Despite numerous efforts to address health disparities in diverse American populations, there is still significant variability in disease risk and prevalence among different ethnic groups. Hispanic Americans are at a higher risk of developing several conditions, including type 2 diabetes mellitus. Creating and implementing evidence-based primary care health promotion strategies could help to address the unmet needs of this population and improve their glycemic control, thus reducing their risk of diabetes. The present paper will provide information about diabetes in Hispanic people and present evidence-based recommendations for health promotion in this population.
The population of Hispanic people in the United States is large and diverse, as it is comprised of people from various backgrounds, including Mexican, Puerto Rican, Cuban, and more. In Los Angeles, California, the share of Hispanic people is significantly higher than in many other cities. According to Brown and Lopez (2013), the city is home to almost 5 million Hispanics, which is 9% of the U.S. Hispanic population. Addressing diseases and conditions that are prevalent in this population could have a positive effect on the overall health status of the city.
One of the most critical health risks for Hispanic people is type 2 diabetes. Duggan et al. (2014) report that Hispanics have a 66% higher risk of developing prediabetes and type 2 diabetes than non-Hispanic white people. The prevalence of diabetes among Hispanic people varies depending on their background, with 18.3% of Mexican Americans, 18.0% of Dominicans and Puerto Ricans, and 13.4% of Cubans affected by the condition (Schneiderman et al., 2014). However, primary care prevention efforts should address all Hispanic people regardless of their background to be more effective overall.
The main reason for the increased prevalence of diabetes among Hispanic people is the lack of knowledge about the condition and its prevalence. Schneiderman et al. (2014) state that diabetes awareness was evident only in 58.7% of participants, 52% of participants did not use adequate glycemic control measures recommended by their doctors, and 48.6% did not have health insurance. Therefore, the identified population needs education about diabetes and its prevention, as well as improved access to care.
Recommendations for Health Promotion
Lifestyle interventions can be used to lower Hispanic patients’ risk of developing diabetes by introducing them to healthy eating and exercise. Poor eating habits and obesity are among the main predictors of type 2 diabetes, and these characteristics are often prevalent in Hispanic populations (McCurley, Gutierrez, & Gallo, 2017). Nurses and other primary care providers could carry out lifestyle interventions by educating at-risk Hispanic patients about their risk of diabetes and suggesting making changes to their eating and exercise.
However, it is also critical for care providers to ensure that the recommendations are feasible for any patient, regardless of their income and occupation (McCurley et al., 2017). For example, rather than recommending an expensive diet and fitness program, nurses and physicians should focus on equipping patients with simple yet effective methods of healthy cooking and motivating them to work out at home or walking to work instead of taking a bus.
Community-Based Health Promotion
Another viable option for addressing the needs of Hispanic people in diabetes prevention is to carry out community-based interventions. Duggan et al. (2014) report on the results of an educational intervention led by community health workers. The intervention consisted of 5 educational sessions providing information about diabetes and a healthy lifestyle. The results of the study showed that there was a significant improvement in HbA1c levels of the intervention groups and that the people who completed the course were motivated to engage in physical activity and develop healthy eating habits (Duggan et al., 2014).
Community-based health promotion interventions can be carried out in short courses (e.g., five hourly sessions) and taught by nurses who have ties with the community. Nurses should also provide participants with brochures and links to websites where patients can find more information about diabetes management and prevention.
Improving Access to Care
Addressing barriers to care that is evident in Hispanic people is crucial to improving access to care. Ortega, Rodriguez, and Bustamante (2015) state that the three common barriers to care among Hispanics are negative perceptions of healthcare quality, poor language skills, and immigration status. A recommended solution to these problems is to create a safe environment for patients to receive health care services (Ortega et al., 2015). For instance, opening a free local clinic with Spanish-speaking nurses where Hispanic people could go to check their health status and receive information about health promotion would improve their use of healthcare resources.
Overall, Hispanic people face a considerably higher risk of type 2 diabetes due to the lack of knowledge about the condition and poor access to care. Given that a significant share of the population in Los Angeles are from Hispanic backgrounds, addressing their health promotion needs would improve the general health status of the city’s population. The three critical recommendations for evidence-based health promotion among Hispanic people are lifestyle interventions, community-based health classes, and free local clinics with Spanish-speaking nurses. Implementing these strategies would improve Hispanic people’s use of health care resources and their awareness of diabetes prevention methods.
Brown, A., & Lopez, M. H. (2013). Mapping the Latino population, by state, county and city. Web.
Duggan, C., Carosso, E., Mariscal, N., Islas, I., Ibarra, G., Holte, S.,… Thompson, B. (2014). Diabetes prevention in Hispanics: Report from a randomized controlled trial. Preventing Chronic Disease, 11(1), 28-38.
McCurley, J. L., Gutierrez, A. P., & Gallo, L. C. (2017). Diabetes prevention in US Hispanic adults: A systematic review of culturally tailored interventions. American Journal of Preventive Medicine, 52(4), 519-529.
Ortega, A. N., Rodriguez, H. P., & Bustamante, A. V. (2015). Policy dilemmas in Latino health care and implementation of the Affordable Care Act. Annual Review of Public Health, 36(1), 525-544.
Schneiderman, N., Llabre, M., Cowie, C. C., Barnhart, J., Carnethon, M., Gallo, L. C.,… Teng, Y. (2014). Prevalence of diabetes among Hispanics/Latinos from diverse backgrounds: The Hispanic community health study/study of Latinos (HCHS/SOL). Diabetes Care, 37(8), 2233-2239.