Latinos need a disaggregated approach to health care

Community Engagement; Diversity; Faculty; Public Health

Latinos are the largest racial/ethnic minority group in the United States, representing 16.3 percent of the population and growing — coming from more than 25 countries in the Caribbean, Central America and South America.

Each Latino group has a unique sociopolitical history and different demographic, socioeconomic, acculturation and settlement patterns that contribute to within-group variations in their health outcomes.

Despite the substantial diversity in this community, Latinos are often treated as a monolithic group in national and state surveillance health surveys.

That’s just one reason why more investment is needed in research, funding and policy to improve the collection and analyses of disaggregated health data for this growing and diverse U.S. Latino population, finds a new report from the Brown School at Washington University in St. Louis.


The report, “Disaggregating Latina/o Surveillance Health Data Across the Lifecourse: Barriers, Facilitators and Exemplars” is co-authored by Leopoldo J. Cabassa, associate professor at the Brown School, and Carmela Alcántara of the Columbia University School of Social Work. Other contributors include faculty from Emory University and elsewhere at Columbia University.

It calls for making health data of this population more specific by examining important subgroups differences that capture the diversity of the Latino population, including racial and ethnic (culture of origin) groups, nativity, acculturation gender, age, and/or socioeconomic status. For instance, as the authors pointed out, Puerto Ricans have the highest incidence of asthma in the U.S. (16 percent), but Mexicans have the lowest prevalence among Latinos (5.4 percent) — with the average for caucasians coming closer to the bottom end (7.7 percent).

The report was released this month as part of Making the Case for Data Disaggregation to Advance a Culture of Health, a partnership between PolicyLink and the Robert Wood Johnson Foundation.

“Understanding within-group differences across the life course — in, for example, cardiovascular disease, asthma, depression and allostatic load — would elucidate genetic, epigenetic, biological and potential environmental pathways that protect some Latina/Latino groups from disease while exacerbating risk in others,” the authors wrote.

The report was comprehensive, suggesting 15 recommendations to advance Latino health data disaggregation across research, funding, policy and priority area domains. Highlights include:

  • Develop clear guidelines for ethnic health data disaggregation and a standardized set of survey items that reflect the disaggregation types most relevant to the Latino community.
  • Invest in research training and mentoring programs at all stages of career development (e.g., high school, undergraduate, graduate, post-doctoral, junior faculty, mid-career) to support careers in Latino health research across the lifecourse.
  • Use an intersectional lens in the design, collection and analysis of disaggregated health data that considers the intersections of migration, ethnicity and social conditions.
  • Support the inclusion of critical dimensions shaping the Latino population that go beyond demographic disaggregation characteristics and include language use, parental ancestry, generational status, racial identity and documentation status.

“The diversity of the Latino/Latina community poses unique challenges for clinicians and policymakers,” Cabassa said. “Understanding the sources of heterogeneity, and their association with health, will allow development and implementation of effective, culturally and linguistically appropriate, health services and policies optimally designed to reduce health disparities in our communities.”