21st Century Latino Cardiovascular Health and Disease: What You Need to Know
|Disclosure:||Dr. González has nothing to disclose.|
|Pub Date:||Monday, July 14, 2014|
Hector M. González, PhD
|Affiliation:||Michigan State University, Department of Epidemiology and Biostatistics|
Rodriguez CJ, Allison M, Daviglus ML, Isasi CR, Keller C, Leira EC, Palaniappan L, Piña IL, Ramirez SM, Rodriguez B, Sims M; on behalf of the American Heart Association Council on Epidemiology and Prevention, Council on Clinical Cardiology, and Council on Cardiovascular and Stroke Nursing. Status of cardiovascular disease and stroke in Hispanics/Latinos in the United States: a science advisory from the American Heart Association. Circulation. doi: 10.1161/CIR.0000000000000071.
Readers may have already heard or seen reports stating that by 2050, 1 in 3 Americans will be Latinos. Depending on what part of the United States the reader lives (e.g, San Antonio, Miami, New Mexico), news such as this may be old news where Latino-ism is simply a part of daily life. Yet in other regions of the country (e.g., North Carolina), the Latino demographic transitions raise questions not only about who the “newcomers” may be, but also for some planners, what impact will they have on their communities? For readers of this journal with clinical and research interests in cardiovascular disease and public health, the answer is that we simply don’t know. Currently, there is little information on the cardiovascular health and disease of Latinos, and what little information that is available, too often gets conflated by a lack of contextual and cultural knowledge of Latinos. Status of Cardiovascular Disease and Stroke in Hispanic/Latinos in the United States: A Science Advisory From The American Heart Association by Rodriguez and colleagues is a good place for practitioners, researchers and other readers to gain useful insights into Latinos in the United States.
First, Latinos currently make up over 16% of the US population, and this proportion will rapidly increase in coming years.1 While this statistic is relevant for current practitioners, it is especially important for students and trainees to recognize that as many as 1 in 3 of their clients, colleagues and staff will be Latino. For those taking heed of these demographic shifts, turning to the existing scientific literature and policy reports for more objective information will be somewhat helpful, but regrettably sometimes not. On the other hand, the science advisory by Rodriguez and colleagues will help readers properly “digest” available information to improve their research inferences. First and foremost, as the authors emphasize, consumers of extant Latino health literature must regularly ask one simple question: Who are those Latinos described in this report? The older literature is fraught with report on “Hispanics” (a term rejected by many Latinos because of its reference to European Spanish colonizers and not Latin Americans) without distinguishing the Latin American background of their study participants. The authors of this science advisory make clear that findings from aggregated Latino reports will likely miss important differences between Latino groups and, at worst, lead to improper conclusions that do not generalize to all Latinos. About 10 years ago, we began several national studies that demonstrated that aggregating Latinos will obfuscate results and lead to incorrect inferences.2 Alternatively, articles will study and describe one group of Latinos (e.g., Mexican-origin), and generalize their results to all Latinos (e.g., Dominicans). While Mexican-origin people make up nearly two-thirds of all Latinos in the United States, their health profiles are very different from other groups (e.g., Puerto Ricans). The science advisory makes these points abundantly clear that Latinos in the United States come from diverse backgrounds and that consumers and producers of scientific or policy reports must responsibly understand or describe who the Latinos are in the reports.
Change is coming, but slowly. Since the dawn of the new millennia, census reports have told us that Latinos were the largest minority group in the United States.3 Yet, precious little information is available on the cardiovascular health and disease of Latinos, and large gaps in the scientific literature remain. As it currently stands, the United States is ill prepared to meet the future public health needs of the changing face of America. Further complicating our preparedness is that many Latinos in the United States are socioeconomically disadvantaged. While we still know far too little about Latino health, we do know that socioeconomic disadvantage bodes poorly for good health. Undertaking studies with sufficient numbers of Latinos of each diverse and major background is daunting and requires the will to invest in the future. The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is, to my knowledge, the only study to assess the cardiovascular health and disease of sufficient numbers of Latinos from diverse backgrounds. While the HCHS/SOL may fill some scientific literature gaps, other voids will remain. Clearly, more work needs to be done to better understand the health and disease of Latinos in other areas. Other work is needed in the area of public health to ensure the health of our nation into the future.
The authors of this science advisory have provided a rich description of the cultural background and history of Latinos in the United States. This is good for starters, but readers, and especially trainees, are encouraged to do more, learn more about who we are as a nation and what is needed to ensure that our public health is strong.
- Census. American Community Survey. 2014.
- González HM, Vega WA, Williams DR, Tarraf W, West BT, Neighbors HW. Depression Care in the United States: Too Little for Too Few. Arch Gen Psychiatry. 2010;67(1):37-46.
- Census. Overview of Race and Hispanic Origing 2000: Census 2000 Brief. Washington, DC: U.S. Dept. of the Commerce Economics and Statistics Administration Bureau of the Census; 2001.
-- The opinions expressed in this commentary are not necessarily those of the editors or of the American Heart Association. --