Cardiovascular Disease: Hispanic Perspective Max Solano M.D., St. Vincent’s Family Medicine Center – Coordinator of Healthy LifeStyle Initiatives Project June 24, 2005 - UNF Hispanic Health Issues Seminar This is part 5 of an 8 part series of seminars on Hispanic Health Issues brought to you by the University of North Florida’s Dept. of Public Health, College of Health, a grant from AETNA, and the cooperation of Duval County Health Department.

1. Cardiovascular Disease Hispanic Perspective Max Solano M.D. St. Vincent’s Family Medicine Center – Coordinator of Healthy LifeStyle Initiatives Project This is part 5 of an 8 part series of seminars on Hispanic Health Issues brought to you by the University of North Florida’s Dept. of Public Health, College of Health, a grant from AETNA, and the cooperation of Duval County Health Department. For more information or register for the seminars, please call 620-1289.

6. U.S. Demographics of Hispanics Total US Population Puerto Rican 9% Cuban 4% Central & South American 14% Other Latino/ Hispanic 7% 13.8% (2003) Mexican 66.9% US Census Bureau 2003

8. Projected Growth by Race and Ethnicity 20.7% 25.1% 14.3% 13.3% 7.5% 9.7% 7.0% 11.4% Projected Increase 00-20 Actual Increase 1980-00 Asian Black White Hispanic

9. 10 States hold 80% of the U.S. Latino Population 80% Of the Electoral votes needed to win the presidency are concentrated in those states

10. $ 13 Million Amount spent in 2004 by both parties on Spanish-language television ads

11. A new major in L.A. A decisive showing in ’04.Latinos are making their mark on politics as never before. Get used to it. Arian Campo-Flores May 30, 2005 Newsweek

12. Si TV “ Speak English. Live Latin” English Tongue with Latin Flavor

17. 873.1 2403351 TOTAL 181.4 499283 Other 11.3 31224 Septicemia 13.5 37251 Nephritis, nephrotic syndrome, neprhosis 18 49558 Alzheimer disease 23.7 65313 Influenza and pneumonia 25.2 69301 Diabetes mellitus 35.6 97900 Unintentional injuries 44.3 12209 Chronic lower respiratory tract disease 60.9 167661 Cerebrovascular disease 200.9 553091 Malignant Neoplasm 258.2 710760 Heart Disease Rate/100,000 No of Deaths Cause of Death Leading Causes of Death in the United States in 2000

18. Mokdad A.; Marks J.; Stroup D.; Gerberding J. Actual Causes of Death in the United States, 2000. JAMA, March 10,2004-Vol 291, No 10 1238-1245 1159 000(48.2) 1 060 000(50) Total 17 000(0.7) 20 000(<1) Illicit drug use 20 000(0.8) 30 000(1) Sexual behavior 29 000(1.2) 35 000(2) Firearms 43 000(1.8) 25 000(1) Motor vehicle 55 000(2.3) 60 000(3) Toxic agents 75 000(3.1) 90 000(4) Microbial agents 85 000(3.5) 100 000(5) Alcohol consumption 400 000(16.6) 300 000(14) Poor diet and physical inactivity 435 000(18.1) 400 000(19) Tobacco No(%) 2000 No(%)1990 Actual Cause Actual Causes of Death in the U.S. in 1990 and 2000

19. Selected Death Rates by Race/Ethnicity, Duval County Source: FDOH, Office of Vital Statistics, 2001-2003 Source Hispanic Population Estimates: Claritas 2003 Source Duval County Population Estimates: Demographic Estimating Conference Database, 4/2004 (R.Remo DCHD)

23. Cardiovascular Disease Spectrum RISK FACTORS CAD Outcomes: Heart Failure Death

28. Hispanic Black only Asian only White only, not Hispanic Under 18 years Hispanic Black only Asian only White only, not Hispanic Hispanic Black only Asian only White only, not Hispanic 18-64 years 65 years and over Figure 5. Low income population by age, race, and Hispanic origin: United States, 2002 NOTES: Poor is defined as family income less than 100 percent of the poverty level and near poor as 100-199 percent of the poverty level. Persons of Hispanic origin may be of any race. Black and Asian races include persons of Hispanic and non-Hispanic origin. See Data Table for data points graphed and additional notes. SOURCE: U.S. Census Bureau, Current Population Survey. Centers for Disease Control and Prevention, National Center for Health Statistics. Health, United States, 2004 Percent

33. Dyslipidemia MMWR Feb 11 2005 /54(05); 117-119

34. Age Male Sex Family History of Premature CAD Hypertension Cigarette Smoking Thrombogenic/ Hemostatic State Diabetes Obesity Physical Inactivity Atherogenic Diet Nonmodifiable Modifiable Nonlipid Risk Factors for CAD

42. Women White only, not Hispanic Men All races Mexican Men Men Figure 17. Obesity among adults 20-74 years of age by sex, race, and Hispanic origin: United States, 1999-2002 NOTES: Percents are age-adjusted. Obese is defined as a body mass index (BMI) greater than or equal to 30. Persons of Mexican origin may be of any race. See Data Table for data points graphed, standard errors, and additional notes. SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey. Percent Black only, not Hispanic Men Women Women Women Centers for Disease Control and Prevention, National Center for Health Statistics. Health, United States, 2004

58. 18-24 years 25-34 years 45-54 years Under 18 years 100-149 percent 150-199 percent 200 percent or more White only, not Hispanic Hispanic (total) Black only, not Hispanic Asian only Mexican Below 100 percent Figure 7. No Health insurance coverage among persons under 65 years of age by selected characteristics: United States, 2002 NOTES: Percents by poverty level, Hispanic origin, and race are age adjusted. Persons of Hispanic origin may be of any race. Asian and American Indian and Alaska Native races include persons of Hispanic and non-Hispanic origin. See Data Table for data points graphed, standard errors, and additional notes. SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey. Percent Age 55-64 years Percent of poverty level Other Hispanic Cuban Puerto Rican Race and Hispanic origin American Indian and Alaska Native only Centers for Disease Control and Prevention, National Center for Health Statistics. Health, United States, 2004 35-44 years

63. 45-54 years Sex 55-64 years Age Hispanic 200 percent or more Below 100 percent Figure 19. Limitation of activity caused by 1 or more chronic health conditions among working-age adults by selected characteristics: United States, 2000-2002 NOTES: Data are for the civilian noninstitutionalized population and are age adjusted. Persons of Hispanic origin may be of any race. See Data Table for data points graphed, standard errors, and additional notes. SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey. Percent Female 18-44 years Male 100-199 percent White only, not Hispanic Percent of poverty level Black only, not Hispanic Race and Hispanic origin Centers for Disease Control and Prevention, National Center for Health Statistics. Health, United States, 2004

64. 1999-2000 White, not Hispanic 1988-94 All ages 1988-94 Figure 31. Percent of adults 18 years of age and over reporting antidepressant drug use in the past month by race and ethnicity: United States, 1988-94 and 1999-2000 NOTES: Data are age age-adjusted. All races includes persons of all races and Hispanic origins, not just those shown separately. Data for adults of Mexican origin and non-Hispanic black adults have been combined due to the small sample size in each of those categories. See Data Table for data points graphed, standard errors, and additional notes. SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey. Percent of population Mexican or Black, not Hispanic 1988-94 1999-2000 1999-2000 Centers for Disease Control and Prevention, National Center for Health Statistics. Health, United States, 2004 SSRI antidepressants Non-SSRI antidepressants

67. Salud para su Corazón (For the Health of Your Heart) is an exciting new and comprehensive community-based heart-health promotion initiative from the National Heart, Lung, and Blood Institute. It targets Latinos living in the United States. The project raises awareness of the risk factors and promotes lifestyle changes to reduce the chances of developing heart disease. Why was Salud para su Corazón established? The Latino population is a very young and rapidly growing segment of our society. However, despite this younger age, the leading cause of death among Latinos is heart disease. Latinos are also generally unaware of important lifestyle changes that could help prevent heart disease. This knowledge gap transcends socioeconomic status. The initiative began in the Washington, D.C. metropolitan area . Community leaders, through the Community Alliance Working for Heart Health , carried out the activities using culturally sensitive strategies and educational materials. Salud para su Corazón offers many educational materials in English and Spanish for the general public and community health planners