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There are nearly 14 million Hispanic American/Latina women in the United States. They include women from diverse cultures, histories, and experiences —Mexican Americans, Central and South Americans, Puerto Ricans, Cuban Americans, and Spanish Americans. While these women currently represent only 11% of the female population of the United States, they are a growing force. By the year 2050, nearly one of every four women in the U.S. will be Hispanic American/Latina.
Asian American/Pacific Islanders and Native Hawaiian women represent one of the fastest-growing and most diverse populations of women in the United States. Asian Americans represent a number of groups, including women from Vietnamese, Korean, Asian Indian, Japanese, Filipino, Cambodian, Laotian, and Chinese descent. Among Pacific Islanders are women who are Hawaiian, Samoan, Guamanian, Tongan, and Fijian. So, this population has a vast array of languages and cultures. Some of these women are 4th and 5th generation Asian Americans, while 75% are recent immigrants and refugees. Native Hawaiians and American Samoans are part of the Asian-American population, but they are native to this country, not immigrants.
Being overweight or obese increases your risk of heart disease, type 2 diabetes, high blood pressure, stroke, breathing problems, arthritis, gallbladder disease, sleep apnea (breathing problems while sleeping), osteoarthritis and some cancers. Obesity is measured with a Body Mass Index (BMI). BMI shows the relationship of weight to height. Women with a BMI of 25 to 29.9 are considered overweight, while women with a BMI of 30 or more are considered obese. All adults (aged 18 years or older) who have a BMI of 25 or more are considered at risk for premature death and disability from being overweight or obese. These health risks increase as the BMI rises. Your health care provider can help you figure out your body mass or go to www.cdc.gov/nccdphp/dnpa/bmi/calc-bmi.htm. Not only are health care providers concerned about how much fat a person has, but also where the fat is located on the body. Women with a "pear" shape tend to store fat in their hips and buttocks. Women with an "apple" shape store fat around their waists. For most women, carrying extra weight around their waists or middle (with a waist larger than 35 inches) raises health risks (like heart disease, diabetes, or cancer) more than carrying extra weight around their hips or thighs. Fifty percent of adult African American women are obese. Obesity is 1.5 times more common in Mexican American women (reaching 52%) than in the general, female population. In one specific population in Arizona, a study found that 80% of American Indians were overweight. Being overweight is a problem for Pacific Islanders. Native Hawaiians and Samoans are among the most obese people in the world. If you are overweight or obese, losing weight can lower your risk for many diseases. And physical activity is an important part of weight loss treatment. Try to be active (30 minutes most days of the week is best) and eat better to help prevent and treat obesity.
You can get diabetes if your body does not use insulin right. Insulin is what is in your body that changes the sugars in food into energy. Type 1 diabetes happens when your body destroys its own cells that make insulin. Type 2 diabetes occurs when the pancreas doesn't make enough insulin. Diabetes affects women of all ages. Overall, African Americans are twice as likely to have diabetes than Whites. A growing number of children are getting type 2 diabetes. Children have a greater chance of getting type 2 diabetes if they are overweight or if a family member has it. Type 2 diabetes is becoming more common in African American children under 20 years old. Diabetes, including gestational diabetes that occurs during pregnancy, is more common in Hispanic American/Latinos than in Whites. Mexican Americans, the largest Hispanic/Latino subgroup, are 2 times more likely to have diabetes than Whites. Also, residents of Puerto Rico are 2 times more likely to have diagnosed diabetes than U.S. Whites. Within the Hispanic American/Latino population, diabetes is more prevalent in women than it is in men. Diabetes is a serious and common problem among American Indians and Alaska Natives. Most people have type 2 diabetes. For American Indians/Alaska Natives (AI/AN), both women and men, the number of new cases of type 2 (or adult) diabetes has reached epidemic proportions. Diabetes contributes to several of the leading causes of death in AI/AN, including heart disease, stroke, pneumonia, and influenza. Specific tribes have much higher rates. For example, 50% of Pima Indians in Arizona who are between the ages of 30 and 64 have type 2 diabetes.
Pregnant AI/AN women with type 2 diabetes are at an increased risk of having babies born with birth defects. Diabetes that shows up in pregnancy is called gestational diabetes. This form of diabetes is high among certain AI/AN. Gestational diabetes increases the baby's risk for problems such as macrosomia (large body size) and neonatal hypoglycemia (low blood sugar). Although the blood glucose levels of women with gestational diabetes usually return to normal after childbirth, these women have an increased risk of developing gestational diabetes in future pregnancies. In addition, studies show that many women with gestational diabetes will develop type 2 diabetes later in life. Serious complications of diabetes are increasing. The most concerning are kidney (or renal) failure, heart disease, amputations, and blindness. Infections, including tuberculosis (TB), are of particular concern to both American Indians and Alaska Natives who have diabetes. Tuberculosis is a disease caused by a bacteria. If TB is in the lungs, it can cause a bad cough, chest pain, fatigue, weight loss, chills, and fever. A study of Sioux Indians showed that their rate of developing tuberculosis is higher if they had diabetes than if they did not.
Data on how many cases of diabetes are in the Asian American/Pacific Islander and Native Hawaiian population are limited. Some groups within these populations are at increased risk for diabetes. For example, data collected from 1996 to 2000 suggest that Native Hawaiians are 2.5 times more likely to have diagnosed diabetes than White residents of Hawaii of similar age. Guam's death rate from diabetes is five times higher than that of the U.S. mainland. And it is one of the leading causes of death in American Samoa. People with diabetes have a higher chance of having problems with their skin, mouth, kidneys, heart, nerves, eyes, and feet. African Americans experience higher rates of at least three of diabetes' most serious complications: eye disease, amputation and kidney failure. Although type 1 diabetes cannot be prevented, there are steps you can take to prevent and control type 2 diabetes:
High blood pressure happens when blood cannot flow easily through your blood vessels. This creates pressure in your vessels, which damages the vessels and strains your heart. As a result, blood doesn't flow as well to your brain or kidneys, and you can have a heart attack, stroke, or kidney failure. The number of African Americans with high blood pressure is high: one out of three African Americans have it. Certain factors increase your chances of having high blood pressure: increasing age (middle aged or older), diabetes, obesity (or being overweight), alcohol use, eating too much salt, a family history of high blood pressure, and not exercising. Among Asian American/Pacific Islander women, high blood pressure is more of a problem for Filipino women. And all Asian American/Pacific Islander women have much lower blood pressure screening rates than other minority women.
Your kidneys clean your blood and keep waste out. With kidney disease, they don't work as well as they should - they could even completely shut down. High blood pressure and diabetes are two main causes of kidney disease. Controlling your blood sugar and blood pressure will help prevent kidney disease. Diabetes is the leading cause of kidney failure in African Americans. African Americans tend to have kidney failure at an earlier age than Whites.
Human immunodeficiency virus (HIV) is the virus that causes acquired immunodeficiency syndrome (AIDS). HIV weakens your immune system, which makes it hard for your body to fight off other health problems that it could normally resist. As time goes on, your body becomes less capable of fighting off diseases. HIV is the leading cause of death for African American women between the ages of 25 and 44. Even though males account for the largest proportion (81%) of AIDS cases reported among Hispanic Americans/Latinos in the United States, the number of cases among females is rising. Females represent 19% of all AIDS cases among Hispanic Americans/Latinos, but account for 23% of cases reported in 2000 alone. And the rate of HIV infection is seven times higher in Hispanic American/Latina women than in White women. For the largest proportion (47%) of adult and adolescent Hispanic American/Latina women with AIDS, heterosexual contact (mostly with injection drug users) is the cause for their disease. Injection drug use accounts for an additional 40% of AIDS cases among Hispanic American/Latina women.
CDC recommends taking these steps to protect yourself:
Lupus is a health problem in which the body attacks its own tissues and organs. It can cause many other health problems, such as trouble breathing, skin problems, arthritis, kidney problems, and headaches. No one knows for sure what causes lupus. Doctors think that lupus may be genetic. It is more common in African American women and other minorities than in White women. The Centers for Disease Control and Prevention (CDC) reports that between 1979 and 1998, 70% more African American women (between 45 and 65 years old) died from systemic lupus erythematosus (SLE).
Women get breast cancer when cells in the breast don't grow right, and a tumor forms. Getting a mammogram (x-ray of the breast) can help find the cancer earlier, which gives women more treatment options and improves chances for survival. Except for African Americans 20-24 years old, African American women are more likely than White women to get breast cancer before age 40. However, they are less likely than White women to get breast cancer after age 40. African American women are more likely than White women to die from breast cancer. Researchers are trying to find out why this happens. Some reasons may be that tumors are found at a later (more advanced) stage so there are less treatment options, or patients don't follow-up after getting abnormal test results. Other reasons might include being overweight or not being able to get a mammography.
We do not know how to prevent breast cancer. There are things women can do to reduce their risk, such as limiting how much alcohol they drink. However, it's vital for women to take steps to find breast cancer if they have it:
The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) program provides free or low-cost breast cancer testing to women who don't have health insurance. Non-profit organizations and local health clinics are the main groups who provide the tests. To learn more about this program, please contact the CDC at 1-888-842-6355 or look on the Internet at www.cdc.gov/cancer Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death among Hispanic American/Latina women. Although breast cancer is diagnosed about 30% less often among women of Hispanic origin, it is more often diagnosed at a later stage (when the disease is more advanced) than when found in non-Hispanic women, even when access to health care is adequate. Lower rates of using screening tests like mammography among Hispanic American/Latina women is thought to add to this later diagnosis.
Breast cancer is less common in Asian American/Pacific Islander and Native Hawaiian women than it is in White or African American women. But, more Asian American/Pacific Islander and Native Hawaiian women have breast cancer than do women of Hispanic or American Indian/Alaska Native descent. Also, the number of Asian American/Pacific Islander women who have been diagnosed with breast cancer has increased. Chinese American and Japanese American women have higher rates of breast cancer than women of their same age in China and Japan. At first, it was believed a Western diet (higher in fat) could explain this difference, but this has not been proven. Among all other populations in the United States, Asian American/Pacific Islander women have the lowest death rate from breast cancer. But, among certain Pacific Islanders, death rates from breast cancer are much higher than among other ethnic groups. For example, Native Hawaiians have the highest death rate from breast cancer than for any racial/ethnic group in the Unites States. Breast cancer also is the leading cause of death among Filipino women. We do not know why the rates vary between these groups. But, among all ethnic groups in this country, Asian American/Pacific Islander and Native Hawaiian women are the least likely to have ever had a mammogram.
Cancers occur when certain body cells don't function right, divide uncontrollably, and produce too much tissue, resulting in a tumor. Cancerous tumors then invade healthy, normal functioning cells. New cases of certain cancers occur more often in African American women, including colorectal cancer, pancreatic cancer, and lung cancer. The death rate from colorectal cancer and pancreatic cancer is higher among African American women than other racial groups. Overall, African American women are more likely to die from cancer than persons of any other racial and ethnic group. There is not enough information to figure out why African Americans bear this cancer burden. Some reasons may be poor access to health care, poverty, tumors found at a later (more advanced) stage, different belief systems, fear of talking about cancer, and lack of trust of the medical system.
Hispanic Americans/Latinos have a lower rate of new cancer cases and lower death rates for all cancers combined, but a higher burden of cancers of the stomach, liver, and cervix than Whites. There are gaps in access to and use of cancer screening programs among Hispanic Americans/Latinos. Death rates from cancers of the breast and cervix, all of which can be found early by screening, decreased less among Hispanic Americans/Latinas than among non-Hispanics. Study results show that the number of new cases of invasive cervical cancer among Hispanic American/Latina women (age 30 years and older) is about twice that for non-Hispanic women. But, Hispanic American/Latina women in the Southwest and Midwest have similar rates to non-Hispanics. Overall, the death rate from cervical cancer is 40% higher among Hispanic American/Latina women than non-Hispanic women. Although invasive cervical cancer can be prevented by regular screening, Hispanic American/Latina women have a low rate of Pap testing.
Every year, 30% of pregnant American women have problems before, during, or after delivery. These problems can lead to long-term health problems and sometimes, can lead to death. The main causes of pregnancy-related death are bleeding, sudden blockage in the lungs by a blood clot or amniotic fluid, and high blood pressure. African American women die in childbirth more frequently than other American women. They have a higher chance of having pregnancy-related high blood pressure (preeclampsia) and seizures from high blood pressure (eclampsia). Try to get your blood pressure checked regularly while you're pregnant. Researchers are continuing to look at the causes of racial and ethnic differences in pregnancy-related deaths.
Heart disease is the main cause of death for American women. It is a group of diseases of the heart and the blood vessel system within the heart. Coronary heart disease, the most common form of heart disease, affects the blood vessels (or coronary arteries) of the heart. It causes angina and heart attacks. Angina is a pain in the chest that happens when a part of the heart does not get enough blood. It feels like a pressing or squeezing pain, often in the chest under the breastbone, but sometimes in the shoulders, arms, neck, jaw, or back. Angina seldom causes permanent damage to the heart, like a heart attack. During a heart attack, you can feel chest pressure, fullness, squeezing, or pain in the center of the chest that lasts longer than a few minutes, or comes and goes, spreading pain to one or both arms, back, jaw, or stomach, or cold sweats and nausea. Some women don't have these symptoms but may have other symptoms, such as an upset stomach, burning feeling in the upper abdomen, and lightheadedness. A heart attack can cause permanent damage to the heart and maybe even death. If you experience any of these symptoms, call 911 or see your health care provider right away.
African American women are more likely to die from heart disease than other groups of women. Diabetes, high blood pressure, high cholesterol, not exercising, and smoking all put women at risk for heart disease. In addition, studies have shown that African Americans don't receive the same care for heart disease as Whites because they don't receive the same procedures and treatments. Heart disease risk and death rates are higher among Mexican Americans partly because of higher rates of obesity and diabetes. Overall, Asian/Pacific Islander and Native Hawaiian women have much lower rates of heart disease than women of other minority groups, but it is still the leading cause of death within their own group. Heart disease risk and death rates are higher among Native Hawaiians and some
Asian Americans (Asian Indians) partly because of higher rates of obesity, diabetes, and high blood pressure.
There are two types of stroke. An ischemic (iss-kee-mik) stroke happens when a blood vessel that goes to the brain is blocked, and blood can't get to the brain. A hemorrhagic (heh-muh-ra-jik) stroke happens when a blood vessel breaks and blood goes into the brain. Sometimes a person can have a "mini stroke," or transient ischemic attack (TIA). A TIA is a stroke that happens when a blood vessel to the brain is blocked for a short time and less blood reaches the brain. A stroke could cause problems that may affect speech, language, movement, vision, balance, hearing, breathing, and swallowing. A stroke could also cause death. African Americans are twice as likely to die from a stroke or its complications than any other racial or ethnic group in the U.S. There are other medical problems that put you more at risk for a stroke, including diabetes, high blood pressure, heart disease, having already had a stroke or mini-stroke (TIA), and carotid artery disease.
To avoid heart attack and stroke, the American Heart Association advises people to take the following steps:
Among Hispanic Americans/Latinos, the risk of stroke is 1.3 times higher at ages 35-64 than for non-Hispanics. Among Asian Americans/Pacific Islanders, the risk of stroke is higher at ages 35-64 than for Whites.
Over 25% of American women have blood cholesterol levels high enough to put them at risk for heart disease. Cholesterol is a waxy substance found in all parts of the body. It comes from two sources: your body and the food you eat. Your liver makes all the cholesterol your body needs. Eating too much cholesterol in animal foods like meats, whole milk dairy products, and egg yolks can make your cholesterol go up.
Cholesterol blocks blood from flowing easily through your body. The higher your cholesterol, the greater your risk for heart disease. High cholesterol is a health problem for African American women. However, African American women have lower cholesterol levels than White women. Control your cholesterol by getting your cholesterol checked, exercising, eating foods low in saturated fat and cholesterol, and keeping a healthy weight. Ask your health care provider about how often you should get your cholesterol checked. Over 25% of American women have blood cholesterol levels high enough to put them at risk for heart disease. Among Mexican American women ages 20-74, almost half have borderline-high risk total cholesterol levels. Low-density lipoprotein (LDL) or "bad" cholesterol levels of 130 mg/dL or higher are related to a higher risk of coronary heart disease. And 41.6% of Mexican American women have an LDL cholesterol level in that range. Among Asian American/Pacific Islander women, high cholesterol rates are highest in Japanese women. Asian American/Pacific Islander women also have low cholesterol screening rates. Because of high levels of cholesterol in their bile, more American Indians have gallstones than other women in the United States. Among the Pima Indians of Arizona, 70% of women have gallstones by age 30.
Over 25 diseases are spread by sexual activity. Some Ss seem to affect certain groups more than others. Overall, African Americans have higher rates of Ss than Whites for chlamydia, gonorrhea, syphilis, herpes, and hepatitis B. While no method is 100% protective against Ss, there are ways that help prevent getting Ss. The Centers for Disease Control and Prevention (CDC) offer this advice:
Asthma is a disease of the lung airways. With asthma, the airways are inflamed (swollen) and react easily to certain "triggers," like viruses, smoke, dust, mold, animal hair, roaches, or pollen. When the inflamed airways react, they get narrow and make it hard to breathe.
Common asthma symptoms are:
When these symptoms get worse, it's an asthma attack. More than 17 million people in the U.S. have asthma, and women are more likely than men to die from asthma, according to the Centers for Disease Control and Prevention (CDC). Asthma is a growing concern in this country, especially for African Americans. African Americans go into the hospital more than Whites because of asthma and are more likely to die from asthma. These factors could increase the risk for getting asthma:
Women who smoke put their health at risk. Smoking during pregnancy increases the risk of miscarriage, stillbirth, preterm delivery, and low birth weight. Smoking increases the risk for a lot of diseases, including cancer, heart attacks, oral diseases, and lung problems. In fact, lung cancer is the largest single cause of cancer deaths in the U.S. For years, men were at higher risk for lung cancer because of their higher smoking rates. However, with the rising number of women who smoke, lung cancer surpassed breast cancer in 1987 as the leading cause of cancer deaths among women. It is the leading cause of cancer death among American Indians and Alaska Natives. American Indians and Alaska Natives have the highest smoking rates and use of smokeless tobacco (chewing tobacco or snuff) of any group in the United States. More people smoke in Alaska and North Plains than in the Southwest, where smoking rates are the lowest. If you smoke, try to quit. At just a few days, your health will begin to improve. There are many organizations to help you quit. Contact the American Cancer Society (1-800-ACS-2345 or www.cancer.org) for help. Lung cancer is the second cause of cancer deaths among Hispanic American/Latina women (behind breast cancer). And the death rates for lung cancer in these women have increased every year. Among Hispanic American/Latino high school students, 31.5% of females smoke cigarettes.
Uterine fibroids are tumors or growths, made up of muscle cells and other tissues that grow within the wall of the uterus (or womb). Although fibroids are sometimes called tumors, they are almost always benign (not cancerous). Fibroids can grow as a single growth or in clusters (or groups). Their size can vary from small, like an apple seed (or less than one inch), to even larger than a grapefruit, or eight inches across or more. No one knows for sure what causes fibroids. Researchers have some theories, but most likely, fibroids are the result of many factors interacting with each other. These factors could be hormonal (affected by estrogen levels), genetic (running in families), environmental, or a combination of all three. Because no one knows for sure what causes fibroids, we also don't know what causes them to grow or shrink. For the most part, fibroids stop growing or shrink after menopause. But, this is not true for all women with fibroids.
Most of the time, fibroids grow in women of childbearing age. While no one knows for sure what will increase a woman's chances of getting fibroids, researchers have found that African American women are 2 to 3 times more likely to get them than women of other racial groups. African American women also tend to get fibroids at a younger age than do other women with fibroids.
Sickle cell anemia (sih-kul sell uh-nee-mee-uh) is a blood disorder, passed down from parents to children. It involves problem red blood cells. Normal red blood cells are round and smooth and move through blood vessels easily. Sickle cells are hard and have a curved edge. These cells cannot squeeze through small blood vessels. They block the organs from getting blood. Your body destroys sickle red cells quickly, but it can't make new red blood cells fast enough— a condition called anemia. Sickle cell anemia can cause serious health problems:
Every year, about 1 in 500 African Americans are born with sickle cell anemia. This means that they got the sickle gene from both parents. People who have only one gene are carriers of the sickle cell, but won't get sickle cell anemia themselves. They can pass the gene to their children. It is estimated that one in 12 African Americans have one sickle cell gene.
Osteoporosis is a condition in which your bones become thin, brittle, weak, and more likely to break. A combination of things, not all of which you can control, can increase your chances of getting osteoporosis. These include:
While White and Asian women have the highest rates of osteoporosis, African American women are at risk as well. As African American women get older, their risk of developing osteoporosis more closely resembles the risk of White women. Lupus and sickle cell anemia, which are more common in African American women, increase the risk for osteoporosis. While all women are at risk for getting osteoporosis, Asian American women have a higher risk because of their lower bone mass and density and smaller body frames. They also have a lower intake of calcium compared to other groups of women. As many as 90% of Asian Americans are lactose intolerant or cannot easily digest dairy products.
Making sure to get enough calcium and exercise in the teen years and beyond can help prevent osteoporosis later in life. Your health care provider can find out if you have osteoporosis by giving you a bone mineral density test, which takes pictures like x-rays of the skeleton. If you are getting osteoporosis, you can prevent future bone fractures by having a calcium-rich diet, daily exercise, and drug therapy. There are a variety of drugs available to help preserve or increase bone mass. Talk with your health care provider about what is best for you.
According to the National Institutes of Health, alcoholism is a disease with these symptoms:
American Indians and Alaska Natives are five times more likely to die of alcohol-related causes than Whites and face high rates of chronic liver disease and cirrhosis. In addition, American Indians and Alaska Natives have a high rate of drinking and driving and alcohol-related fatal crashes compared to the general population.
Prevent problems related to alcohol. If you drink, the National Institutes of Health advises a safe level of drinking: for most adults, moderate alcohol use—up to two drinks per day for men and one drink per day for women and older people. However, some people should NOT drink at all:
Illicit drugs are illegal drugs, like heroin, marijuana, ecstasy, cocaine, PCP, and LSD. Subgroups of Hispanic Americans/Latinos vary in their rates of substance abuse, alcohol dependence, and need for illicit drug abuse treatment. But overall, compared to the total U.S. population, Mexicans and Puerto Ricans have high rates of illicit drug use, heavy alcohol use, alcohol dependence, and need for drug abuse treatment.
Suicide, or the taking of one's own life, is a tragic problem. Suicide is a leading cause of death in the U.S. In some segments of the American Indian and Alaska Native populations, there have been high rates of suicide. Between 1979 and 1992, the U.S. Surgeon General reported that overall, these groups have a higher rate of suicide, compared to the rest of the American population. Also, the age of suicide for American Indians is quite unlike that for the general population, because of the high rates among young adults and lower rates among the elderly. Of all women, American Indian/Alaska Native women ages 25-44 had the highest suicide rate in 2000. Many American Indian people who commit suicide haven't seen mental health providers; suicide often results from missed opportunities to treat such problems as depression, alcoholism, child abuse, and domestic violence. You can help prevent suicide. You can call 911, 1-800-SUICIDE, or the number of a suicide crisis center (you can find the number in your phone book) if you feel suicidal or know someone who talks about it. It is important to talk with someone right away. Asian American women have the highest suicide rate among women 65 or older. And suicide rates are higher than the national average for Native Hawaiians. One possible reason for the higher rate of suicide among Asian American/Pacific Islander and Native Hawaiian women is
that seeking mental health support is not socially acceptable in those cultures. And many of them wait to seek treatment until symptoms of mental health problems, such as depression, reach crisis levels. Nearly one out of two Asian American/Pacific Islanders will have problems using mental health treatment because they do not speak English or cannot find services that meet their language needs. Islander and Native Hawaiian women is that seeking mental health support is not socially acceptable in those cultures. And many of them wait to seek treatment until symptoms of mental health problems, such as depression, reach crisis levels. Nearly one out of two Asian American/Pacific Islanders will have problems using mental health treatment because they do not speak English or cannot find services that meet their language needs.
Tuberculosis is a disease caused by a bacteria. While it can affect any part of your body, it usually attacks your lungs. TB is spread through the air. If someone with TB of the lungs or throat coughs or sneezes, people nearby who breathe in the bacteria may get TB. Some people who breathe in the bacteria may not have symptoms and can't give it to other people. This is called latent TB infection. If the body can't stop the bacteria from growing, people develop TB disease. If this happens and the TB is in the lungs, it can cause several symptoms:
Among all women with TB, 81% of TB cases affect minority women. Of these cases, 26% are among Asian American/Pacific Islander women (second only to African American women, who make up 30% of TB cases among minority women).
Understanding infant death is difficult and can bring anger, pain, sadness, and confusion. Causes of infant deaths vary, but could include Sudden Infant Death Syndrome (SIDS), congenital anomalies, pre-term/low birth weight, problems from pregnancy, accidents, or respiratory distress syndrome. African American women have the highest number of infant deaths in the U.S. These health problems are prevented in different ways. You can improve your chances of having a healthy baby by taking these steps:
Depression is an illness that affects the body, mood, and thoughts. People who are depressed may feel hopeless, worthless, very sad, and have no energy or interest in doing anything. Some people describe depression as an "empty, or sad feeling that won't go away." This kind of depression that does not go away is called "clinical depression." It is different from feeling "blue" or down for a few hours or a couple of days. The rate of depression in Hispanic American/Latina women remains about twice that of men. And major depression (also known as clinical depression, in which symptoms last for at least 2 weeks but usually for several months or longer) and dysthymia (a type of depression that lasts for at least two years) may be diagnosed slightly more frequently in Hispanic American/Latino women than in White women. Possible differences in how symptoms appear may affect the way depression is recognized and diagnosed among minorities. For example, African Americans are more likely than Hispanics to report symptoms of depression that affect their whole body, such as appetite change and body aches and pains.
Many things cause depression. Depression can run in families. Changes in your brain chemistry and living through painful and difficult events in your life can cause depression. Sometimes depression is caused by certain medications people take for cancer, arthritis, heart problems, and high blood pressure. Some illnesses such as Parkinson's disease, stroke, and hormonal problems can cause depression. Most people with depression get better when they get treatment. The two most common treatments
for depression are medication and psychotherapy (talking with a trained counselor). Support groups can help. Talk to your health care provider about how you are feeling. Get a checkup to see if there are physical problems or medicines that are causing your depression.
Although this isn't a problem with the health of women, it can lead to health problems because many women can't get the right health services, medicines, and supplies when they need them. Some reasons include:
There are a lot of reasons why there are differences in health among women. Lack of health insurance is a major stumbling block to health care for African American women. Compared with White women, African American women are twice as likely to lack health insurance. Below are resources for women to help them get health care services. There are more uninsured Hispanic American/Latino women than any other race/ethnic group (30%), even though many of them are employed or live with someone who is employed. Only 26% have private health insurance, 27% receive Medicaid coverage, and 7% receive Medicare. This lack of insurance is due in part to the fact that Hispanics are more likely than non-Hispanics to be employed in industries and jobs that do not provide health benefits. Also, within the various industries, Hispanics are less likely than non-Hispanics to be offered health coverage by their employers. Problems with language, transportation, child care, immigration status, or cultural differences act as further barriers to health care services. Lack of access to health care is a major barrier to early detection and treatment of breast cancer and cervical cancer, and one that many Hispanic American/Latino women face. Uninsured Hispanic women with breast cancer are more than twice as likely than other women to be diagnosed with breast cancer in the advanced stages of the disease. The disease is more difficult to treat successfully when it is diagnosed in its advanced stages, and survival rates are lower.
More often than any other group, Hispanic Americans/Latinos have no regular source of health care. In addition, the low incomes of many Hispanic Americans/Latinos, as compared to other groups, make it hard to obtain individual health insurance outside of employer- or government-sponsored plans. Even when they are eligible for Medicaid or state-sponsored child health insurance programs, many Hispanic American families fear that enrolling family members in such plans could be used against them when they apply for citizenship. Because they believe ill health is part of the normal aging process, American Indians/Alaska Natives may be less likely than others to get care for problems that can be treated. They have faced racism and have been denied medical care in the past, which are also barriers for some people to get care later in their lives. In fact, one study found that older American Indians fear non-Indian health professionals and do not expect to be treated fairly by them.
Another barrier is not having medical care close by. Even though the U.S. Department of Health and Human Services' Indian Health Service (IHS) offers health care services for American Indians and Alaska Natives, many do not have a health care provider to see for preventive health services or medical care. Only 1 in 5 American Indian or Alaska Native uses health care from the Indian Health Service. IHS services clinics are mainly located at reservations. So, American Indians and Alaska Natives who live in urban areas can't use it.
Overall, about 21% of Asian American/Pacific Islanders lack health insurance, compared to 16% of all Americans. Even with health insurance, culturally accepted medical models such as acupuncture and herbal medicines often are not covered services, a fact that further limits access to health care. Asian American women are more likely to report using traditional health practices and medicines than Asian men - 69% versus 39%. By ethnic group, nearly all Cambodian women (96%), nearly a fifth (18%) of Laotian women, and nearly two-thirds of Chinese women (64%) report using traditional health practices. Nearly one out of two Asian American/Pacific Islanders will have problems using mental health treatment because they do not speak English or cannot find services that meet their language needs. And not all English medical/health terminology can be readily translated into the various Southeast Asian languages, nor can many Southeast Asian expressions describing physical and mental conditions be directly translated for U.S. health care providers. Thus, it may be difficult for Asian patients to accept their diagnoses as real or to accept western treatment regimens for them. Fear of difficulties in communicating, compounded by shame, guilt, anger, depression, and other responses to certain stigmatized conditions such as mental illnesses, also may deter Asian Americans from seeking care promptly. Access to health care among Samoans living on American Samoa is unique, in part because of the political relationship between the United States and its territory. Although this set of islands, located 240 miles southwest of Hawaii (the nearest site for tertiary care for residents of American Samoa), is medically underserved, American Samoa has operated a locally appropriate form of Medicaid since 1983. All inpatient and most outpatient services are provided at the Lyndon Baines Johnson (LBJ) Tropical Medical Center in the village of Faga'alu on the island of Tutuila. For persons living in the urban areas of Tutuila, this aging facility built in 1968 is convenient; however, for persons in rural areas of Tutuila or on other islands within the U.S. Territory of American Samoa, it is difficult to access care. Financial access to services at LBJ is not a problem for the Samoan population because of the Medicaid program. However, other things, such as an insufficient number and scope of needed health professionals, the unavailability of sophisticated diagnostic tools, and the lack of financing to replace the aging and increasingly outdated medical center, hinder the access to quality care in American Samoa. Samoans living on the United States mainland are more likely to be poor than other Americans and also are less likely to hold higher paying jobs that provide insurance coverage for families. Other barriers in access to health care for American Samoans result from their linguistic isolation, their culture and traditions, and their beliefs about the etiology of disease. Among groups on the U.S. mainland, urban American Samoans are one of the most linguistically isolated. Linguistic isolation makes it difficult for Samoans to seek and receive appropriate health care. Only in Hawaii, where the Samoan community is visible and concentrated in three distinct areas (Laie, Kalihi, and Waianae), have community-centered clinics been developed to provide culturally appropriate health care and education.
Finding health insurance often requires good research and finding answers to lots of questions. There are a number of different kinds of health care coverage:
Employer sponsored - fully or partly paid by an employer, includes health maintenance organizations, preferred provider organizations, and point of service plans. Contact your employer for information on plans available to you Individual insurance - private health insurance that a person buys through an insurance company. You may want to talk to an insurance broker, who can tell you more about the health care plans that are available for individuals. Some states also provide insurance for very small groups or people who are self-employed. You may also want to go to the Quality Interagency Coordination Task Force Web site on health care quality at http://www.consumer.gov/qualityhealth/ for information on selecting a health plan. If you do not have access to the Internet, or don't know how to use a computer, call 1-800-994-WOMAN (1-800-994-9662).
Medicare - federal government health insurance program for people 65 and older, or who are disabled, or who have permanent kidney failure. You can call the Social Security Administration at 1-800-772-1213 or contact your local Social Security Office for more information. Medicaid - federal and state health insurance program run by states for low-income or disabled people of all ages. Click on http://cms.hhs.gov/medicaid/tollfree.asp for a list of Medicaid toll-free lines in each state. If you do not have access to the Internet, or don't know how to use a computer, call 1-800-994-WOMAN (1-800-994-9662).
Lesbians comprise a subgroup of women whose health status and risks have not been widely researched. One reason for the limited research on lesbian health is the methodological problem of defining what constitutes lesbian sexual orientation, since sexual orientation is commonly described as both behavioral, (i.e., desire or attraction), and cognitive (i.e., identity). Lesbians are found among all subpopulations of women, and are represented in all racial and ethnic groups, all socioeconomic strata, and all ages. There is no single type of family, community, culture, or demographic category characteristic of lesbian women. It is important to note that views about sexual identity and sexual behavior can vary significantly across cultures and among racial and ethnic groups, so it should not be assumed that a lesbian sexual orientation or identity is the same for lesbians of different racial, ethnic, or cultural backgrounds. Fundamentally, lesbians need access to the same high quality health screening and preventive care that is appropriate for all women throughout the life cycle. Lesbians and their providers often remain uninformed about important health issues, including the need for: cervical and breast cancer screening, reducing the risk of sexually transmitted diseases and HIV; caring for mental health issues including depression; diagnosing and treating substance abuse; pregnancy and parenting assistance; and understanding domestic/intimate violence. Differences in health risks for lesbians from women in general could be attributed to a number of factors. A woman's health behavior, stress, and the nature of her experiences with the health care system can all affect her risk for various health conditions.
Physiological responses to stress can have many negative health consequences, especially over a long period of time. Lesbians may have additional stresses that compound the everyday stress that everyone experiences.
Elements of the health care system itself, such as managed care, legal rights, and the attitudes and training of health care providers, contribute to negative experiences that can discourage lesbians from seeking appropriate and necessary health screening and treatment.
More research is needed on lesbian health issues for several reasons:
Office on Women's Health
U.S. Department of Health and Human Services
200 Independence Ave, SW Room 712E
Washington, DC 20201
(202) 690-7650
Office of Research on Women's Health
National Institutes of Health
Building 1, Room 201
Bethesda, MD 20892
IOM Report: Lesbian Health: Current Assessment and Directions for the Future. Andrea L. Solarz, Editor. Institute of Medicine. Funded by the National Institutes of Health and the Centers for Disease Control and Prevention, U.S. Department of Health and Human Services.
Office of Minority Health
Phone: (301) 443-5224 (301) 589-0951 (D line) (800) 444-6472 (Publications)
Internet address: http://www.omhrc.gov
Office of Minority and Women's Health
Phone: (301) 594-4490
Internet address: http://bphc.hrsa.gov/OMWH/home.htm