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Strengthening Diabetes Outreach

Lessons from the Latino community

Can your ethnic heritage increase your risk for developing diabetes? The answer may be “yes.” According to the U.S. Department of Health and Human Services’ Office of Minority Health, Mexican-Americans are 1.9 times more likely than non-Hispanic white adults to be diagnosed with diabetes by a physician. Despite these challenges, however, one expert has an optimistic – yet realistic – view of how the Latino community is tackling diabetes-related issues.

San Diego-based Dr. Leonel Villa-Caballero, co-author of Diabetes? No Problema!: The Latino’s Guide to Living Well with Diabetes, is a physician and clinical researcher at the University of California, San Diego, and the Latino Initiative Director of the non-profit organization Taking Control of your Diabetes, He is also a frequent lecturer on issues related to diabetes, health disparities among Hispanics, and global health. Dr. Villa-Caballero and his co-author, Dr. Sheri Colberg, wrote Diabetes? No Problema!, published in 2009, hoping to help the millions of Latinos who have or are at risk for type 2 diabetes better understand and manage their condition. Villa-Caballero and Colberg also wanted to offer lessons that every community, but particularly minorities, could learn from the Latino experience.

leonel-villa-caballero

Dr. Leonel Villa-Caballero

“The Latino community in the US is growing at a very fast pace,” explains Dr. Villa-Caballero. And Hispanics, he adds, have historically had trouble expanding and evolving as a group without also grappling with health-related challenges. In Dr. Villa-Caballero’s view, “the biggest problem is that as Latinos have assimilated into modern American society – taking advantage of everything from cheeseburgers and sodas to minivans and video games – they have begun to experience the negative health-related issues that can result, including obesity and diabetes.

“Latinos may grow sick when they adopt some American habits, particularly in terms of diet and exercise,” he says. “In their original countries, for instance, Latinos often used to eat more fruits and vegetables – now they eat more fat and sugar.” In his experience, “I see that Hispanics in America tend to rate low in measures of physical activity,” he adds.

“Public health agencies and other organizations have reached out to the Latino community with a variety of programs related to nutrition, physical activity, and diabetes education,” says Dr. Villa-Caballero. “But while there have been many accomplishments and success stories, Latinos still lag behind in terms of taking advantage of those opportunities, which means doctors, nurses, and other public health workers must figure out how to improve their efforts.”

Dr. Villa-Caballero says there are already several essential lessons those working with Latinos living with diabetes can share:

Diabetes programs must be culturally sensitive.

One of the main problems in successfully reaching out to Latinos living with or at risk for diabetes, says Dr. Villa-Caballero, is the cultural communication gap – that is, well-intentioned programs don’t necessarily take into consideration cultural barriers, differences, and sensitivities. “Unfortunately, there is a lack of culturally competent nurses and health-care professionals,” he explains. “But when there is the right training, and patients have been able to connect with the right programs, they have been able to educate themselves and slowly but surely change their habits.” Read about some programs trying to make a difference in Latino communities.

Diabetes treatment should be individual and personal.

“There is often the misconception that all Latinos are the same,” says Dr. Villa-Caballero. “But there are many cultural, language, and other differences depending on the origin of the patient – whether they are from Mexico, Puerto Rico, or Argentina, for example. The diets and the habits are different from region to region and country to country,” he says, pointing out that any successful community-based diabetes effort should take the individual into account.

Addressing personal health beliefs is essential.

“It’s important to keep in mind that many Latinos have beliefs about diabetes and their health, often linked to religion, that may need to be addressed,” says Dr. Villa-Caballero. “Providers must work to help people understand that this is a disease that may be managed,” he says. Another common belief among some Latinos is related to fatalism – the idea that getting diabetes is a person’s destiny. “Physicians must be clear about the physiology, explaining diabetes to the patient,” he says. “It may be important to make the case that this isn’t about destiny, this is about your body.”

“Nearly every health professional or community program may be able to learn from the Latino experience in terms of the importance of good cross-cultural communication,” says Dr. Villa-Caballero, “including other minority groups such as African-Americans and Native Americans.”

As for the future of the Latino community’s efforts to educate and treat those diagnosed and at risk for diabetes, “I have a very positive view on the things we can accomplish,” he says. “Just recently I had an opportunity to speak to over 400 patients and relatives who were very interested in both new technologies available to treat diabetes, as well as the cultural side. And, at the same time, I had a conversation with receptive physicians and nurses where I really emphasized the need for cultural competence training. I am definitely very optimistic.”

Sharon Goldman is a New Jersey-based freelance writer who has written on health, fitness, and nutrition for such publications as Health, Self, Marie Claire, Whole Living, Yoga Journal, and EatingWell. Her family history of diabetes inspires her to learn more about how to try and stay healthy by eating right, exercising and reducing stress. Goldman is a paid contributor for The DX.  All opinions contained in this article reflect those of the interviewee, and not of Sanofi US, its employees, agencies, or affiliates.

© 2012 The DX: The Diabetes Experience

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