The relatively young median age of Latinos represents a tremendous opportunity for interventions to increase preventive health practices and to reduce behaviors that increase risk of disease and premature death. Such interventions could result in reductions in chronic illness and morbidity and could eventually lead to decreased mortality. Preventive interventions must be tai lored to meet the specific needs of Latino subgroups and to make full use of the community's resources, including the skills and commitment of its people. Improvement of modifiable risk factors such as nutritional habits, alcohol consumption, cigarette smoking, sedentary lifestyle, obtaining health care screenings, and environmental exposures need to be addressed by linguistically, culturally, and educationally appropriate methods. Largely preventable diseases such as invasive cervical cancer, cirrhosis, and lung cancer can be greatly reduced through reductions in associated risk behaviors. In 1998, 11% of Latinos reported an interval of greater than 3 years since their last health care contact compared with 5.0% of whites (National Center for Health Statistics 2000). Among children younger than 18 years, 19.5% of Latinos reported no health care visits within the past 12 months compared with 10.7% of white children (National Center for Health Statistics 2000). Thus, increased access to preventive care and raising awareness of risk reduction strategies among Latinos continue to be important public health concerns.
An analysis of pooled NHIS data on Latina women for 1990 and 1992 provided estimates of cancer screening rates for Latino subgroups (Zambrana et al. 1999). According to this study, the proportion of women aged 18 and older who reported having had a Pap smear in the past 3 years ranged from 72% in Mexican women to 80% in Mexican American women. Seventy-three percent of Cuban women and 77% of Puerto Rican women reported having had a Pap smear in the past 3 years, although these rates were still well below the Healthy People 2000 target of greater than 95% (Zambrana et al. 1999). The proportion of women aged 35 and older who reported having had mammography in the past 3 years ranged from 35% in Mexican women to 54% in Mexican American women. The rates for Cuban and Puerto Rican women were 77% and 83%, respectively (Zambrana et al. 1999). The true prevalence of breast and cervical cancer screening may be lower because these estimates were based on telephone survey methods and excluded poorer households without telephones. These estimates also included women in the denominator for whom recommendation of a specific screening examination (mammogra-phy for women younger than 50 years) remains controversial.
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