Health issues affecting wisconsin hispanics latinos
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Health Issues Affecting Wisconsin Hispanics/Latinos. Mary Ann Borman UMOS Inc. Major Issues Affecting Hispanic & Migrant Health. Socio-economic Status Primary Language Education Legal Status Country of Origin Length of Residency Work Related Conditions

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Health issues affecting wisconsin hispanics latinos

Health Issues Affecting Wisconsin Hispanics/Latinos

Mary Ann Borman

UMOS Inc.


Major issues affecting hispanic migrant health

Major Issues Affecting Hispanic & Migrant Health

  • Socio-economic Status

  • Primary Language

  • Education

  • Legal Status

  • Country of Origin

  • Length of Residency

  • Work Related Conditions

  • Lack of Specific Health Related Data


Hispanic health data

Hispanic Health Data

  • 17% of Hispanics,16% of African Americans report they are in fair or poor health, compared to 10% of white Americans.

  • 30% of Hispanics, 20% of African Americans lack a regular source of health care compared to 16% of whites

  • Hispanic children are nearly 3x as likely than non-Hispanic children to have no source of health care.


Hispanic health data1

Hispanic Health Data

  • 13% of Hispanics are more likely to rely on emergency hospitals for their usual source of care.

  • Hispanic, African American patients less likely to receive invasive cardiac procedures in hospitals.

  • Elderly Hispanic, African Americans less likely to have sensory & communication aids such as glasses & hearing aides

.


Migrant health profile

Migrant Health Profile

  • Demographic,socio-economic, living and working conditions reflect 3rd world countries

  • Migrants have difficult and more complex health problems

  • Poverty, malnutrition, infectious/parasitic diseases, poor housing, lack of education and health insurance make them a vulnerable population


Hispanic economic data

Hispanic Economic Data

  • Largest growing population in US;Project 3 times growth from 2005-2050 with increase to 29% of US population in 2050, compared to 14% in 2005. (Pew)

  • Hispanic household net worth is one-tenth of white households and lower than African American households.

  • Median Hispanic net worth is lower than whites; Hispanics, $30,735, $27,910, whites $42,504.

  • Hispanics are less likely to have checking or savings accounts; 42%, of Hispanics compared to 7% of whites have no accounts.


Economic data cont

Economic Data cont.

  • Any economic gains are a result of working more hours, and jobs rather than wage gains.

  • Household income is a predictor for health in Hispanics and African Americans.

  • 55% have annual incomes below poverty level.

  • Hispanics are less likely to have retirement savings, 62% of Hispanics do not have retirement savings.

  • 25% of Hispanic families with children are poor; from 1992-99, poor families with children rose from 20% to 25.9%.


Migrant economic data benefits

Migrant Economic Data/Benefits

  • 55% have annual incomes below poverty level.

  • 57% earn less than $7,500 for a family of six.

  • Few qualify for workman’s compensation or disability benefits

  • Less than 25% receive food stamps

  • Fewer than 12% apply for Medicaid, although many are eligible

  • Social security applicants often lack proof of work


Economic contributions

Economic Contributions

  • Migrant labor supports a multi-million dollar agricultural industry

  • Without MFWs production and harvesting of most fruit/vegetable crops and cattle, dairy and poultry would not be possible, or unaffordable

  • Presence of MFWs increases the economic output of the community

  • While 3 percent of unauthorized workers are employed in agriculture, 33 percent have jobs in service industries and substantial shares can be found in construction and extractive occupations (16%) and in production, installation and repair (17%).


Migrant background information

Migrant Background Information


Migrant stream travel

Migrant Stream Travel

  • Midwest Migrant Stream

  • West Coast Migrant Stream

  • East Coast Migrant Stream

  • New Migrant Stream Travel


Health issues affecting wisconsin hispanics latinos

Migrant Population

FL.MFW

0 - 100

101 - 250

251 - 500

501 - 800

0

62.5

125

250

375

500

801 - 13104

Miles

HRSA Health Clinic Sites

Migrant Population

in the

Eastern Region


Health issues affecting wisconsin hispanics latinos

MFW Population

TX.MFW

0 - 100

101 - 200

201 - 300

Sonora

301 - 400

401 - 31894

Chihuahua

HRSA Health Clinic Sites

0

30

60

120

180

240

Miles

Coahuila

Nuevo Leon

Sinaloa

Durango

Tamaulipas

Zacatecas

San Luis Potosi

Nayarit

Migrant Population

in the

Southern Region


Health issues affecting wisconsin hispanics latinos

Migrant Populations

WA.MFW

0 - 1000

1001 - 3000

3001 - 6000

6001 - 9000

9001 - 18262

HRSA Health Clinic Sites

0

75

150

300

450

600

Miles

Migrant Population

in the

Western Region


Health issues affecting wisconsin hispanics latinos

EthnicityFarmworker Place of Birth

  • US Dept of Labor, 2000


Migrant legal status

Migrant Legal Status

  • Racially and culturally diverse; however majority are Hispanic, Mexican American or Mexican

  • Changing Demographics: Majority used to be families, US citizens or legal residents with a work permit for agricultural work (H2A)

  • Majority of new Migrants are Mexican Nationals, without legal status, majority are male.

  • At least 13.9 million unauthorized workers were employed as of March 2004, comprising 4.3 percent of the civilian labor force. Since 1986 it has been illegal for employers to hire workers lacking proof of proper immigration status.

  • Many are targeted victims of racial prejudice, profiling and/or hostility

  • The number of persons living in families in which the head of the household or the spouse is an unauthorized migrant was 13.9 million as of March 2004, including 4.7 million children. Of those, 3.2 million are US citizens by birth living in "mixed status" families in which some members are unauthorized, usually a parent, while others, usually children, are Americans by birthright.


Migrant working conditions

Migrant Working Conditions

  • Agricultural work is rated among the top three most dangerous occupations in the nation

  • Constant exposure to pesticides, elements, dangerous equipment

  • Frequent injuries, falls, heat stroke, dehydration, and pesticide poisoning common

  • Few sanitary working conditions; lack of toilets, drinking water in the fields, workplace

  • Few are covered by health insurance or work men’s compensation


Migrant education

Migrant Education

  • Constant mobility makes education difficult

  • 45% high school drop out rate; improved 10% in past five years

  • Children often present in fields and/or working there; Ag industry allows childrenunder 16 to work, Wisconsin one of few exceptions

  • There are an estimated 290,000 children and adolescents working in agriculture, including an estimated 55,000 unaccompanied youth, mostly from Mexico, who are the most vulnerable

  • Primary language often Spanish; Of the farm workers from Mexico or Latin America, less than 5 per cent report speaking English well. An estimated 85 percent of farm workers would have difficulty obtaining information from written materials in any language.


Migrant housing conditions

Migrant Housing Conditions

  • Majority of housing substandard or non-existent in most states; Wisconsin has rules for camps/facilities with over 25 workers

  • High cost of inadequate housing

  • Dangerously crowded conditions

  • Some sleep out doors, in tents, vehicles


Migrant health status knowledge

Migrant Health Status Knowledge

  • Little information is available on the health status of migrants.

  • Little to no research is done on this population

  • 2008 Pew Hispanic Center study estimates that there are 13.9 million unauthorized MFW in US;

  • Only 5-20% of migrants utilize migrant clinics

  • Most migrant workers lack legal authorization to work in the U.S., contributing to a reluctance to come into contact with persons assumed to be authorities, including medical service providers.


Major hispanic migrant health problems

Major Hispanic & Migrant Health Problems

  • Diabetes

  • Upper Respiratory Problems

  • Cardiovascular Diseases

  • Cancer

  • HIV/AIDS/STD’s

  • TB

  • Maternal/Child Health Issues

  • Mental Health Issues

  • Dental Problems


Diabetes

Diabetes

  • 2 million or 10.2% of all Hispanics have diabetes; 1.9% more likely than whites, with Mexican Americans 2 x more likely.

  • Leading chronic health condition in Hispanics/ migrants; 25% prevalence in Mexican Americans

  • 2-3 times higher than non-Hispanic whites One Midwest survey indicated 25% of adults over 20 had diabetes

  • Pennsylvania study showed 50% of 100 migrants surveyed had a family history of diabetes


Diabetes cont

Diabetes cont.

  • 1998 Diabetes Screening of 400 Wisconsin Migrants ages 35-60 by UMOS & Medical College of Wisconsin indicated that 325 or 81.2 % had blood glucose levels over 300; some as high as 600-800.

  • Follow-up testing was available to those who had high levels.

  • Follow-up treatment was unavailable due to lack of insurance and treatment in home base.


Diabetes cont1

Diabetes cont.

  • Hispanic women more likely to have diabetes than men

  • Risk factors such as family history of diabetes, gestational diabetes, impaired glucose tolerance, and insulin resistance more prevalent in Hispanics

  • Higher rate of diabetic complications, with the exceptionof heart attacks metabolic syndrome


Upper respiratory diseases asthma

Upper Respiratory DiseasesAsthma

  • Mainland Puerto Ricans have a higher rate of asthma than other Hispanic groups with a higher death rate; 40.99 per million compared to 14.7 per million than whites.

  • Hispanic children have an asthma rate 3x higher that the general population.

  • In one study only 39% of Hispanic & African American children with severe asthma took their medication daily.

  • Migrants have heavier exposure to lung irritants, pollens and pesticides.


Asthma cont

Asthma cont

  • In one Harvard study, Hispanic & African American adults were more likely to suffer from asthma than whites; income, residence and education explained ethnic differences

  • Hispanic teens smoke more than African Americans & whites; 31.5% females compared to 17.7% African American females. 34% Hispanic males compared to 21.8% African American males.

  • Smoking rates higher in Puerto Ricans than Mexicans.

  • Smoking rate in Hispanic teens increased 29% between 1991-99.

  • Increase due to targeting to Hispanic market by tobacco companies.


Cancer

Cancer

  • Lung cancer in Hispanics is low compared to other ethnic communities, but recent increases being seen.

  • Due to aggressive marketing to Hispanic community by tobacco companies.

  • Increased from 10 to 28% per 100,000 in men, from 4,8 to 11.2 % per 100,000 in women.

  • Mortality rates 31.6% for men, 11.0 in women.

  • Hispanic women have elevated rates of cervical cancer, little data exists.

  • Older Hispanic women are less likely to be screened for breast & cervical cancer.


Cancer in migrants

Cancer in Migrants

  • MFW’s have elevated rates of non-Hodgkin’s lymphoma, multiple myeloma, prostate, testes, brain, liver, buccal cavity, pharynx and lung problems

  • Females have a higher rate of cervical cancer

  • Children suffer from higher rates of brain cancer and leukemia

  • Possible source: Heavy exposure to chemicals, pesticides, smoke in fields, housing


Cardiovascular diseases

Cardiovascular Diseases

  • High blood pressure (HBP) and obesity are risk factors for heart disease, diabetes, stroke and other health problems.

  • 22% of Hispanic women and 34% of African American women had HBP compared to 19% of white women.

  • Obesity is highest in Mexican American women,52%, African American women, 53%, whites, 34%.

  • Cardiovascular disease lower in migrant Hispanics


Hispanic migrant hiv aids std s

Hispanic & Migrant HIV/AIDS/STD’s

  • Significant misunderstanding about HIV transmission

  • High incidence of STDs; treatment approach confused, often assumed to be the same for HIV/AIDS

  • Attitudes and beliefs towards persons living with HIV/AIDS continue to be strongly stigmatized and grounded in fear

  • HIV risk related behaviors high: lack of condom use, multiple partners, MSM issues


Hiv aids cont

HIV/AIDS cont

  • Understanding of HIV transmission correlates with degree of education and enculturation

  • Few testing programs available for Hispanics/migrants

  • Limited treatment and Case Management programs available, especially in home base for migrants


Health issues affecting wisconsin hispanics latinos

TB

  • The majority of TB cases are in persons of color; declines in all populations except Hispanics and Asian Americans.

  • Hispanics overall had a 11.3% rise in the last 10 years.

  • The majority of new cases among foreign born Hispanics;4-5 x higher; 37% in Hispanics,45% in Asians


Tb in migrants

TB in Migrants

  • TB presents special problems due to the need for long term treatment and the mobility of MFW’s

  • Cultural myths and beliefs often inhibit Hispanics and MFW from seeking help

  • Some studies found a 49% rate in MFWs 15-34, and 59% rate in ages 35 and over. Incidence rate in children under 15 at 2% indicating continuing transmission


Teen pregnancy

Teen Pregnancy

  • 40 % of Hispanic live births in 1987-1992 were to US born Hispanic women; 60% to foreign born Hispanic women.

  • 13% of all US births are to teens; one-third receive no prenatal care.

  • Babies born to teen moms have low birth weight, childhood health problems and are hospitalized more.

  • Fathers of these babies tend to be usually 5 plus years older than mothers.

  • 78% of teen births occur outside of marriage.

  • One –fourth of teen moms have a second child within 2 years of the first.


Teen pregnancy cont

Teen Pregnancy cont.

  • 2% of sexually active teen girls have Chlamydia.

  • 10% have gonorrhea.

  • 15% have human pappiloma virus, (HPV)

  • High pregnancy rate in Migrant teens.

  • High STD rate in Migrant men and women.


Maternal health pregnancy related mortality

Maternal HealthPregnancy Related Mortality

  • Birth weight of infants not always a risk indicator for Hispanic women.

  • In one 14 year study , pregnancy related mortality ratio was 10.3 deaths per 100,000 for Hispanic women compared to 6.0 deaths for white women.

  • Mexican women had the highest mortality rates followed by Puerto Rican women and Cubans.

  • Risk of death grew as women grew older, as well as for women with 3 or more live births. (Pregnancy induced HBP, followed by hemorrhage, embolism and infection.)

  • Migrant women have higher rates of mortality; poor prenatal care, exposure to toxins, chemicals, unclean water.


Birth defects in migrants

Birth Defects in Migrants

  • A Minnesota study of live births indicated that children of pesticide applicators had a birth defect rate of 30 per 1,000 births; General public birth defect rates are 18.3 per 1,000 births.

  • Anecdotal reports of unusual neurological disorders, birth defects among populations in Mexico along Rio Grande river where manufacturing companies discharge effluent. Little to no research published as yet


Migrant dental issues

Migrant Dental Issues

  • Little to no statistics on general Hispanic dental health

  • High incidence of dental baby bottle caries; propped bottles, high sugar content of fluids.

  • Research indicates that MFW’s had 150-300 % higher decay rates than their peers.


Migrant mental health

Migrant Mental Health

  • Very little information on mental health issues of Hispanics, due to cultural taboos.

  • Inconsistent standards for MFW men in U.S and home base, is a contributing factor to depression

  • Often MFW men from outside the US do not feel they belong anywhere

  • Women’s traditional roles change when a man migrates without his family, or when she is the primary wage earner


Pesticide related problems

Pesticide Related Problems

  • Nearly I billion pounds of pesticides are applied in agriculture annually

  • EPA estimates that 10,000-40,000 MFW’s suffer from pesticide related illness each year due to occupational exposures

  • US Bureau of Labor Statistics indicate that MFW’s suffer the highest rate of chemical related illness of any other occupational group.

  • The majority of pesticide mixers, loaders and applicators are not trained in proper pesticide handling procedures

  • Long term pesticide exposure results in cancer, brain, kidney, liver damage, leukemia, and birth defects

  • Pesticides contain over 100 active ingredients which are possible or probable carcinogens


Pesticides cont

Pesticides cont

  • Washington State study, indicated MFWs had a rate of systemic pesticide poisoning, 3.3 times higher than that of all workers; in the same study, they had a rate of toxic disease that was 2.2 times the rate of other workers

  • According to EPA studies, one-third of pesticides are applied incorrectly

  • Workers and families are often accidentally sprayed


Resources

Resources

Hispanic Health Disparities

Office of Minority Health

www.omhrc.gov/

CDC, National Ctr for Chronic Disease & Health Promotion

www.cdc.gov

Migrant Health

Nat Ctr for FW Health

1.800.531.5120

www.ncfh.org/fact sheets

Migrant Clinicians Network

512.327.2017

www.migrantclinician.org

Pew Hispanic Center http://pewhispanic.org/newsroom/releases/release.php?ReleaseID=33

Adrienne DerVartanian

Farmworker Justice

www.farmworkerjustice.org

Juan Jose Lopez, Director

Bureau of Migrant, Refugee and Labor Services DWD/DET

608.266.0002

608.261.8506 Fax


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