Ten-Year Changes in Cancer-Related Health Behaviors and Screening Practices Among Latino Women and Men in California
Abstract overview:
This is a ten-year follow up study to a companion paper, Cancer-related Health Behaviors and Screening Practices Among Latinos: Findings From a Community and Agricultural Labor Camp Survey. The value in this study can be found in the changes observed in cancer-related health behaviors, risk factors and screening practices related to cervical, breast, and colorectal cancer among Latinos of predominantly Mexican origin, living in Monterey County, California. Few studies before this one have compared changes in prevalence in the last decade. Moreover, few studies have examined changes in Latino populations of predominantly Mexican origin – a group that makes up the largest number of Latinos in the United States. And few studies have assessed whether changes have differed within the Mexican population itself. This study attempts to track changes in cancer-related health behaviors, risk factors and screening practices to better determine where future education and intervention programs should focus their efforts.
Cancer is an increasing health concern for U.S. Latinos. It is the second leading cause of death, and it accounts for 20 percent of Latinos total death rates. Latinos are roughly two times more likely to be diagnosed with several major cancers including stomach, liver and cervical cancer. They are also 20 percent more likely to die from a malignancy than non-Latino whites. But the good news for Latinos and their health care providers is that these cancers are highly associated with preventable risk factors, and with early diagnosis, many patients will respond well to treatment.
The threat of cancer to Latinos is noteworthy because of their rapid population growth and changing age distribution. Latinos are the largest ethnic minority in America, and they are projected to account for more than 25 percent of the U.S. population by 2050. The health concerns of this minority group will have a far-reaching impact in the future.
The study found three main results: 1) During the ten year follow-up period, obesity rates among all groups studied greatly increased, but among labor camp men there was a 91 percent increase in obesity prevalence. This is especially troubling as this group is generally made up of young adults. Obesity prevalence increased by 48 percent among community women and 47 percent among community men. Fresh fruit and vegetable consumption remained low as data concerning diet for all groups revealed consumption of fried foods remains high. But there is good news concerning diet: A shift from consuming whole-fat milk to lower-fat milk was recorded among labor camp men and women from the community. Also, the use of lard or meat fat for cooking purposes greatly declined among men and women from the community group. 2) Additionally, alcohol consumption dropped in the ten-year period among men in the community and labor camp, and smoking rates dropped in the labor camp sample as well. 3) Large improvements for mammography and annual pap screenings were made, but no progress was made in increasing annual blood stool testing in all groups.
Consistent with obesity trends in the general U.S. population, the prevalence of obesity greatly increased in the ten-year follow-up period for our study participants. The men in our study were hit particularly hard: Obesity prevalence among community men increased about 50 percent, while the prevalence increased nearly 90 percent for labor camp men. It is no surprise, then, that dietary behaviors associated with weight gain changed as well. Considerable proportions of the samples (15 to 26 percent) continued to report that they had not eaten any fruits and/or vegetables on the day before the survey in 2000. And consumption of fried foods remained popular—54 to 77 percent of respondents reporting they had eaten something fried the day before the survey was taken. Some significant dietary behaviors improved, however. Worth noting is the shift from whole-fat to lower-fat milk consumption by community women (33 percent) and labor camp men (55 percent). Women and men from the community saw the most improvement in other dietary-related behaviors like frequent removal of skin from chicken and choosing other less saturated cooking fats instead of lard fat from meats. By contrast, men in the labor camps did not adopt these healthy behaviors over the ten-year period.
Alcohol consumption decreased in the labor camp men. Those who answered positively that they had drunk alcohol in the past month dropped to nearly 37 percent in 2000 from almost 66 percent in 1990.
Annual pap and mammography screening increased in the ten-year period. Seventy-one percent of women age 18 and older said they had had a pap test within the past year in 2000 compared to 53 percent of women in 1990. Mammogram screening for women 40-years-old and older rose to 53 percent in 2000 compared to 15 percent in 1990. But blood stool tests, an early predictor of colon cancer, remained infrequent and virtually unchanged in the follow-up study data.
Secondary findings of the study:
Survey respondents showed little gains in health insurance coverage from 1990 to 2000, with almost 30 percent of the community sample and 65 percent of the labor camp sample reporting no coverage in 2000. Most survey respondents reported increased interactions with doctors or health care providers; however, the increase did not ensure the ability to afford the care they received. One-fifth to one-third of the community sample and nearly two-thirds of the labor camp sample said they had been unable to afford a doctor or fill a prescription when they needed to in the past year. These indicators—inability to afford health care and/or prescription medication—point to a vastly under-insured or uninsured population.
Implications and recommendations from the study:
This study highlights the need to create policies and initiatives that improve knowledge of and preventative care for Latinos, especially related to obesity and colorectal screening. Our research finds that this population is generally stable: The majority of the community sample and about one-half of the labor camp sample had lived in America for 10 years or more. Therefore, finding ways to reach this population with health care information and screening for preventable and/or treatable diseases will curb overall health costs in the long run and contribute to this population's overall longevity. Additionally, the number of respondents who reported Spanish as the primary language they speak at home increased to more than 75 percent of the men and women in the community group and 100 percent of the labor camp men. This demonstrates a need to produce health care materials in the patients’ native language and provide health care workers who communicate well in Spanish.
Proposed news articles and related information:
What factors contribute to the increasing prevalence in obesity in Mexicans living in America? How do environments saturated with high calorie, low fiber foods impact this at-risk group?
What factors have influenced the number of Latina women getting yearly pap tests and mammography screenings, and how can we adopt the same factors to increase the number of men who get preventative health care and important screening tests?
