal of preparing a child for a life characterized by these and other challenges," the authors write.

-- Melissa Healy

Latino youths fare better if raised biculturally, study says

Teenagers of Latino families new to the United States appear to be more successful if they retain their ties to their Latino heritage and if their parents make an effort to embrace American culture, say the authors of a new study.

Researchers at the University of North Carolina interviewed 281 Latino youths and parents in North Carolina and Arizona as part of a longitudinal study called the Latino Acculturation and Health Project, which is supported by the Centers for Disease Control and Prevention. The families were asked questions that measured the teens' mental health, lifestyle and academic success.

The study found that teens who maintained strong ties to their Latino culture performed better at school and adjusted more easily socially. For every one-point increase on a scale that measured involvement in Latino culture, there was a 13% increase in self-esteem and a 12% to 13% decrease in hopelessness, social problems and aggressive behavior.

But these adolescents also benefit from parents who are willing to learn about their new homeland. For every one-point increase in a parent's involvement in U.S. culture, there was a 15% to 18% decrease in adolescent social problems and behavior problems.

The findings illustrate the need for both teens and parents to do the opposite of what their natural tendencies tell them. The authors said parents need not cling to their former culture and teens need not reject it.

"Such results suggest that Latino youth and their parents benefit from biculturalism," the lead author of the study, Paul Smokowski, said in a news release. "Parents who were more involved in U.S. culture were in a better position to proactively help their adolescents with peer relations, forming friendships and staying engaged in school. This decreases the chances of social problems arising."

The study is published in the Journal of Primary Prevention.

-- Shari Roan

Photo credit: Daniel Martinez