Overview: Tobacco-Related Disparities Among Hispanics/Latinos

1. TM Overview: Tobacco-Related Disparities Among Hispanics/Latinos Centers for Disease Control and Prevention Office on Smoking and Health 2005 National Conference on Tobacco or Health May 4, 2005

2. TM Introduction Overview: Tobacco-Related Disparities Among Hispanics/Latinos Nisha Gupta, MPH Office on Smoking and Health 2005 National Conference on Tobacco or Health May 4, 2005

3. Topics • Program Development and Capacity BuildingDebra Torres • Smoking among Hispanics/LatinosRalph Caraballo • Border Region Opportunities and OSH Initiatives Nisha Gupta • Hispanic/Latino Adult Tobacco SurveyRalph Caraballo

4. TM Program Development& Capacity Building Debra S. Torres, MPH Office on Smoking and Health 2005 National Conference on Tobacco or Health May 4, 2005

5. Why Focus on Hispanic/Latinos? • Fastest growing sub-group of the U.S. population • Younger than general population

6. Who are Hispanic/Latinos ? • Heterogeneous • Country of origin • Geographic region • Immigration status • Language • Acculturation levels • Education • Socio-economic status

7. Social Context • Most likely to live in poverty • Lower proportion of people aged 25 > with at least a high school diploma • More likely to be unemployed • Less likely to be covered by health insurance

8. Social Context - 2 • Hispanic/Latinos similar mortality outcomes as non-Hispanic Whites? • Data aggregated for Hispanic/Latino’s as a whole • Socio-demographic characteristics • Some studies not conducted in Spanish

9. Program Planning,Development & Implementation • Consider challenges and opportunities

10. Challenges • Competing priorities social and health issues • Targeting by tobacco industry • Advertising • Sponsorship • Philanthropy

11. Opportunities • Family oriented • Value traditions and culture • Strong social networks/ sense of community • Commitment to social justice issues

12. “Forty Years ago, Cesar Chavez led the struggle for better working conditions for Hispanic/Latino farm workers in the United States. As a leader, he made sure workers were paid fair wages and were protected from the dangerous chemicals in the fields.” Latino/a Research & Policy Center

13. Today Hispanic/Latinos still struggle with exposure to deadly chemicals in the workplace exposure to secondhand smoke.

14. Hispanic/Latino’s are the least protected group by comprehensive smoke-free policies in the workplace.

15. Program Planning Strategies • Identify stakeholders • Engage stakeholders • Obtain skilled Hispanic/Latino facilitator

16. Program Planning/Development Strategies • Increase quantitative and qualitative data • Tailor interventions

17. Program Strategies • Develop and implement • Community competent • Comprehensive interventions • Prevent initiation: youth and young adults • Promote quitting among adults and youth • Reduce exposure to secondhand smoke

18. Program Strategies - 2 • Monitor industry marketing tactics • Link tobacco control with other health and social issues • EVALUATE, EVALUATE, EVALUATE • Publish findings

19. On-Going Program Activities • Cultivate partnerships • Foster inclusivity

20. On-Going Program Activities - 2 • Build capacity • Allocate resources • Sustain funding • Provide training and technical assistance

21. Health Communications • Avoid direct translations • Develop tailored messages • Use local Hispanic/Latino media outletsie., Univision, radio, newspapers • Place messages in mainstream media outlets

22. Take Home Message • Get to know your community • Engage community • One size doesn’t fit all • Context is key

23. Conclusion “Envision a future where those responsible for addressing tobacco prevention and cessation take on a major role in ensuring culturally competent services and participate in advocacy initiatives to reduce tobacco related disparities among Hispanic Latinos.” Hispanic Latino Education Network of California

25. TM Program Development& Capacity Building Debra S. Torres, MPH Office on Smoking and Health 2005 National Conference on Tobacco or Health May 4, 2005

26. TM Smoking among Hispanics/Latinos Ralph Caraballo, PhD, MPH Office on Smoking and Health 2005 National Conference on Tobacco or Health May 4, 2005

27. Topics to be Covered • Hispanic/Latino Demographics in the U.S. • Tobacco Industry Advertising for Latinos • Smoking Prevalence and Trends • Secondhand Smoke Exposure • Smoking during pregnancy

28. U.S. Hispanic/Latino Demographics

29. Uniqueness: Specific Population Groups • Important to understand the diversity and uniqueness of specific populations • What we think is one group may be several, with varying customs and needs

30. Percent Distribution of Hispanics/ Latinos by Ancestry: 2004 8% Mexican South American Central American 10% Dominican 63% Cuban 4% Puerto Rican 3% All Other Hispanic 7% 5% Source: Hispanics: A People in Motion; The Pew Hispanic Center, January 2005

31. Hispanics/Latinos in U.S. by Ancestry: 2002 Source: Current Population Survey, March 2002, PGP-5

32. 12.6% 24.4% 2050 69.4% 50.1% White Hispanic Black AAPI AIAN Population Growth:U.S. Population by Race/Ethnicity 2000 Source: U.S. Census Bureau, 2004, "U.S. Interim Projections by Age, Sex, Race, and Hispanic Origin," www.census.gov/ipc/www/usinterimproj Internet Release Date: March 18, 2004

33. 110 102.6 100 87.6 90 80 73.1 70 59.7 60 Population in millions 47.7 50 35.6 40 30 22.4 20 10 0 1990 2000 2010 2020 2030 2040 2050 Hispanic/Latino Population—United States Source: U.S. Census Bureau, 2004, "U.S. Interim Projections by Hispanic Origin," www.census.gov/ipc/www/usinterimproj Internet Release Date: March 18, 2004

35. 10 U.S. States Where 80% of Hispanics Reside (Year 2000) NY NJ NV IL CA CO AZ NM TX FL High Percent of Hispanics Lower Percent of Hispanics

36. Census 2000: Top 10 States by Hispanic Percent Change Since 1990 N. Carolina Arkansas Georgia Tennessee Nevada S. Carolina Alabama Kentucky Minnesota Nebraska

37. Language Use Among U.S. Hispanic/Latino Adults, 2002 Spanish Dominant Bilingual English Dominant Source: Pew Hispanic Center/Kaiser Family Foundation National Survey of Latinos, December 2002

38. Native/Foreign Born U.S. Hispanics/Latinos: 2004 Native Born Foreign Born Source: Pew Hispanic Center tabulations from the Annual Social and Economic Supplement, Current Population Survey, March 2004

39. Legal/Undocumented Hispanics/Latinos: Living in U.S.: 2004 Legal Undocumented Source: Pew Hispanic Center estimates based on March 2004 Current Population Survey (Passel 2005). Includes an allowance for persons omitted from the CPS.

40. No Health Insurance by Race/Ethnicity and Place of Birth (Native vs. Foreign), 2004 Native Foreign Hispanic Black Asian White Source: U.S. Census Bureau, Current Population Survey, 2004, Annual Social and Economic Supplements

41. Percent with Less Than 9th Grade Completed by Hispanic/Latino Origin: 2002 (Population 25 years andover) Source: Current Population Survey, March 2002, PGP-5

42. Smoking among Youth

43. Targeted Marketing and Promotion • Magazines • Point of purchase advertising

48. Boy Girl Current Smoking among Latino Adolescents (12-17 years), by Gender, 1999-2001 Cuban Mexican Puerto Rican Central and South American Source: National Survey on Drug Use and Health, 1999-2001

49. Current Smoking among Youth 12-17 Years:Mexico (urban), Mexico (rural), and U.S. Mexican/Mexican-American Urban Rural Mexican/Mexican Americans Source: Encuesta Nacional de Adicciones, México, 2002, and National Survey on Drug Use and Health, 1999-2001

50. Current Smoking among Youth 12-17 Years: Urban vs. Rural: United States, 2002 Urban Rural Source: Encuesta Nacional de Adicciones, México, 2002, and National Survey on Drug Use and Health, 1999-2001