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Latino Health Institute Hopes to Accomplish Multiple Missions

Institute seeks to discover and document disparities between Latino healthcare and that of the general population.

The Latino Health Institute of New Jersey was founded this fall. One of its many missions: document the disparities between the healthcare of the state's 1.5 million Latinos and that of its overall population.

Funded by a $190,000 federal grant to the Latino Leadership Alliance of New Jersey, the institute will explore the relatively high incidence of chronic ailments like heart disease, obesity and diabetes among Latinos, according to Martin Perez, president of the alliance.

The institute also will investigate the limited options for Latinos to adopt healthy lifestyles due to a lack of fresh fruits and vegetables and opportunities to exercise in their neighborhoods, as well as the impact of poverty and limited access to health insurance and medical care on Latino life.

According to the institute, 30 percent of Latinos are uninsured, compared with 14 percent of New Jerseyans. And 20 percent live in poverty; the overall rate for New Jersey is 10.7 percent.

The institute cited CDC statistics that some 12 percent of Latinos have been diagnosed with diabetes -- but about a quarter of all cases are believed to be undiagnosed.

"Diabetes is obviously for us one of the leading killers," said Robert Montemayor, director of the Latino Information Network at Rutgers University. "My mother and father, my brother and sister and myself as well," all have diabetes. "This may be something that can be caught earlier with some education and outreach efforts," he said, speaking at a Latin Health Summit this past month.

There is a wealth of information available on Latino health, acknowledged William J. Ayala, institute director. But he added that much of that information is outdated or not specific to New Jersey.

Ayala said the institute's goal is to become a storehouse of information on Latino health in New Jersey, which will be available to all. "Information should be readily available to everyone and easy to access, and we don't have that on the state level," he said. Researchers "do very good work, and they publish papers that wind up in a medical journals. And when you go online you have to pay $40 to access them -- and that is a barrier. We want to create a system where the work is being done that has a practical utility for the community."

Ayala said the institute will soon launch a new website where the information it gather will be open to the public. U.S. Sen. Robert Menendez (D-NJ) was instrumental in getting the Centers for Disease Control and Prevention (CDC) to fund the institute. Perez said that social and cultural factors generate Latino health disparities, "Our education system is failing our kids, and we are not producing the [Latino] doctors that we want to see."

Menendez noted that only 4 percent of U.S. physicians are Latino, creating "a cultural divide between Latinos and healthcare" because more than a third of Latinos cannot communicate in English.

Yet he pointed out that major change is coming, with the Affordable Care Act set to extend health coverage to about 30 million uninsured Americans, including some 9 million Latinos, in 2014.

"How do we go from acknowledging disparities to seeking to end them?" Menendez asked, "So that the happenstance of being born in America to a Hispanic family does not change your chances compared to other Americans?"

He said it "comes down to this: If we as a community make this one of the essential issues that we ask those who seek to represent us in the state legislature or in Congress, if they hear it as often as any other issue, like immigration or access to capital, then public policymakers will think and act upon and move forward an agenda that will end this disparity."

One of the many changes introduced by the Affordable Care Act is to enable low- and moderate-income families to buy health insurance at reduced rates. But Ayala warns that merely throwing a blanket of health coverage over the Latino community won't make the problem magically disappear.

"We have polling data from the Latino community showing overwhelming support for healthcare reform," Ayala said. "The only part they don't support is the mandate to purchase health insurance. We have to dig deep" to understand why Latinos like reform—but will need convincing before they'll purchase health coverage.

Robert Montemayor, director of the Latino Information Network at Rutgers University, said the state's Latino population is expected to rise from 1.5 million to 2.3 million in 2020, noting that 37 percent are currently under 18. Except for New York, New Jersey has the most diverse Latino population in the nation, with significant representation from Puerto Rico, Mexico, the Dominican Republic, Colombia, and Ecuador.

Latinos tend to be workers and renters -- and Montemayor said the high rate of labor force participation by Latinos aged 16 and older means "they are not in school but are working to provide for their families. The flip side is that they lose out on education." Education, according to the institute, play a key role in healthcare disparities, because the better educated get jobs with health insurance, and educated individuals are better equipped to navigate the healthcare system.

Perez said the World Health Organization "defines disparities as 'differences in health which are not only unnecessary and avoidable but, in addition, are considered unfair and unjust.'"

He said the institute is a step "toward eliminating the unfair and unjust circumstances surrounding health care that are imposed on our community."

The institute will soon issue a report from its initial conference in October. It drew public health experts from academia, the healthcare system, and government, who explored issues affecting Latino health ranging from teenage pregnancy to childhood obesity, language barriers, poverty and education.

Ayala said another conference in six months will "bring in some more researchers who have done work on Latino health and present their research and upload it on the website and make it available to everyone."

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