When it comes to their health and health care, Latinas are in a class of their own. Unsuccessful treatment and death rates for certain illnesses tend to be higher among Latinas than other populations, and the reason for this lies beyond genetics. “There are so many factors to consider for Latinas and health care,” says Dr. Jessica Guajardo, clinical research coordinator at Laredo Medical Center in Laredo, Texas. Lack of education about health care and screenings, lack of insurance, language barriers, and even culture play a part in putting Latinas at higher health risk.

Healthcare Pitfalls
The biggest problem is a lack of awareness of possible diseases and their symptoms, and of available screenings. “The main source of communication [among Latinos] is within the family,” Guajardo explains. “So we listen to hearsay rather than seeing a physician or reading pamphlets. Then the only way we really know about a disease is if someone in the family has it.” When not fully informed, Latinos are less likely to go for screenings or regular checkups. “Physicians can explain all the exams available, “Guajardo continues, “but that’s if they can get patients in to begin with, and that brings up the problem of [health] insurance.”

More Latinas are uninsured in the United States than any other ethnic group, according to the U.S. Department of Health and Human Services. Of the 14 million Hispanic/Latina women in the country, only 26 percent have private health insurance, 27 percent receive Medicaid, and 7 percent receive Medicare. The possibility of financial burden causes people to skip screenings if they have to pay out of pocket, instead waiting to see a doctor until symptoms are unbearable.

“People don’t usually go to the doctor until they are ill,” Guajardo explains, “rather than saying, ‘Let me go to the doctor even though I feel perfectly fine.’ When you think about it, prevention costs less. Going when you are really sick is when it costs the most. But it is a mater of priority.”

Partly due to cost and partly due to a cultural tradition of nurturing, Latinas will also put the family ahead of themselves. “We see a lot of women when they are pregnant,” says Dr. Nereida Correa, a New York–based private-practice physician and associate professor of obstetrics and gynecology at Albert Einstein College of Medicine in the Bronx. Then they continue to bring their children in, “but everything else gets set aside,” Correa continues. “We tend to take care of others and then think of ourselves.”

Some Latinas also have other hesitations about seeing a doctor. “We can be a little bit shy about undressing and about having a breast or pelvic exam,” Correa says. Guajardo adds that some of this is because of a sense of modesty, but unfortunately, machismo can also play a role. “Sometimes it’s the husband who doesn’t want his wife or daughters to unclothe in front of a physician,” Guajardo says.

In addition, there is the natural fear that people share of receiving bad news. Because Latinos tend to delay medical visits, diseases aren’t diagnosed until they are advanced, and successful treatment is less likely. Often, the only experience Latinos have with an illness is knowing a family member who died from it. “A lot of people feel that, ‘If there’s no cure for what I have, mejor no me digas.’ That’s the fear, but in many cases it isn’t true, especially if they are [diagnosed early],” Guajardo says.

Common Diseases
The diseases for which Latinas are at greater risk are indeed very serious, but most are treatable—and even preventable—with a little awareness. Here is a brief look at the most common illnesses among Latinas.

Cancer: Most women worry about breast cancer, Correa says, but they don’t always think of other types. Breast cancer is the most commonly diagnosed cancer and still the leading cause of cancer death among Latinas, reports the National Women’s Health Information Center (NWHIC), and it is also diagnosed 30 percent less often and in more-advanced stages among Latinas than other women. Cervical cancer is also a major concern for Latinas because of late diagnosis, according to Correa, who is on the national advisory committee of the National Hispanic Medical Association. The cervical cancer death rate is 40 percent higher for Latinas than for other women. Stomach and liver cancer are also frequently found among Latinos.

Diabetes: Many people are aware of the prevalence of diabetes in the Latino community, but it is important to note that it is more rampant among Latina women than men and that it is familial. There are two types of diabetes. In Type 1, the body destroys its own insulin-making cells. Type 2, in which the pancreas doesn’t make enough insulin, is often associated with obesity or weight gain. Type 2 can be prevented by maintaining a healthy weight and limiting sugar intake, especially if other family members have had the disease. People with diabetes also have more problems with their skin, mouth, kidneys, eyes and vision, nerves, and feet, and they are more likely to have heart problems, another serious concern for Latinas.

Heart Disease: Heart disease is the leading cause of death for American women. Angina (pain caused when the heart does not get enough blood) and heart attacks are the result of coronary heart disease, the most typical type. High blood pressure and high cholesterol, two other health problems Correa sites as significant for Latinas, are often closely related to heart disease. In addition, Latinas’ risk is higher due to links with diabetes and obesity.

Obesity: As obesity is often linked to heat disease, diabetes, and a series of other health problems, such as stroke, arthritis, asthma or other breathing problems, sleep apnea, and some cancers, Latinas must be very aware of their weight. Women should pay attention to their Body Mass Index (BMI) rather than just what the scale says, Correa advises. BMI shows the relationship of weight to height, and a BMI within the range of 23 to 25 is considered healthy; 26 to 29.9 is overweight, while a BMI over 30 is considered obese. Obesity is a growing issue for youth, Latino children included. “Fat babies are culturally accepted and desirable [in Latino culture]. It’s very difficult to tell a mother that she has a fat baby,” Correa says.

STDs: Though less publicized and often harder to discuss, HIV/AIDS and other STDs are spreading quickly in the Latino community, and young Latinas and African-American women have the highest number of new incidences. In fact, the NWHIC reports that the rate of HIV infection is seven times higher in Latinas than in white women. Not only do Latinas not seek out the necessary screenings, Correa says, but they also tend to be reluctant to negotiate with their partners about safe sex.

Prevention
The good news is that the probability of developing all of these ailments can be reduced. Eating a healthy diet, exercising, controlling weight, not smoking, getting regular checkups, and practicing safe sex are the keys to a healthy life.

Luz Alvarez Martinez, executive director and co-founder of the California-based Latina Health Organization, believes that achieving balance keeps a body disease free. “Your body talks to you. Listen to it. If you are unbalanced—body, mind, or spirit—you will feel it,” Martinez says. Certain lifestyles, such as being too sedentary, retaining too much stress, or overeating, lead to illness. Sometimes women have to look at what is at the root of that and “eliminate the situations that are making you sick,” Martinez says. “Nothing is worth your health.”

The most important thing is to be proactive, Correa says. The information is out there, Guajardo adds. “Look for it at your community health clinic,” she says. “Ask questions about yourself when you take your child to the doctor. See if they have information about anything you should be aware of.” After all, she says, we can’t take care of anyone else unless we take care of ourselves first.