Hayes-Bautista D E, Baezconde-Garbanati L, Schink W O, Hayes-Bautista M
Center for the Study of Latino Health, School of Medicine, UCLA.
Fam Med. 1994 Oct;26(9):556-62.
Family practice, especially when applied to the Community-oriented Primary Care model, needs to incorporate the epidemiological profile and health care needs of a particular community. The rapidly growing Latino population is creating a great number of largely Latino communities. While they tend to have high poverty rates and low education rates, their family and health profiles contradict many assumptions made about poor, underserved minority groups. Data for the 29.8 million California residents, including 7.7 million Latinos, show a strong Latino health profile. Compared to Anglos and blacks, Latinos have high complete nuclear family rates and low non-family rates. They have low rates of low birth weight babies and low infant mortality, about equal to the rate among Anglos and Asians. Latinos also have lower age-adjusted death rates due to heart disease, strokes, and cancers, again, about equal to Asians. Latinos do, however, have higher death rates due to motor vehicle accidents and cirrhosis than Anglos, blacks, or Asians and a diabetes death rate higher than Anglos or Asians. Surprisingly, Latinos have lower age-adjusted death rates due to drug-related causes and weapons-related causes than Anglos or blacks, but substantially higher than Asians. It is suggested that, much against the stereotype, Latinos should be considered a high-level wellness population for whom family practice, based on prevention and primary care, would be an ideal match.
家庭医疗,尤其是应用于以社区为导向的初级保健模式时,需要纳入特定社区的流行病学特征和医疗保健需求。迅速增长的拉丁裔人口正在形成大量以拉丁裔为主的社区。虽然这些社区往往贫困率高、教育水平低,但他们的家庭和健康状况与许多关于贫困、服务不足的少数群体的假设相矛盾。加利福尼亚州2980万居民的数据,其中包括770万拉丁裔,显示出拉丁裔强大的健康状况。与盎格鲁人和黑人相比,拉丁裔的完整核心家庭比例高,非家庭比例低。他们的低体重儿出生率和婴儿死亡率低,与盎格鲁人和亚洲人的比例大致相当。拉丁裔因心脏病、中风和癌症导致的年龄调整死亡率也较低,同样与亚洲人相当。然而,拉丁裔因机动车事故和肝硬化导致的死亡率高于盎格鲁人、黑人或亚洲人,糖尿病死亡率高于盎格鲁人或亚洲人。令人惊讶的是,拉丁裔因药物相关原因和武器相关原因导致的年龄调整死亡率低于盎格鲁人或黑人,但远高于亚洲人。有人认为,与刻板印象相反,拉丁裔应被视为健康水平较高的人群,基于预防和初级保健的家庭医疗对他们来说将是理想之选。