Getting the word to Hispanics about diabetes

NIH grant is helping to educate immigrant population about diseases

Medical

December 03, 2004|By Kelly Brewington | Kelly Brewington,SUN STAFF

In some Hispanic cultures, folklore has it that a tea made from a Peruvian vine cures everything from diabetes to high blood pressure.

But Evelyn Rosario has spent many afternoons at the Hispanic Apostolate in Fells Point convincing clients that the vine known as UM-qa de Gato, or Cat's Claw, is no substitute for insulin or hypertension medication.

Educating the region's growing Hispanic community about the health issue is no small feat, considering cultural nuances, the language barrier and the high proportion of uninsured residents.

But a $2.5 million grant from the National Institutes of Health is helping local health care workers spread the word about diabetes and the often misunderstood eye disease it can cause.

Researchers at the Johns Hopkins Wilmer Eye Clinic and the university's Bloomberg School of Public Health have teamed up with advocates at Catholic Charities' Hispanic Apostolate to design an outreach program aimed at Baltimore's burgeoning Hispanic population.

The project, known as Pro Vision, will take place over four years, starting in January, with a survey of 400 Hispanics in Southeast Baltimore to gauge their knowledge of diabetes and diabetic eye disease.

Rosario, coordinator of services at the Hispanic Apostolate, said diabetes is much misunderstood in the Hispanic community, even though the disease disproportionately afflicts Hispanics.

She described one patient from Mexico who told a doctor at the Hispanic Apostolate that he received a diagnosis of diabetes in his home country, but had no idea he should check his blood sugar regularly.

"He said he took the medicine the doctor gave him and then he never went back," Rosario recalled.

Once completed, the study partners hope the outreach program designed in Baltimore becomes a model for other cities.

"We want to get to know the community," said Dr. Sheila West, a professor at the Wilmer Eye Clinic, who is leading the study. "We want to give them a holistic health communication package. Not just stuff on the Internet or posters. We want them to know if you have this problem, this is what you have to do."

For years researchers have tried to determine why Hispanics have disproportionately high rates of adult-onset diabetes. About 10.2 percent of Hispanic Americans have diabetes, and they are nearly twice as likely to have it as non-Hispanic whites of the same age, according to the National Diabetes Information Clearinghouse.

Much of the research points to diet, although other studies indicate that the Native American ancestry of many Hispanics gives them a predisposition to develop the disease.

In a 2001 study of Hispanics in Arizona, West found nearly one in five adults ages 40 and older have diabetes. About half of those have diabetic retinopathy, a diabetic eye disease that can cause blindness. Yet 15 percent of Hispanic diabetics are unaware of their condition.

"We found that diabetic eye disease was the single most important reason why people had vision loss in the working age Hispanic population," she said. But few of the patients studied were controlling their blood sugar or had access to health or eye care.

Many of Baltimore's new Hispanic immigrants will put off eye screenings because of cost, said Rosario. Although an eye doctor from the Maryland Society for Sight visits the Hispanic Apostolate four times a year to conduct free screenings, only about 40 patients can be seen at a time.

"Meanwhile the community is just getting bigger and bigger," Rosario said.

West decided Baltimore would be the ideal location to start a program because of its rapidly growing and diverse Hispanic population, along with a web of outreach organizations that serve new immigrants.

"It's a very interesting population; it's not just Mexican-American, but it represents a lot of different Latino groups," West said. "Like a lot of cities, it's a burgeoning population and many are underserved. By looking at Baltimore, we are studying a microcosm of the United States."

Diabetes can affect microscopic blood vessels, causing eye disease, as well as kidney disease and a variety of vascular problems. But the eye disease can be treated, with laser surgery, said West.

Her goal is to connect Hispanics to information on controlling diabetes, as well as affordable services to treat eye disease.

"Right now, there are people who come down and volunteer, and there are scattered clinics," said West. "But there is no clear way to say to people, if you have this problem this is where you can access the service to fix it."

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