Doctors talk health issues in Hispanic adults, kids

(upbeat Latin music) - Good evening and welcome to Horizonte, a show that takes a look at current issues through a Hispanic lens.

I'm your host, Catherine Anaya.

April is National Minority Health Month.

Tonight we will talk about the top health issues impacting the Hispanic community for both adults and for children.

Two Arizona doctors will join me to discuss the specific health issues and why they're so prevalent.

But first, we hear from one person dealing with diabetes, a disease that hits hard in the Hispanic community.

- It was diagnosed about 18 or 19 years ago.

Most of my family members have diabetes or they're pre-diabetic at some point.

When you're first diagnosed, it's kind of a shock.

I couldn't comprehend that I was diabetic at that point.

At the beginning it was difficult and it was, "Let's get as strict as possible."

But like everything else, life changes and your lifestyle changes and you just need to adjust as you go along.

You become groggy, you become disoriented, you become dizzy.

It just weakens you for some reason.

'Cause you're used to probably running high on sugar.

Then you take the medicine that drops the sugar down.

So you're, you're, you're not feeling the same, you don't feel like the same person.

You do feel different.

Well, you become a little more cognizant of the what you're consuming.

Especially as Hispanics, we consume a lot of carbs.

Everything has carbs in it.

Everything has corn in it or flour or something.

So you try to limit yourself in what you're eating.

They started me on metformin at the beginning.

I'm on three more medications now.

The things that I've kind of struggled with are just staying on track.

It's kind of like having to be on a diet for the rest of your life, which is something you should do anyway.

But diabetes gives you a reminder every time you get outta control and you start feeling strange.

- Joining me to talk about the health issues impacting Hispanic children is Dr. Ruben Espinoza, a pediatrician at Banner Children's at Desert in Mesa.

Thank you so much for joining us.

We appreciate it.

- Thank you, very nice to be here.

- So I did a little research and according to insurekidsnow.gov, 25.6% of Hispanic children have obesity.

Why is this such a prevalent health issue among Latino children?

- Well it's a very prevalent issue amongst all children.

Like the last number, AAP, which is the American Academy of Pediatric, just came out with like a new practice guideline and they mentioned then that it's 14.4 million children in the US that have the obesity.

So it is the most prevalent chronic disease in pediatrics.

There's multifactorial causes for it and that makes our community the Hispanic part and minorities more prone because there's genetic predisposition.

There's also studies that show that children or persons that have been exposed to trauma, especially at a young age, like our immigrant population or just not being born in this country and having to have immigrated from your home country can create trauma and that stress can change their metabolism.

So they're doing a lot of research in terms of that to, and that will explain why it's so prevalent in our community.

- So those are contributing factors?

- Yes.

- How can families then approach this in a preventative way?

What can they do?

- Well, preventative way that we continue to encourage parents and families to have healthier eating habits.

But sometimes according to the, you know, social determinants of health, which sometimes they have scarce resources to like good whole foods because that's basically been the gold standard up to this point to treat it to try to, you know, get nutritional education and make sure to just, you know, increase your protein load, go down on your carbohydrate intake.

But most of the foods, sometimes, are higher price and that just puts a big toll on the family.

So then families that are struggling, sometimes they just whatever they can afford and sometimes it's not the optimal diet.

- Yes, it becomes a very big challenge.

One of those challenges we just heard from somebody dealing with is diabetes and type two diabetes is very prevalent among Latino children.

Can you describe type two diabetes for us and why the incidence of that is so high?

- Yes, type two diabetes is the diabetes that is actually it's more genetic and it's what we call it multifactorial because yes, you have to have a genetic predisposition, but also there's a lot of factors like external, like the diet, if you were exposed to stress now that you come with that, lack of exercise, all those things put us at higher risk if you have that genetic predisposition.

So the Hispanic community, we are predisposed, most of us have a family member that already has it.

So that means that it's runs in our families and it's different than type one, because type two it's called like an insulin resistant, meaning that your body starts to have struggles to metabolize glucose and carbohydrates at a very young age.

And it just kind of like, you're kind of like overloading your pancreas, which is the one that produces the insulin that we all know that that's what we need to metabolize the the sugar.

So then you become resistant.

That means that your body needs to produce more of that.

- So how do you go about diagnosing that and for families again, you know, how do you go about preventing that?

- Well the diagnosis is done when you go to your provider, to your primary care doctor, your pediatrician in this case with children, and we check your weight and your height and we get like a body mass index and we ask about family history.

So then we will run some tests like blood tests that can tell us, you know, if you have that predisposition or if you're already borderline running the sugars high, that's when we start to get concerns.

There's also some physical signs and symptoms of that, which is changes in your skin and things like that that we as clinicians know how to pick up.

- Well that's why those well checks are so important on a regular basis and getting your children in to see the doctor at least once a year.

Vaccines are also something that you believe is very important for Latino children, right?

- Yes.

I cannot emphasize enough and if we're gonna get something out of this is the message to make sure that all children get their annual wellness and because children are still constantly evolving, they're growing, they're developing and the wellnesses are designed to do that, to catch things early.

And also the immunization.

I deal with mostly Hispanics in my practice, huge Hispanic population.

And sometimes they're just that misconception that if they don't need any immunizations then they shouldn't go and do the the checkup.

But a yearly checkup, that's the opportunity for us to catch these things, you know, earlier, and like any other chronic disease, earlier detection is the key to success.

- And when we're talking about some of the barriers, we're talking about, you know, the food challenges and the prices of food.

We're talking about insurance and you know, all of these other implications sometimes that families have to deal with.

So what is your suggestion as far as resources go within Banner particularly?

- So we have a lot of resources in Banner in terms of like our website.

There's a lot of tips and tricks of like nutrition.

There's a lot of like recipes and there's like a whole page on healthy eating habits and things like that.

There's also resources for underserved families.

We have for pediatrics, we have our community clinics and the resources are there where children that don't have insurance can get access to basically, well check, immunizations, screenings, everything that least elemental basic healthcare.

- Well thank you so much doctor.

Appreciate you joining me to talk about these very important issues.

Appreciate it.

- Okay, thank you for your time.

- Good to see you.

- Thank you.

- You bet.

Coming up next we talk with another Arizona doctor about the top health issues impacting Hispanic adults.

(upbeat Latin music) - Joining me now is Dr. Jesse Bracamonte, a family physician with Mayo Clinic.

It is so nice to have you.

I appreciate it.

- Nice to be here, thank you.

- So we talked about some of the issues, health issues impacting adults.

Now we wanna, or excuse me, children, now we wanna focus on adults.

What would you say are the top three health issues that Latino adults deal with?

- Well, very similar to the pediatric population, one is diabetes, hands down.

That is an epidemic in our society, particularly among Latinos.

And that's number one on my list.

Number two is hypertensive cardiovascular disease, hypertension and heart disease.

And screening for that is very important.

Third, I would say like, cancers, trying to catch preventable cancers that can be effectively treated are of utmost importance as a family doc.

And I really preach the choir or get onto my soapbox and tell patient that we gotta get screened for this, 'cause if it's caught early, it's treatable.

- Well let's talk about each one.

- Sure.

- Starting with diabetes, how do you go about diagnosing it and what is the key to prevention?

- Well, diabetes is a simple screening test.

So just like my colleague and from pediatrics discussed, checking a body mass index, a weight, blood pressure, are all standard things that you go to a doctor for.

But it's a simple test.

It's basically a glucose check.

It can be a finger stick test or a lab check and we can check your sugar.

We can even check something called an A1C, which measures your sugars over three months to give you an average of what it's worth or what the levels are.

If it's caught, you can be effectively treated with some medications which are phenomenal and they work.

Secondly, if you do catch it early and you catch it and you give the right medications along with lifestyle, diet changes, exercise, it can be effectively treated sometimes without medication - And sometimes people don't realize that it is treatable.

So what causes it to be so prevalent?

- 100%, and sometimes when I do some work at some clinics in the community here, many people don't know until it's too late.

They get a bad infection, they have chest pain, they go to the ER and they find out their sugars can be up as as high as 400, excuse me, four times the normal value.

And then by that time, horse is out of the barn and things have already happened.

So what causes it?

Like my colleague said, multifactorial, lots of issues for it can be genetic, which means what we inherited from our parents, our grandparents.

It can be environmental, which means our processed foods, our sugar intake, lack, in our society, we're not so much hunters and gatherers anymore.

What it means we're, we don't exercise as we once did as a child and your body's way of metabolizing sugars changes.

That is a perfect storm, particularly with Latinos, to develop sugars.

Your pancreas just stops functioning to work to process the sugars.

When that happens, your sugars go high.

You have four times the risk of complications for heart disease, numbness, kidney damage, and eye damage.

- Well let's talk about, 'cause you mentioned heart disease, hypertensive cardiovascular disease is what you said was - Correct.

- Probably the second most important health issue.

- So one of the number one causes of death in the United States is heart disease.

And an easy screening tool to pick up on that or just to prevent that is checking a blood pressure.

So going to your doctor's office and just getting a blood pressure check can be the first step in just treating, preventing that from happening.

So simple blood pressure check can happen along with that, along with checking for your sugar, you can also check for your cholesterol.

Those two things, if caught early and treated appropriately, can prevent long-term complications of heart disease, even kidney damage.

So a little bit of exercise, eating healthy, there's even a diet called the DASH diet, which stands for diet approaches to stopping high blood pressure, can be beneficial and treat for the blood pressure.

But the first step is getting checked by your doctor or your clinician or provider to get checked to make sure that that's not an issue.

- Well and when you talk about cancer screening, is it a particular cancer or multiple cancers?

- Great question.

So science is pretty, science is pretty solid on some of the cancers we can prevent.

One that affects men and women and it's one of the leading cause of cancer is colon cancer.

And there's some easy tests that you can do.

Some are just simple stool studies.

They can collect a sample and they can assess that and see if you're at risk for delving colon cancer.

It's a simple test.

Second is breast cancer for women, you know, one of the leading causes of cancer and it's totally catchable and treatable if caught with a simple mammogram.

So if you catch those early, you can fend off a lot of disease in a lot of heartache long term.

Last for women, if you're over 21, checking a pap smear for cervical cancer.

Again, very preventable if caught early.

- Well we know that there are health disparities when it comes to minority health.

So how do you go about approaching that when we are talking about the costs of some of these tests?

Insurance issues?

Even the cultural issues.

- Yeah - Language.

- 100%, so that is a barrier to getting effective care, we all know that.

Fortunately, most insurances will allow for a sugar and a glucose and a well check at least once a year paid.

So check with your insurance.

Number two, finding facilities or clinics that offer low cost or low fee for service evaluations or some and there are many facilities here that offer care for the underserved.

One is like St. Vincent of Paul, which offers care and screening tests, but all of those who just mentioned for free for those that are really in need and have the disparities and don't have those resources to do that.

- Well, I know you've been volunteering at St. Vincent De Paul, great organization, for a number of years.

Do you see a prevalence of these issues that you talked about just among the people that you serve?

- 100%, yeah.

It's there, it's evident.

Fortunately, Mayo Clinic where I work allows me to go down there and they partner with 'em, which I think is a huge blessing to go do that.

St. Vincent De Paul is just a wonderful resource to the community and there's many other ones there.

I'm just using that cause I volunteer my time with that and teach there with my students and they do those screen tests there and they help people.

And it just takes a simple phone call to if you're think you're in need and need some assistance, call St. Vincent De Paul.

And it's one of many resources in the valley.

- And we know that children we, you know, wanna get those well checks at least once a year.

What do you recommend for adults?

- Great question.

Normally what, so if you're above 50, make it some once a year minimum.

In your forties, you can do it every couple of years as well if things really check out okay.

But most times I have my rule telling patients if you're over 50, I wanna see you every year just get those screening tests.

In their forties, depending on their health, or if we find something may be yearly, or at minimum twice annually.

- Great information.

Thank you, it's good to see you.

- It's my pleasure.

- Appreciate you being here.

- Thank you very much.

- Thank you.

That's our show for tonight.

For Horizonte and Arizona PBS, I'm Catherine Anaya.

Thanks for joining us, have a great night.

(upbeat Latin music)