Page 56 - Cultural Competence in Health Education

34 Cultural Competence in Health Education and Health Promotion

Some other health conditions and risk factors that significantly affect Hispanics are

asthma, chronic obstructive pulmonary disease, HIV/AIDS, obesity, suicide, and liver
disease. Mexican American adults in the United States are considerably more obese
than non - Hispanic whites, but the prevalence of obesity (defined as a body mass index,

or BMI, greater than 30) has risen for all U.S. adults in the decade from 1999 to 2000
(American Obesity Association, 2007). There are also disparities among Hispanic sub-
groups. For instance, although the rate of low birth weight infants is lower for the total
Hispanic population than it is for non - Hispanic whites, Puerto Ricans have a low birth
weight rate that is 50 percent higher than the rate for non - Hispanic whites. Puerto
Ricans also suffer disproportionately from asthma, HIV/AIDS, and infant mortality.
Mexican Americans suffer disproportionately from diabetes. In a study to assess the
health status of Mexican American, mainland Puerto Rican, and Cuban American chil-
dren by examining the prevalence of poor pregnancy outcomes and chronic medical
conditions, the health status of Cuban American children was similar to that of non -
Hispanic white children and the Hispanic subgroup at greatest risk of poor health was
Puerto Rican children (Mendoza et al., 1991).

African Americans

In the 2000 census, 36.4 million people identified themselves as black or African

American, and 35.4 million of these individuals identified themselves as non - Hispanic.
African Americans bear a disproportionate burden of disease, injury, death, and suffer-
ing. Although the top three causes of death and seven of the leading causes of death
are the same for non - Hispanic and Hispanic whites, the risk factors and morbidity and
mortality rates are greater among blacks than among whites and three of the leading
causes of deaths for non - Hispanic blacks are not among the leading causes of deaths
for non - Hispanic whites (CDC, 2005). Homicide is the sixth leading cause of death for
non - Hispanic blacks, followed by HIV disease (seventh), and septicemia (ninth).
African American men have the highest death rate of all racial and ethnic groups, male
or female, as well as the lowest life expectancy. They are also negatively affected by
high rates of incarceration, high unemployment, low college graduation rates, and
problems with access to health care and quality of care (Henry J. Kaiser Family Foun-
dation, 2007).
Cancer mortality rates are 35 percent higher in blacks than in whites (AHRQ,
2002). Although cancer is the second leading cause of death for both non - Hispanic
blacks and non - Hispanic whites, the age - adjusted incidence per 100,000 population for
2000 is much higher for black women for colorectal cancer (57.2 versus 46.9) and
for pancreatic and stomach cancer combined (21.2 versus 13.5). For black men the
age - adjusted incidence was much higher for prostate (281.2 versus 169.4), lung/bron-
chus (109.2 versus 76.6), colorectal (72.0 versus 62.7), and stomach (18. 7 versus 9.9)
cancers (National Center for Health Statistics, 2004, table 53).
What is striking is that even though African Americans have higher screening rates
for breast and colorectal cancer than Asians and Hispanics do, increasing cancer screen-
ing in the African American population would have a bigger impact on African Americans ’

7/1/08 2:50:11 PM
c02.indd 34 7/1/08 2:50:11 PM
c02.indd 34