Vista clinic program reaches out to Latino families

By: RUTH MARVIN WEBSTER - Staff Writer | Saturday, September 22, 2007 10:11 PM PDT ∞

While the national obesity epidemic threatens the health and welfare of every community, nowhere is it felt more keenly than among Latinos, where heart disease, cancer, stroke and diabetes ---- all of which have obesity as a risk factor ---- account for nearly 60 percent of all Latino deaths.

In 2005, the California Department of Health Services found that nearly seven out of 10 California Latino adults were overweight or obese and that Latino teenagers are the most likely of any other ethnic group to be overweight or at risk of being overweight. (In the 2003 California Health Interview Survey, 37 percent of Latinos, 35 percent of African-Americans, 16 percent of Asian and 23 percent white adolescents were overweight or at risk of being overweight).

One factor given for the disparity between obesity in the Latino community and that of other ethnic groups is a certain genetic susceptibility. But experts say the real reasons are a diet higher in calories, fat and sugar and a lack of physical activity.

And the numbers are not improving; the risk is so great that it is projected that half of Latino newborns will likely develop diabetes during their lifetime.

At the Vista Community Clinic, Beatriz Celis coordinates a program called Rayos de Salud that has been serving more than 2,000 children and 1,600 adults for the last three years. It seeks to combat the ravages of obesity by teaching families how to select and prepare affordable, healthy foods rather than choosing highly processed ones.

"They tell us about nutrition," said Adela Resendiz, 35, from Vista, who attended a recent family event at the beach south of the Oceanside Pier on Aug. 24. "They teach us how to grow kids. My 16-year-old said she wishes they had this program when she was little. Now, I play more with my kids. I know how to discipline them better. And I use a lot of salad recipes."

The program's case managers say they see improvement from the education classes right away. Almost at the beginning, they say, they see parents starting to incorporate more fruits and vegetables in their daily diet, exchanging water and milk for Coca-Cola, and using less lard.

First, the basics

"Most of them are first-generational immigrants from rural Mexico," said Diana Mendoza, 34, who is the lead case manager for the program. "In Mexico, they had other needs to take care of first ---- basic needs. If you had to build a home and earn enough money just to eat, you don't have time to worry about this kind of stuff."

In fact, recent immigrants to the United States tend to have some the highest rates of obesity, due at least in part to the decrease in physical activity and loss of traditional foods often prepared and eaten in the home.

"I would say that unfortunately, we are eating more fatty foods and not doing enough exercise, and that has made us prone to develop diabetes, heart disease and high cholesterol," said Dr. Andres Smith, who was born in Tijuana and is currently medical director at the Sharp Chula Vista Medical Center.

"A prime example would be with the children who are not eating enough milk-related products, like cheese and yogurt. In their countries of origin, they were drinking a lot of milk, but one generation in the U.S. and the custom is lost ---- they are drinking soda."

Smith recently spoke at Sharp's Third Annual Health Conference for Latinas, which enjoyed record attendance this year. He noted that education about healthy nutrition is paramount.

"I think children are beginning to learn about nutrition and diet management in schools, and they are also seeing it in the media," he said. "There is more importance on eating right, and I think that is helping. Unfortunately, though, it has always been a little more expensive to eat vegetables and fruit."

Poverty, said the Latino Coalition for a Healthy California in a 2006 report, increases the risk for obesity because limited purchasing power makes it more difficult to buy lower-calorie, nutrient-rich foods that tend to be more expensive. Long work hours also limit the time available for food preparation, and low-income neighborhoods often have limited access to affordable, healthy food options.

Education is key

More than 200 families are enrolled at any time in the Vista Rayos de Salud program. It includes visits to homes, goal planning and a case manager for six months. One of the main goals is to get immunizations for children and to educate their parents on how to receive health and social services for which they are eligible.

There is also a strong educational component, with classes and family outings, about nutrition, discipline and health care.

Laura Luna, 19, an outreach worker, said that one of the elderly women in the program who comes to events with her daughter and grandchildren said she wished they had had these programs when "she was growing her children" because she has learned so many valuable lessons. "We try to focus on self-sufficiency," Luna said.

Setting examples

The Rayos de Salud caseworkers are also trying to lead by example.

Poway resident Marty Chumpitas, who used to work as a case manager for the County of San Diego's Department of Adoptions, now has the clinic's office workers playing volleyball during their lunch breaks, taking 10 or 15 minutes from their desk to do crunches, and cutting up fruit for all to share as snacks. "We're focusing on health in the office, too," said Mendoza. "I've lost weight since I started my job."

During the program, families also learn to shop for and prepare ethnic dishes. Celis, coordinator of the program, has assembled a recipe book called "The Healthy Eating Habits Cookbook," with help from the community and caseworkers.

The book includes such favorites as taco salad, freshly made salsas and mole sauce. Celis hopes the recipe book will encourage families to cook at home, rather than buying processed foods filled with extra sugar and sodium, and use healthier methods of cooking, rather than deep-frying.

"You have to start when they're small," said Ilsse Jimenez, 19, who works as an office clerk at the clinic and has been going there with her mother, Lucia Jimenez, since she was 2 years old. "And if you do, they'll love fruits and vegetables."

Contact staff writer Ruth Marvin Webster at (760) 740-3527 or rwebster@nctimes.com.