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Hispanic Kids Face Health Woes

The nation's surging population of Hispanic children has a disproportionate share of asthma, obesity and other health problems that are not being adequately treated, researchers warn in a new report.

The problem is urgent, said Dr. Glenn Flores, a Boston Medical Center physician and lead author of the report in Wednesday's Journal of the American Medical Association.

"If the disparities continue it has the potential to affect the health and productivity and well-being of our entire nation," Flores said.

There were 12.3 million Hispanics under age 18 in 2000 – the largest such minority group in the country, according to Census Bureau data. The population is expected to grow in coming years.

Yet because of cultural barriers, a lack of awareness about the ethnic group's health needs and perhaps racial bias, many Hispanic children receive sub-optimal health care, the report suggests.

Compared with whites and blacks, Hispanic children "are much more likely to have no health insurance, drop out of school, have no regular doctor ... to have cavities, to attempt suicide if they're a girl, to be obese if they're a boy," Flores said.

There aren't clear reasons for the disparities because Hispanic children are rarely included in medical research, he said.

Flores is the chairman of the Latino Consortium, an American Academy of Pediatrics-sponsored group of experts that examines research and policy issues in Hispanic children's health. The JAMA report is a consensus statement based on consortium members' views of critical health needs.

The U.S. Hispanic population jumped 58 percent from 1990 to 2000, according to census data. Nearly 35 percent are under age 18, compared with 26 percent of the nation's overall population.

"The demographics have changed so quickly that we're now in a position of having very limited data to understand what's happening," said Dr. Elena Fuentes-Afflick, a San Francisco pediatrician and consortium member.

Dr. Dennis Styne, chief of pediatric endocrinology at the University of California at Davis, has many Hispanic patients he said are disproportionately affected by obesity and diabetes.

Styne said genetics and cultural norms may partly explain why. "Middle-class Caucasian culture doesn't accept heavy body size," but it may be less of a taboo among Hispanics, he said.

According to the report, data shows that:

  • Asthma affects 11 percent of U.S. children of Puerto Rican descent, more than double the rate in blacks and nearly triple the rate in non-Hispanic whites.
  • Hispanic children are more than 13 times more likely than non-Hispanic whites to be infected with tuberculosis.
  • Hispanic children, especially Puerto Ricans, face a comparatively high risk of behavioral and developmental problems.
  • Among children hospitalized with arm or leg fractures, Hispanics receive significantly lower doses of pain medication than non-Hispanic whites.

    Language barriers may explain some of the disparities, the authors said. Hispanics make up just 5 percent of U.S. pediatricians, 2 percent of nurses and 2.8 percent of dentists.

    Also, Flores said, very few U.S. medical schools have separate courses addressing Hispanic cultural issues.

    The report should enlighten decision-makers and help lead to solutions, said Carlos Ugarte, deputy vice president for health at the National Council of La Raza, a Hispanic advocacy group not involved in the report.

    "A group as large as Latinos affects the entire nation," Ugarte said. "We're talking about the future of the country."

    By Lindsey Tanner

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