Latin@s in the United States are the most diverse population in cultural, demographic, geographic and socio-economic terms. The Hispanic population in the US is descended from Mexico (66%), Puerto Rico (9%), Cuba (4%), Central and South America (15%) and other Spanish cultures (6%). They live in all 50 states; however, the vast majority concentrates in urban areas. A very large percentage of Latino families live below poverty level and education/employment attainment is much lower for Latin@s than for other communities. Economic, educational, social and language barriers, all contribute to the health disparities that exist between Latin@s and the rest of the population in the United States. Making matters worse, Latin@s are more likely to be uninsured, due to either unemployment or undocumented status, and, therefore, have less access to preventive and primary health care. Unattended health problems worsen with time and, eventually, lead to costly hospitalizations and more serious health issues.

Due to differences in lifestyle, behavioral, hereditary, environmental and medical factors, Latin@s have different health issues and risk factors to certain diseases than the rest of the population in the United States. Furthermore, due to the great diversity within the Latino community, differences are also seen between the various Hispanic communities. For example, Hispanics born in the US have different risks for cancer than foreign born Hispanics. Therefore, it is important to identify what the main health problems are within the Latino community and within specific Hispanic ethnic groups in order to provide appropriate medical care and improve health in general.
Some of the main health problems seen in the Latino community in the US include heart disease, cancer, obesity, diabetes, HIV/AIDS, asthma and alcoholism, among others. According to a report by the American Cancer Society, heart disease and cancer are the first and second leading causes of death among Hispanic adults, respectively. Heart disease is very tightly linked to the problems of obesity and diabetes, since both are high risk factors for heart disease. According to a recent article published by the Pan American Health Organization, the Latino community in the US is one of the most affected by obesity; El Paso, Texas, being one of most affected communities. This is mainly due to lack of physical activity and fitness, type of food consumed and genetics. Obesity can also be a high risk factor for type 2 diabetes, arthritis and certain types of cancer. The increasing prevalence of diabetes among Hispanics is also very alarming due to its linkage to heart disease and obesity. Hispanic Americans are 1.9 times more likely to have diabetes than non-Hispanic whites, and diabetes is twice as common in Mexicans and Puerto Ricans as in non-Hispanic Whites (National Institute of Diabetes and Digestive and Kidney Diseases, NIH). Just like obesity, the high prevalence of diabetes among Hispanics is due to lifestyle and genetics factors.

Following heart disease in the list of leading causes of death among Hispanics is cancer. Some of the most common types of cancers seen in Hispanics include stomach, liver, gallbladder, breast, cervix, colon, lung and prostate cancer. Indeed, the incidence and mortality rates from cervix, stomach, liver and gallbladder cancers are significantly higher in Hispanics than in white-non-Hispanics. More specifically, the incidence of cervical cancer among Hispanic women is twice as large as for other women; women born in Mexico and living in the US being at a higher risk than other Hispanic women. The higher incidence of cervical cancer among Hispanic women is mainly due to lack of Pap smear tests. On the other hand, the high incidence of stomach cancer is mainly due to the crowded conditions in which Hispanics tend to live, which foster infection with H. pylori (a high risk factor for stomach cancer). Screening tests are not only important in detecting certain types of cancer during early stages of development, but they are also important in preventing cancer from developing at all. There is a great need to educate Latin@s on the importance of preventive measures such as breast, cervical, colorectal and other screening tests, as well as on the behaviors that could place them at higher risk of developing cancer.

Preventive measures not only include screening tests in order to prevent cancer, but also eliminating the risky behaviors that lead to the spread of sexually transmitted diseases, like HIV. Hispanic men and women accounted for 20% and 18% of new HIV infections among men and women, respectively, in the United States, as of the end of 2002. Even though the percentage of newly infected Hispanic women is slightly lower than for men, the cases for women have been rapidly increasing. In fact, in 2001, AIDS was the 4th leading cause of death among Hispanic women in the US between the ages of 35 and 44 (for white women, it was the 9th leading cause of death). Hispanic women are mainly getting infected by husbands or boyfriends that are bisexual or intravenous drug users. Other factors that contribute to the rapidly increasing rate of infected Hispanic women include poverty, gender-role beliefs, sexual coercion and sexual abuse, among others. Latin@s need to be educated on the importance of taking preventive measures against HIV infection. That includes: practicing safe sex, monogamy and, more importantly, getting tested for HIV.

Some of the health problems discussed in this article will be further described in the next issues of "¿Qué Pasa, OSU?", in terms of their nature, as well as incidence, prevalence and risk factors among Latin@s. Mainly, we want you to understand how these diseases might affect you in the future or may be affecting you now. Even if you are not affected, we want you to take responsibility for passing your knowledge on to others who might suffer from these diseases. It is up to us whether we want to allow these problems to continue to harm our own people, or to take a stand and make a difference in the quality of life of our community.