BY ANA VECIANA-SUAREZ, MiamiHerald.com

When a recruiter from the University of Miami’s Behavioral Medicine Research Center knocked on Claudia Berrios’ Little Havana door, she didn’t know the encounter would change her life.

The medical school representative wanted her family to consider participating in a landmark study on Latino health that would serve as baseline data for the largest minority group in the country. But the comprehensive battery of tests delivered some surprising news to the Nicaraguan native: She was prediabetic. As a result, Berrios changed her diet and began working out in the gym, shedding more than 20 pounds since September.

”A lot of people don’t really know what they have until something bad happens,” said Berrios, 28. “They neglect their health. I was lucky to find out.”

Berrios’ transformation was an unexpected byproduct of this historic research project taking place at UM’s Miller School of Medicine and three other field centers in San Diego, the Bronx and Chicago. Funded by the National Heart, Lung, Blood Institute, the Hispanic Community Health Study/Study of Latinos seeks to expand the scope of current research on Hispanic health.

Most of the data available to health experts now is based on studies involving only Mexican Americans, which means that little is known about other Latino groups.

”What we know about the health of Hispanics in the U.S. is about Mexican Americans,” says Neil Schneiderman, the study’s principal investigator and the James L. Knight Professor of Psychology, Medicine, Psychiatry and Behavior Sciences. “We have a fair amount from Puerto Ricans because of New York, but we don’t know much about Cubans and Central and South Americans.”

SIX-YEAR STUDY

The six-year, $61 million study hopes to gather baseline health data from 16,000 Latinos at the four national sites, with a data coordinating center at the University of North Carolina

Each site focuses on a particular population. At UM, 51 percent of the 4,000 study participants will be Cuban and the remaining Central and South American. The participants, ages 18 to 74, are being recruited from 20 contiguous Census tracts along Southwest Eighth Street, extending into parts of Coconut Grove and Coral Gables.

Unlike most other studies, participants cannot simply volunteer. They are recruited from preselected communities that are more than 80 percent Hispanic. This provides a better cross-section of the population.

The first three years of the study will be devoted to data-gathering, followed by three years of follow-up. A 20-person team sees about six people a day, who are usually picked up by a UM van about 7 a.m. — while they’re fasting — and transported to the offices occupied by the research group.

”The assessments are quite thorough,” says Dr. Marc Gellman, research director at the Behavioral Medicine Research Center. “They get tests here they wouldn’t get in a doctor’s office in a typical physical.”

Indeed, in addition to the standard blood tests, researchers also include psychosocial assessments, dental exams, neuro-cognitive testing, and hearing and lung function. Participants take home a sleep monitor to wear for one night to measure respiration and a physical activity monitor they use for several continuous days. They receive a full report in about three weeks.

Participants then get a follow-up phone call four to six weeks after the initial clinic visit. Study personnel also contact them once a year to complete a health update interview.

”We do not treat patients,” Gellman says. “We’re an observational study, but people can go back to their own doctors with this information.”

TAKING PART

Victor Monzon-Aguirre, 59, says he decided to be part of the study because ‘I’m of that age that you begin to wonder, `how am I physically?’ I wanted to establish a baseline for me and this was very convenient. I could have all the tests done in one place in six hours. No waiting, no lines.”

As he learned more about the actual study, the management consultant was happy to contribute his time. ”It’s really a great opportunity to get information that will help the community,” he says.

The study will also measure how assimilation affects the health of immigrants. ”We’re not just measuring blood pressure and lipids,” Schneiderman says. ‘We’re looking at acculturation and how immigrants’ habits change over time. Since arriving here, are they smoking more or less? Are they eating more or less? What are they eating? How does assimilation affect health?”

Gellman likens the Hispanic Community Health Study to the famous Framingham Study, which began in 1948 with more than 5,000 adult subjects in the Massachusetts town by the same name and is now on its third generation of participants. Much of what we know about heart disease is based on this study.

INITIAL FINDINGS

While it’s still too early to draw any conclusions from the data gathered so far, some information has garnered the researchers’ attention:

• There’s a higher incidence of diabetes among Hispanics.

• Many participants have an elevated level of cholesterol.

• A ”terrifically high rate” of participants do not have a personal physician, an HMO or insurance. UM researchers hope information gleaned from the study will help set health policy.

”As Hispanics continue to become a larger percentage of the population, we need to prepare health care for the future,” Schneiderman says. “We will be able to identify needs and what has to be done to improve the health of our community.”

Popularity: 15% [?]

By PATRICK O’CONNOR, POLITICO.COM

Hispanic voters turned out in droves last fall to elect Barack Obama and his Democratic allies on Capitol Hill.

Those allies get their first chance to return the favor on Wednesday when the House takes up a children’s health care measure that would grant Medicaid coverage to children of new immigrants whose families came to the U.S. legally.

The immigration status of Treasury nominee Timothy Geithner’s former housekeeper might dominate the headlines, but this House vote has a much deeper impact on the country’s immigrant population and could set the tone for future debates.

“We really believe that this is the first opportunity for the president-elect and the Congress to demonstrate their commitment to the Latino community,” said Jennifer Ngandu, a spokeswoman for the National Council of La Raza.

Democrats and Republicans got bogged down in an emotional fight over an extension of the State Children’s Health Insurance Program (SCHIP) in the last Congress, with Democrats forcing vote after vote to embarrass vulnerable Republicans. But they could never overcome President Bush’s veto.

During the later stages of that debate, Republicans complained that the legislation would also allow illegal immigrants to receive health coverage under Medicaid, forcing Democratic leaders to add a line specifically forbidding the money from going to the children of illegal immigrants.

This time around, the House bill allows individual states to lift a five-year waiting period for the children of legal immigrants to receive health coverage under Medicaid. Pregnant women are also included.

The Senate bill, however, does not lift that waiting period because it was excluded from a compromise Democrats negotiated with Republicans in 2007, according to a release issued by Democrats on the Finance Committee Tuesday.

In a statement, Finance Chairman Max Baucus (D-Mont.) said Tuesday he “looks forward to an opportunity to support” the measure as it “moves toward final approval.”

National Council of La Raza and other groups have lobbied hard for repeal of the five-year waiting period for SCHIP.

Yet many GOP lawmakers still view the proposed repeal as a “wink-wink, nod-nod” for immigrants in the country illegally to receive federally-funded health coverage through state-run Medicaid programs.

“You don’t want to encourage people to come to this country just for the freebies,” said Republican Rep. Phil Gingrey of Georgia, a physician who also opposes the SCHIP legislation on the grounds that it would cover middle-income households.

But Republicans paid a price at the polls last fall among Hispanic voters for hyping the illegal immigration issue.

In 2004, Bush, who has been sympathetic to the immigrant community since his days as Texas governor, won 44 percent of the Latino vote, according to Democratic pollster Sergio Bendixen. Four years later, Arizona Sen. John McCain, who took heat from his own party for pushing comprehensive immigration, got only 31 percent of the vote. In Florida, Bush earned 55 percent of the Hispanic vote in 2004 and McCain dropped to 42 percent in 2008.

For a number of first-year Democrats, like Martin Heinrich of New Mexico and Ann Kirkpatrick of Arizona, this will be their first vote on the immigration issue. In their border states, the immigration debate is a double edged sword, because opponents of illegal immigration complain that illegal immigrants are a drain on the budgets of local governments and contribute to higher crime rates in many of those communities. Yet immigrants are an emerging political force in many communities and have tried to turn the tide on the debate.

Republicans like Gingrey argue that budget shortfalls in many of these states mean cash-strapped Medicaid programs have even less money to expand their coverage which forces the federal government to up its contributions. The Republican skepticism will do little to stop the House from easily passing the SCHIP expansion Wednesday.

California Democrat Xavier Becerra argues that these shortfalls are the reason why Congress must act now to expand children’s health-care coverage, including those kids whose families recently immigrated to the U.S.

“It’s a good time to address the issue in sensible, practical ways,” Becerra said. “It’s not just about Hispanic families; it’s an issue of providing some sense of health care security for all families.”

Popularity: 13% [?]

By Mark Gomez, Mercury News

Vangi Uribe was enjoying a weekend at the San Jose Jazz Festival with her husband in 2005 when she suffered a near-fatal stroke. The San Jose State University graduate and former Silicon Valley executive survived because of the quick actions of her husband, who recognized the symptoms in Uribe’s sudden headache and weakness in the leg.

“I knew the clock was ticking,” said Matt Sorgenfrei, consulting technical director at Oracle who has received first responder training through the city of Palo Alto. “Any delay at all and it’s like jumping off a cliff without a parachute.”

Uribe, 53, is among a growing number of Latinos who are suffering strokes at a relatively young age, according to medical experts. In an effort to educate the Spanish-speaking community about the dangers and warning signs, the American Heart Association will soon launch an awareness campaign in five Western metropolitan areas including San Jose. The grass-roots program “Together Against Stroke” kicks off Jan. 22 with a reception scheduled for 6-8 p.m. at the San Jose Museum of Art.

“The problem that we face is this: We have plenty effective treatments for stroke but we have a very tight window for treatment, not more than six hours,” said Raul Guisado, a San Jose-based neurologist who runs the stroke centers at Regional Medical Center and O’Connor Hospital. “When patients can come to us in six hours, then we can oftentimes reverse stroke back to normal, or improve significantly.

“The problem we have is people don’t come in within that window for a number of reasons. “… If people were to recognize symptoms and understand the implications and get to us, then we could help them.”

Ray Durazo, chairman of the American Heart Association’s Latino Stroke Task Force, said the program mirrors a similar campaign a few years ago that targeted the African-American community. Because African-Americans and Latinos are at a higher risk of stroke than whites, the Western States Affiliate of the American Heart Association requested and received $200,000 to launch a six-month pilot campaign in San Jose, Los Angeles, Las Vegas and Riverside and San Bernardino counties.

San Jose was chosen, in part, because of its large Hispanic population and reputation for initiatives within that community, Durazo said.

To reach out to the Spanish-speaking community in San Jose, health officials will rely on local health promoters, or promotoras, people who have a history and some understanding of health education. The promotoras will learn the basics about stroke, a condition that can cause brain damage due to a blockage of blood flow. The most common cause of stroke is untreated high blood pressure, said Guisado, adding that strokes are also very common in people who have diabetes, high cholesterol and a family history of strokes. About 80 percent of strokes are preventable, according to the National Stroke Association.

The most common symptoms of stroke are sudden headache, slurred speech, the sudden onset of weakness or numbness in one arm or leg or both, or the sudden onset of vision problems, including loss of vision, double vision, blurred vision, Guisado said.

“If stroke is not treated promptly, that can lead to brain damage,” Guisado said. “And that damage is permanent.”

While the medical community has made great strides in educating the community about strokes, “some groups don’t seem to be getting the message,” Guisado said. With eight stroke centers in Silicon Valley, primary care for people who suffer strokes in the Bay Area is better than anywhere else in the country.

On Aug. 15, 2005, Uribe, the former Silicon Valley executive, told her husband she had a migraine and wasn’t feeling quite right. Sorgenfrei called 911 to report a stroke emergency.

Uribe was rushed to Valley Medical Center, where a CT scan indicated her brain cavity had filled with blood, a serious condition that can quickly lead to death.

Uribe was in a coma for about six weeks and spent about five months in the hospital before being released on Christmas Eve. After months of rehabilitation, Uribe can string together just a few words at a time and still uses a walker and cane to get around.

“Recovery is learning all over again,” Sorgenfrei said. “Her stroke didn’t impact her memory. She was literally like a newborn in her cerebellum; it completely wipes out, like a computer.”

At her peak, Uribe was spending 30 hours a week in therapy. She still spends four hours a week with two neurological physical therapists; two hours of Pilates with a physical therapist and two hours to work on the mechanical aspects of walking.

“People don’t know how long it takes to get well,” she said.

Popularity: 16% [?]

LOS ANGELES — Public health officials and community leaders gathered in Los Angeles Tuesday to discuss the growing number of Latinos affected by HIV/AIDS.

“Our Community, Our Responsibility: Latinos in Action,” marked the start of a week of AIDS-related activities and free HIV testing and counseling centered around National Latino AIDS Awareness Day, which was Wednesday.

Free HIV testing and counseling will be offered at about 40 sites throughout Los Angeles County through Saturday, according to a statement from the county Department of Public Health.

Latinos make up almost half of all newly diagnosed HIV/AIDS cases in the county and 19 percent nationwide. Studies show that Latino victims are often infected for eight to 10 years before they are tested, increasing the likelihood that they will unknowingly spread the deadly disease, according to the statement.

The Elizabeth Glaser Pediatric AIDS Foundation issued a call for a concerted effort to raise awareness about HIV/AIDS and increase testing to prevent new HIV infections in the Latino community. Testing is a key component of HIV prevention, and testing of pregnant women is a critical first step to prevent mother-to-child transmission of HIV.

“On this national day of awareness, let us make a pledge to increase testing and awareness,” said Pamela W. Barnes, president and CEO of the Elizabeth Glaser Pediatric AIDS Foundation. “Together we can end the stigma and dramatically reduce new HIV infections.”

Universal, routine counseling and HIV testing are the most effective ways to increase the number of pregnant women who know their HIV status, and give them the chance to protect their own health and the health of their babies, Barnes said. Testing for HIV is a regular part of pre-natal care and can be done in places as convenient as community health centers. If a woman finds out that she is HIV-positive, she can receive the medicines that can reduce the risk of passing HIV to her baby to less than two percent.

“Medical advances have given us highly effective tools in the fight against HIV, allowing HIV-positive pregnant women to give birth to HIV-negative babies. The first and most powerful step is taking an HIV test, which is an act of courage the whole community can and should support,” Barnes added.

Popularity: 22% [?]

By LINDSEY TANNER AP

CHICAGO (AP) — Many immigrant children get even less vigorous exercise than their U.S.-born counterparts, the largest study of its kind suggests. Plenty of earlier evidence shows that U.S. children are pretty inactive. The new study of nearly 70,000 children simply found even lower levels of activity among immigrants.

Almost 18 percent of foreign-born children with immigrant parents got no vigorous exercise on any days of the week, and 56 percent didn’t participate in organized sports.

By contrast, 11 percent of U.S.-born children with American parents got no vigorous exercise, and 41 percent didn’t participate in sports.

Given the obesity epidemic and immigrants accounting for about 13 percent of the U.S. population, the authors said it is important to know whether there are ethnic differences in physical activity and sedentary behaviors. They were led by Dr. Gopal Singh, a researcher at the U.S. Department of Health and Human Services’s Maternal and Child Health Bureau.

Here’s how the researchers explain their results: Immigrant families surveyed were on the whole poorer than nonimmigrants and lived in less safe neighborhoods. That means they likely had less time for exercise and sports, and worse access to places to engage in those activities.

But also, many immigrant parents place a high emphasis on reading, language lessons, studying and other inactive pursuits.

Interestingly, earlier research found that immigrants tend to be less overweight and obese than people born and raised in the United States. That difference tends to wear off with longer exposure to U.S. culture including junk food and television.

The new study also found that immigrant children generally watched less TV than American-born kids, although it did not look at obesity levels.

“Many of our American norms are not healthy,” said Dr. Sarah Armstrong, a Duke University childhood obesity expert. “Could we just teach them our good habits, and not our bad?”

Armstrong said it was the largest study by far to look at the topic.

The study appears in Monday’s Archives of Pediatrics and Adolescent Medicine. It is based on 2003-04 telephone interviews with parents of children aged 6 to 17, including white, black, Hispanic and Asian immigrants.

Singh said the results among Hispanics were particularly striking: nearly 23 percent of children in families where both parents were born in Spanish-speaking countries got no vigorous physical activity. Also, two-thirds of them didn’t participate in organized sports.

Moreover, among Hispanics, U.S.-born children with foreign-born parents were less active than kids whose parents were both born in the United States. By contrast, among blacks and Asians, U.S.-born children with U.S.-born parents were less active than kids with at least one foreign-born parent.

Dr. Mita Sanghavi Goel of Northwestern University said the results in Hispanics are troubling because of high rates of obesity and diabetes — both related to inactivity — among Hispanics, the nation’s largest immigrant group.

“That just highlights how important it is to intervene early and set healthy lifestyle patterns early on,” Goel said.

Rates for other immigrants who got no vigorous activity were 13 percent for blacks, almost 10 percent for whites and 7 percent for Asians. For no participation in sports, the rates were 49 percent for blacks, 38 percent for Asians and 32 percent for whites.

The authors said more research is needed to verify results in Asians because relatively few Asians were studied.

Among all immigrant groups combined, 65 percent got regular physical activity, versus 75 percent of U.S.-born children whose parents were both born in America.

Regular physical activity was defined as getting at least 20 minutes of vigorous exercise such as running, swimming and basketball at least three days weekly. That was the minimum amount the government recommended when families were surveyed.

Newer government advice recommends an hour of moderate-to-vigorous exercise most days. Just last month, a study found that fewer than a third of U.S. 15-year-olds got even that minimum amount.

The authors acknowledged that parents may not always know exactly how much activity their children get, a potential limitation of the new study.

Popularity: 15% [?]

When it comes to Latinos and cancer, Ysabel Duron wants to take away the miedo.

It’s that miedo, or fear, that the veteran San Francisco television broadcaster - and a cancer survivor herself - believes is one of the many reasons her community remains in the dark about a disease that will claim the lives of one in five Latinos.

So Duron organized the National Latino Cancer Summit, a conference that starts today in San Francisco, bringing together oncology experts and health care workers from across the country with one main goal: bridge the gap between the Latino community and the experts who are on the cutting edge of cancer research and treatment.

“We are focused on bringing together those researchers with community members who are working in the trenches,” said Duron, who was diagnosed with Hodgkin’s Lymphoma 10 years ago. “It [the information] gets out there on television, but who really hears it and how much do they hear, and how do they understand it?”

Statistically, the incidence of cancer is higher among whites and blacks compared with Latinos.

But Latinos’ survival rates are lower, because their cancers are often diagnosed at an advanced stage, said Dr. Elmer Huerta, president of the American Cancer Society, and the first Latino to hold that position.

About 40 percent of the U.S. Latino population is foreign-born, according to the 2006 American Community Survey. Many of them lack health insurance, Huerta said, or don’t speak English and don’t understand the American medical system, so they wait to see a doctor.

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Popularity: 15% [?]