Obesity Within the Hispanic Population

Obesity Within the Hispanic Population

Obesity Within the Hispanic Population

Samantha M. Tallarine

Capella University

Health Promotion and Disease Prevention in Vulnerable and Diverse Populations

Evidence-Based Practice

August, 2018

Obesity Within the Hispanic Population

The term “Hispanic” is used to describe a number of different ethnicities; Mexican, Puerto Rican, Salvadoran, Cuban, Dominican, Guatemalan, and many others. The obesity epidemic does not discriminate based on age, 42.5% of Hispanic adults are considered obese, and they “also have the highest prevalence of obesity among ethnic groups of able-bodied U.S. children and adolescents” (McDonald, Huang, Proudfoot, Le, Chiang & Bush, 2016, p. 1957). There are numerous amounts of risk factors that come with obesity, and mixing these risks with issues in accessing healthcare is a potentially fatal problem. Obesity “is a common denominator in the development of metabolic syndrome, non-alcoholic fatty liver disease (NAFLD), diabetes, and cardiovascular disease (CVD)” (Velasco-Mondragon, Jimenez, Palladino-Davis, Davis & Escamilla-Cejudo, 2016, p. 10). These co-morbidities make the need for preventative medicine and easy access to healthcare even more important within the Hispanic population.

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Childhood Obesity Within the Hispanic Population and Parental Involvement

Childhood obesity is an epidemic throughout the nation, but particularly higher within the Hispanic population. Being one of the fastest growing minority groups in the United States, we need to focus on first of all preventing children from becoming obese, but for the ones who are sadly already facing obesity, there needs to be proper protocols put into place. According to the CDC, they consider “a child between the ages of two and 18 years to be overweight if between the 85-95th percentile, and obese if above 95th percentile” (McDonald, Huang, Proudfoot, Le, Chiang & Bush, 2016, p. 1962). BMI was the main focal point of the study by McDonald, Huang, Proudfoot, Le, Chiang & Bush because it was found that people of Hispanic ethnicity have a higher average BMI.

One of the biggest barriers to helping children and adolescents deal with obesity is dealing with the parents. In the study conducted by Gauthier and Gance-Cleveland, the way Hispanic parents perceived their preschool aged child was examined, and if it effected the child’s weight development. It was found that “the majority of parents did not have an accurate perception of their child’s actual weight status, and most frequently underestimated their child’s actual weight category … when asked which children looked the healthiest, the majority of parents selected photos of overweight or obese children” (Gauthier & Gance-Cleveland, 2015, p. 551). Most parents in the study equated their children with being healthy to them being happy, not considering the actual health part of it. If their child shows signs of intelligence, and are excelling in school, if they’re happy, and feel good, parents seem to be okay with them being overweight or obese. As the study progressed, it was found that the parents weren’t lacking knowledge, as they correctly identified the causes of obesity, but were lacking in implementing strategies for not only the actual weight loss, but putting preventative measures in place for other children.

The Hispanic culture is known to equate food with family gatherings, and love, as well as family members using food as both a reward and punishment. Residence within the United States seems to have had a major impact on the obesity levels of Hispanic people. Many Hispanic people are living below the poverty line and this leads to “changes in parenting practices related to increasing work hours, lack of time with family, and less time to cook … parents acknowledged increased accessibility of ‘junk food,’ change in choices of food available (e.g., high-fat foods), and increased food costs as being significant factors” (Gauthier & Gance-Cleveland, 2015, p. 557). These families need to be educated on making healthy and flavorful modifications to their traditional foods, as well as resources within their community to gain access to fresh foods and low-cost exercise programs. In order to appeal specifically to the Hispanic culture, the family needs to be treated as a unit, and healthy eating and exercise needs to become a lifestyle among all members. Knowledge is power, and the more we teach people on how to prevent diseases, the less chronic illness we will see in the future. We need to ensure that vulnerable populations get access to the same top-notch healthcare that the majority receives.

Familism and Its Effect on Obesity in Hispanic Older Adults

Traditional Hispanic values place the utmost importance on putting the family as a unit before one’s self, and this is referred to as familism, or familismo. Older adults have been observed to place great emphasis on this value, and pass it down to the future generations as they grow up. This value can be both a positive and a negative when talking about obesity among Hispanic older adults. Savage, Foli, Edwards, and Abrahamson found that compared to white older adults, Hispanics are more likely to be obese, especially women. “46.6% of Hispanic women ages 65 to 74 are obese compared to 38.9% of White, non-Hispanic women in the same range” (Savage, Foli, Edwards & Abrahamson, 2015, p. 2).

Although Hispanics have a longer life expectancy, they are known to not use preventive care, and seek long-term care less than other populations. Some of this is in part due to lack of healthcare access, but it also is because they have a skewed view of familial roles from their beliefs in familism. Loyalty, solidarity, and reciprocity are their driving forces, and it is believed within the Hispanic culture that the younger generation has a duty to care for the elderly. Caring for family members is nothing to be frowned upon, but when an older adult is facing numerous co-morbidities they need to be cared for by trained individuals.

Gender roles are regarded very heavily in the Hispanic culture, and this places both men and women in extreme danger of becoming fatally ill. “Men may refrain from spending money or taking time off from work instead of visiting clinicians for preventive care or acute visits in an attempt to save money for their families … Hispanic women are more likely to stop cancer treatment if they perceive they have duties to fulfill within their families. Some Hispanic women will not pursue care, fearing it may interfere with their roles within the family” (Savage, Foli, Edwards & Abrahamson, 2015, p. 3). In ensuring that the Hispanic population receives access to affordable healthcare, we can make preventive screening a normal occurrence, and decrease the chance of chronic illness.

One potential barrier that I observed through my research is that there are a limited number of Hispanic healthcare professionals. Only 5% of physicians, and 1.7% of licensed registered nurses are Hispanic, which may add to the reason as to why older adults in the Hispanic population do not seek help with their health. They may fear going to the doctor and not being able to effectively communicate with them due to language barriers, or a fear of being ethnically misunderstood. As stated earlier, Hispanics hold their culture and their families in the highest regard, and if that value is threatened they will most likely remove themselves from that situation. In increasing the outreach to younger generations, and providing opportunities for more Hispanic healthcare workers, we can make the workforce more diverse, and inclusive, especially within the Hispanic population.

Implemented Health Care Initiatives

NYU Langone Hospital – Brooklyn is in the heart of Sunset Park, Brooklyn, NY, and they have implemented numerous programs in order to combat some of the diseases plaguing the community that they serve. They are striving to provide affordable and sometimes free healthcare to populations who are in need, specifically targeting the Hispanic population. Their hospital has piloted a program called Healthy Habits Program/Programa de Habitos Saludables to help combat childhood obesity, and it consists of a “12-session multi-disciplinary program for 10- to 11-year old obese Hispanic children and their parent(s)” (Kaplan & Hopkins, 2018). The program focuses on teaching children and their parent’s about the 5-2-1-0 health model which promotes 5 or more fruits & vegetables per day, 2 hours or less of recreation screen time, 1 hour or more of physical activity, and 0 sugary drinks (more water and low fat milk). The goal is to stabilize BMI, and to help families make better overall choices when shopping and preparing meals.

Epidemiology of Obesity Within the Hispanic Population

Epidemiology is defined as the study of the distribution and determinants of health-related states or events, and the application of this study to the control of diseases and other health problems. In conducting my research, I used four different studies as reference points. All of the studies shared a common interest in digging deeper to understand why the Hispanic population is so vulnerable to obesity, how we can prevent it, and how can we treat it. The two different factors I wanted to explore were obesity in children, and obesity in the older adult. The studies I chose highlighted both age groups, and it was found that in both instances family roles play a major part in the prevalence of obesity. Immigration into the United States has further added to the risk to become obese due to the convenience of high fat, low nutrient foods. Hispanics in urban settings face immense risk because the rising price of living, and the large percentage of people living below the poverty line. Obesity is a major problem looming on the Hispanic population throughout the nation on a daily basis, and we need to increase education on healthy living, increase access to fresh foods, and implement affordable screening techniques for the co-morbidities that can result from obesity.

Conclusion

The largest ethnic minority in the United States are Hispanics, with 21.9% of children (ages 2-19), and 42.5% of adults being overweight or obese. “The most recent reports show that the leading causes of disease among Hispanics are heart disease, cancer, and high blood pressure, while the leading causes of death are cancer, heart disease, and unintentional injuries” (Velasco-Mondragon, Jimenez, Palladino-Davis, Davis & Escamilla-Cejudo, 2016, p. 2). With the exception of unintentional injuries and certain cancers, obesity may precede all of the above diseases. In order to decrease the occurrence of obesity in all age groups, healthcare access needs to be improved upon, and patients need to be educated on implementing a healthy lifestyle in their homes. Parents must play a greater role in recognizing if their child is gaining too much weight, and they need to be working hand in hand with their pediatrician to keep their children healthy.

Healthcare facilities also need to make sure that they are adequately representing their surrounding community, and implementing strategies to deal with each health concern that plagues the different populations within it. NYU Langone Hospital – Brooklyn’s pilot program is a prime example of how facilities can take a greater interest in the diverse population surrounding them, and help to treat and prevent the diseases that they are vulnerable to. If all healthcare facilities would implement affordable or free programs to target diseases that plague the demographics within their communities, we can help to reduce the incidence of chronic illness that precedes a preventable disease.

References

Gauthier, K. I., & Gance-Cleveland, B. (2015). Hispanic parental perceptions of child weight in preschool-aged children: An integrated review. Childhood Obesity, 11(5), 549-559. doi:http://dx.doi.org.library.capella.edu/10.1089/chi.2014.0152

Kaplan, S. A., & Hopkins, K. (2018, April). NYU hospitals center progress report. Retrieved from https://nyulangone.org/files/april-2018-csp-progress-report.pdf

McDonald, M. L., Huang, A., B.A., Proudfoot, J. A., M.Sc, Le, J. T., Chiang, G. J., & Bush, Ruth A, (2016). Association of obesity, BMI, and hispanic ethnicity on ambulatory status in children with spinal dysraphism followed near the california- mexico border. Journal of Health Care for the Poor and Underserved, 27(4), 1956-1969. Retrieved from http://library.capella.edu/login?qurl=https%3A%2F%2Fsearch.proquest.com%2Fdocview%2F1844319689%3Faccountid%3D27965

Savage, B., Foli, K. J., Edwards, N. E., & Abrahamson, K. (2015). Familism and health care provision to hispanic older adults. Journal of Gerontological Nursing, , 1-9. doi:http://dx.doi.org.library.capella.edu/10.3928/00989134-20151124-03

Velasco-Mondragon, E., Jimenez, A., Palladino-Davis, A., Davis, D., & Escamilla-Cejudo, J. (2016). Hispanic health in the USA: A scoping review of the literature. Public Health Reviews, 37doi:http://dx.doi.org.library.capella.edu/10.1186/s40985-016-0043-2