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Posted Saturday, January 20 at 12:39 PM

As immigrants' health declines, groups rev up prevention outreach
by The Associated Press

ATLANTA - At a health fair in the Mexican consulate's parking lot, long lines of immigrants of all ages stretched in front of booths offering quick dental exams, two-minute cholesterol screenings, diabetes blood tests, and information on sexually transmitted diseases.

"Health is what gets reported principally, the No. 1 necessity," said Heidy Lough of the Latin American Association, a social service organization for Latinos in the Atlanta area.

Experts say community-based groups, not medical providers, are in the best position to spread health information and push for prevention among immigrants, who often share the mind-set "I don't want to see a doctor, I'm going to work till I'm dead," in the words of Dr. Elena Rios, president of the National Hispanic Medical Association.

"I have no insurance and no time," said Felix Rebollar, a 37-year-old construction worker from Mexico who wanted to get vaccines at the fair for his two young daughters, but he ended up also getting tested for cholesterol and diabetes.

Last week, the consulate, which helps as many as 300 Mexican immigrants every day, opened a permanent health desk with a $30,000 grant from the Mexican government and a $10,000 donation from Saint Joseph's Mercy Care Services. The desk teaches prevention, promotes healthy behavior and provides referrals to low-cost clinics.

Most immigrants come from countries where they're used to walking everywhere and where eating on-the-go means mostly fruit and vegetables from roadside stands, so it's no surprise that their health deteriorates the longer they are exposed to the fattening fast food and car-driven lifestyle of the U.S.

"They come here and there's no more vegetables but hamburgers and fries," Rios said.

Add to that some challenges many immigrants carry with them - little education, little English fluency, low incomes that make cheap fast food the easiest option and insurance unattainable - and the health problem becomes a time bomb for this community.
Diabetes is an example of how many factors conspire to create a long-term challenge. One in four Mexican immigrants - including teens - have diabetes and don't know it, said Dr. Astrid Rozo-Rivera of Kennesaw State University, who directs Project IDEAL, the initiative for diabetes educational advancement for Latinos.

If left untreated and compounded with unhealthy diets, lack of exercise and stress, the condition can lead to heart and eye diseases that require expensive care.

So at the fair, Rozo-Rivera used a plate with plastic food in the colors of the Mexican flag - green vegetables, white potatoes and red meat - to teach diabetics about a healthy diet that they can easily control.

"Knowing the time limitations for learning, we create our own curriculum, material that's sensible but complete and entertaining, full of color, popular refrains, and mental images that are easy to remember because they are specific to Latin culture," said Rozo-Rivera. "The traditional relationship of dependence, of waiting for the doctor, the health system, or the medicines to be the sole ones with responsibility for health, must be replaced with prevention and self-care."

That starts with information, which immigrant communities often lack, said Jacqueline Wilson Lucas of the federal National Center for Health Statistics. She co-authored a March 2006 study that found foreign-born adults are in much better shape than U.S.-born ones even though they're poorer and have less access to doctors. The study also found that Hispanic immigrants suffer more from obesity, hypertension and heart disease the longer they stay in the U.S.

"As people become more Americanized, they're picking up on our bad habits," said Dr. Barbara McMillan-Persaud, the chief medical officer at Atlanta's Southside Medical Center, which was staffing some of the booths at the consulate fair. "The kids are huge."

Hispanic immigrants also are the least likely to have insurance, according to the study. That makes it even more crucial for them to get health information outside hospitals and clinics, through community groups they trust and that have the flexibility to adjust to local needs, said Adolph Falcon of the National Alliance for Hispanic Health.

The group, for example, tried to put together a sex education workshop but came to realize what was needed instead was training in family communication between parents and teens, Falcon said.

Sexual health is often a thorny issue in the immigrant community, because of little information about STDs and stereotypical gender roles. At the fair, 24-year-old Juan Cruz Noyola waited in line with his wife at one booth with information on STDs. The Mexican construction worker and father of three, who has lived in the U.S. for 12 years but has no insurance, said he hoped to learn how to recognize symptoms.

"We're here to learn how to prevent (diseases)," he said in Spanish. "Sometimes with the little English one knows, it's difficult."