Winkleby Lab In the Prevention Research Center

Cancer-related Health Behaviors and Screening Practices Among Latinos: Findings From a Community and Agricultural Labor Camp Survey

Winkleby MA, Snider J, Davis B, Jennings MG, Ahn DK "Cancer-related health behaviors and screening practices among Latinos: findings from a community and agricultural labor camp survey." Ethn Dis 2003; 13: 3: 376-86.

Abstract overview:

          This study focuses primarily on the health behaviors and cancer screening practices of a group of Latinos: Mexicans who have lived in the United States for many years. This study connects with this population in the communities and agriculture labor camps where many of them live and work.  The study achieves an unusually high response rate – 87 percent for the community sample and 98 percent for the labor camp sample.  The labor camp sample includes only men, as there were too few women in this group to make the data meaningful.

          While past studies have examined the health behaviors of Latinos in the United States, rarely has this group been broken down into the important subgroups that traditionally identify as Latino: Puerto Rican, Cuban and Mexican. Each of these subgroups has different health profiles, and therefore it is important to study them separately. This study was able to successfully survey women and men of varying ages, most of whom were born in Mexico and have lived in the United States for many years. In fact, 80 percent of the community sample and almost 50 percent of the labor camp sample had lived in the United States 10 years or more.

          The results of the study highlight positive health behaviors like high rates of cervical and breast cancer screenings for women, as well as other health practices that raise warning flags within the health care community, including low rates of colorectal cancer screenings and high obesity rates, even among young farm workers.

While this study highlights both positive and negative cancer-related health behaviors and screening practices, three main findings are worth highlighting:

          Screening for cervical and breast cancer was high relative to overall screenings for treatable cancers, the study found. More than 70 percent of women aged 18 and older had received a Pap test, and more than 50 percent of woman aged 40 and older had received a mammogram within the past year. Unmarried women had approximately twice the odds of not receiving a Pap test or mammogram in the past year, and/or not conducting a breast self-exam in the past month as compared to married women in the survey.

          In both the community and labor camp surveys, more than 60 percent of the respondents were overweight including more than 20 percent who were obese. Years lived in the United States factored heavily into the survey obesity rates. For every one additional year lived in the U.S., there were higher odds of obesity for women.  For every one additional year lived in the U.S., there were higher odds of high fat/fast food intake and high alcohol use for the men from the labor camp sample. Moreover, for every additional 5 years lived in the U.S., the odds of obesity increased 25 percent for women. For labor camp men the odds of high fat/fast food intake and high alcohol intake increased 35 percent and 50 percent respectively.

          Screening for colorectal cancer was low for those surveyed. Among those aged 50 and older, approximately 70 to 80 percent of women and men from the community sample, and 100 percent of men from the labor camp sample had never received a blood stool test. These low rates may stem from reluctance on the part of the patient to perform the procedure, or patients may not understand the directions for collecting stool samples. Also, physicians may be concerned that patients will be unable to comply with follow-up tests due to cost or the complexity of the tests and may not rate colorectal screening a high priority.

Secondary facts of the study:

          Smoking rates were low among all survey respondents, with more than 84 percent of women from the community sample and more than 82 percent of men from the labor camp sample reporting that they had never smoked. Men from the community sample were more than twice as likely to smoke as women, but 30 percent reported they had quit smoking. While this finding is encouraging, it should be noted that other studies find smoking rates among young Latinos, especially young Latina women, is on the upswing. For more information, please refer to Changing Patterns in the Health Behaviors and Risk Factors Related to Chronic Diseases, 1990-2000 abstract.

          Despite being a young population, more than 35 percent of the community sample and 14 percent of the labor camp sample rated their own health as only fair or poor. Health insurance coverage for both samples was low. Nearly one-third of the community sample and two-thirds of the labor camp sample reported no health insurance coverage at all. Most people surveyed from the community sample had seen a doctor within the last year, but only 45 percent of the labor camp sample had visited a physician. Many respondents said they had been unable to afford a doctor and/or fill a prescription when needed.

Implications and recommendations from the study:

          Special cancer outreach programs for Latinos should focus on the adoption and maintenance of healthy lifestyles including weight control, physical activity, and good nutrition. Specifically, outreach programs should focus on cancer screenings for the early detection of treatable cancers, particularly colorectal cancer. At-risk subgroups including men from labor camps, unmarried women, and women and men with increasing “exposure” to the toxic American lifestyle must be bolstered with increased access to healthcare, improved patient/doctor interactions, and community environments that support healthy behaviors.

Proposed news articles and related information:

    • How should the health care community better reach the Mexican people who live and work in the United States? This population has long been considered migratory, but, in fact, data shows that they have lived in the United States for many years. Given that this population has special health risks, how can the health care community improve the health messages these communities receive about cancer screenings or health risks associated with particular behaviors like smoking or sedentary behavior?

    • Most of the Latinos surveyed in this study have inadequate or no health insurance, and yet there were high rates of breast and cervical cancer screenings among women. What health care barriers were lifted to make it possible for these women to get these valuable tests, and how can the same thing be done to ensure that Latinos get tested for colorectal cancer and other preventative screenings?


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