Culture a Key to Healthier Immigrant Communities

The obesity epidemic in this country is running rampant, and it’s hitting Latinos especially hard. A program at the University of Illinois seeks to address that issue by focusing on the connection between culture and health.

According to the Centers for Disease Control, Hispanics have lower mortality rates due to stroke, cancer, and heart disease compared to non-Hispanics. However, deaths caused by diabetes are higher among Hispanics compared to non-Hispanics. Northwestern University Professor Aida Giachello studies health disparities in the Latino community.

“That kind of paradox is the one that we call the epidemical paradox among Latino,” Giachello said. “The paradox emerges about why people who have low levels of education and income may still do better in a number of health indicators.”

Giachello said the “epidemical paradox” can be seen with a variety of immigrant populations. She said Latinos are generally much healthier when they first come to the United States – they smoke and drink less, work out more.

“Some cultural factors could be that they continue eating the kinds of foods that they ate back home,” Giachello said. “They’re embedded in a family system where they get emotional and social support...including money whenever they need that.”

But Giachello said the health of Latino immigrants gradually declines after they come to the United States. If they don’t smoke or drink, she said they’re more likely to start.

If they eat fresh fruits or vegetables, then she said they’re more likely to turn to fast food out of convenience and affordability. She also said there are other pressures that can take a toll on a person’s mental health – like being undocumented, unemployed, or not making enough money.

“In other words, it is our view that living in the United States is a danger to your health,” Giachello said.

However, Giachello said there is something else to think about - bad health decisions can not only affect first generation immigrants, but they can also impact second and third generations.

Milagros Jerrell at the University of Illinois at Urbana-Champaign wants to stop that from happening. Jerrell helps coordinate a wellness program for Spanish-speaking immigrant families with school-age children. The program is called Abriendo Caminos.

“It’s very sad that Latinos are the race more prone to obesity for one reason or another, and we are trying to change that,” Jerrell said. “We don’t want, you know 50 years from now, to have a population of Latinos all sick.”

Abriendo Caminos involves a series of workshops over a six-week period. The program promotes healthy eating, positive family interactions, and active living. So far, nearly a hundred families have participated over a two-year period.

Angela Wiley is a U of I professor in human and community development. She leads the program.

“The idea for us is that interventions must be culturally tailored, and so we know about the Latino community that there is a strong familialism that the culture really orients around,” Wiley said.

That focus on familialism that can go a long way in this particular community.

The workshops include brief lectures, discussion, hands-on demonstrations and separate 30-minute nutrition classes for parents that are taught in Spanish. Children also take part in classes taught in both Spanish and English. The curriculum is based on dietary guidelines released by the U.S. Department of Agriculture, which indicate that fruits and vegetables should compose half of every meal.

Wiley said families are shown how to prepare meals that taste and look like the meals of their home countries.

“So, they might have had a favorite fruit that they could get on a tree outside of their house for free that was very nutritious, but now that they’re here in this environment they no longer have that,” Wiley said. “One has to be almost a detective in the grocery store.”

Wiley said Abriendo Caminos encourages families to spend more time together at the dinner table. They also learn about boosting physical activity through culturally relevant activities, such as Latin dancing.

Michelle and Marcos Tavárez and their four-year-old daughter, Eva, took part in Abriendo Caminos in 2009 within about a year after coming to the United States from the Dominican Republic. They now live in Urbana.

To stay healthy, they have made some lifestyle changes that reflect their culture. For example, dancing is now a regular routine for them around dinnertime. With Maranga music blaring from a stereo, Michelle chases Eva in the family room.

"I try to chase Eva dancing, but she needs to dance Maranga to do that," Michelle said, smiling in Eva's direction.

In the kitchen, all three prepare dinner. On the menu - chicken, corn, grapes, a Dominican–style red beans and rice recipe known as Moro, and a salad made by Eva. With the exception of the salad, the Tavárezes control each person’s portions.

Marcos cooks the chicken, while Eva washes vegetables.

“Are you all done with this?” Michelle said to Eva.

Yes, mommy,” Eva replied.

“Remember to wash very carefully,” Michelle said.

“Mommy, I’ll wash them,” Eva said.

In order to stay healthy, the Tavárezes are spending more money on food. They have also had to change their perspective on the world – moving away from the belief that overfeeding and overeating are always good to do.

“My dad is almost 75 now, and when I was a kid - this is going to sound very strange for you – the way he used to compliment ladies was, ‘Wow, you really are fat,’” Marcos said. “Here if you tell a lady, 'You are fat,' I don’t think she takes that kindly."

Michelle said in her culture, it was also encouraged to raise children to be overweight.

“Like if you have kind of chubby kids, you assume that the kid is healthy, and it’s a myth but it’s still there you know,” she said. “If you have like a very thin little kid then these parents don’t worry about this little kid, ‘Look at him or look at her.’ ”So yeah, that’s funny now."

Michelle and Marcos say being healthy in America can be a tug of war with their culture. But they say it is a sacrifice that makes sense, especially for their daughter, Eva.

“We still have a strong culture, but now it’s kind of fighting the culture, changing a little bit to work harder,” Michelle said. “And then if we are healthier, then she will be healthier than us.”

“I just agree with what she said,” Marcos said. “I mean like we have a lot of information now. Back in the day, our parents may not have had all the information to make a wise decision. We have no excuse.”

The Tavárezes eventually gather around the table. They have plates in front of them – each with moderated serving sizes. Before they eat, they pray.

Michelle leads the prayer: “Thank you God for this food, and thank you God for this wonderful moment in family. Allow us to enjoy the food and provide this food to those who don’t have anything on the table this month. In Jesus’ name...Amen.”