Academic journal article Health and Social Work

Health Inequalities among Latinos: What Do We Know and What Can We Do?

Academic journal article Health and Social Work

Health Inequalities among Latinos: What Do We Know and What Can We Do?

Article excerpt

WHAT DO WE KNOW?

Numbering over 40 million, Latinos constitute 12.5 percent of the U.S. population, and that number is projected to grow to 103 million, with Latinos representing 24 percent of the population by 2050 (U.S. Census Bureau, 2003). Contrary to the public perception that Latinos are "one culture," the demographic profile is diverse. Comprising a youthful age structure, one-third of Latinos are younger than 18 years of age, and the median age of Latinos in the United States is 27 years, which is considerably lower than 40, the median age for white people (Pew Hispanic Center, 2006). Latinos have multiple origins (63.9 percent are Mexican, 9.1 percent are Puerto Rican, 3.5 percent are Cuban, 10.2 percent are Central American, 5.4 percent are South American, and 8.1 percent are other). Languages spoken among Latinos vary; 80 percent of those younger than 18 years of age reported that they speak English very well, whereas 53 percent of those older than 18 claimed a similar level of English fluency. Among the immigrant population older than 18, nearly three out of four said they speak English less than very well (Pew Hispanic Center, 2006). The geographic location of Latinos is varied, with some residing in traditional urban hubs (that is, Los Angeles, Miami, New York, and Chicago) and with others residing in new growth communities. From 2000 to 2005, the percentage change of the Latino population more than doubled in states like North Dakota (62.1 percent),Arkansas (58.6 percent), South Carolina (51.4 percent), and Tennessee (51.3 percent) (Pew Hispanic Center, 2007). In addition, their family compositions include a rich generational mix of foreign-born and U.S.-born members. For example, three in 10 Latinos are native-born children of foreign-born parents (Pew Hispanic Center, 2006). From 2000 to 2020, the second generation will contribute to 47 percent of the growth of the Latino population, whereas the first generation will contribute only 28 percent (Suro & Passel, 2003).

Planning for the future requires measuring these demographic trends against what is happening within the current U.S. health care context. The increasing federal and state budget deficits, the rising number of uninsured people, and the escalating health care costs present new challenges for policymakers and health practitioners. Consumer needs for health services such as preventive and specialty care, prescription drugs, technological innovations in treatment, and end-of-life care are far exceeding our nation's system capacity to provide affordable, quality, and accessible coverage to a diverse citizenry. Furthermore, a historical pattern of existing health-related inequalities among racial and ethnic minorities and the lack of political will to address them accelerate this health crisis. Given the growth of a heterogeneous Latino population and the emerging challenges facing the nation, what should policymakers, health care providers, and social workers consider in planning for the future?

On the one hand, we should be cautiously optimistic because research has demonstrated that Latinos have favorable health outcomes despite having low levels of education, income, and health insurance coverage (Escarce, Morales, & Rumbaut, 2006; Franzini, Kibble, & Keddie, 2001; Vega & Amaro, 1994; Wei, et al., 1996). This apparent health advantage seems to be particularly evident among immigrants compared with their U.S.-born counterparts with regard to infant mortality, low-birthweight, and all-cause mortality (Acevedo-Garcia, Soobader, & Berkman, 2005; Frisbie & Song, 2003; Hummer, Rogers, Amir, Forbes, & Frisbie, 2000; Singh & Siahpush, 2001).

On the other hand, research on the positive health profile of Latinos suggests a pattern of worsening health outcomes for Latino immigrants with longer durations of stay in the United States and for later generations (Cacari Stone, Acevedo-Garcia, & Viruell-Fuentes, 2007). …

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