Monday, January 31, 2005

What is LHAL? What is I-LEAD?

LHAL is the "Latino Health Advocacy and Leadership" Program for Pittsburgh.

A new health advocacy program has come to the Pittsburgh Area Latino Community! With the guidance of the I-Lead organization and the commitment of the community, we have a Latino Health Advocacy and Leadership Program.

The LHAL Program is I-LEAD's community-health specific version of its tested and proven community leadership curriculum. The key activity for the end of the first half of the curriculum will be a family-oriented culturally appropriate day of health education and screenings. The class will jointly analyze findings with relevant health partners and make recommendations for and pursue appropriate action with all partners. In other words, this is a long-term effort for health advocacy that comes from within the community and its leaders.

For detailed information about I-LEAD, please visit their website at:

The Pittsburgh Latino Health Advocacy and Leadership Program (LHALP) was created by and is operated by I-LEAD, Inc. and funded by the Pennsylvania Department of Health. I-LEAD’s Vice President of Community Health, Susan M. Myers, MA, MPH, leads this program.

LHALP is modeled after the WK Kellogg Fellows program, the Centers for Disease Control’s National Public Health Leadership Institute and includes public health fundamentals. The LHALP includes individual skill-building and content in a learning community setting. Classes are held one Saturday a month from 9:30 am – 3:30 pm. LHALP has been conducted in Philadelphia and now, in Pittsburgh. About twelve students participate on a regular basis. They come from many countries of origin and have many different professional disciplines. LHALP is endorsed by Pennsylvania’s Governor’s Advisory Commission on Latino Affairs.


Sunday, January 30, 2005

LHAL visits the Pittsburgh Filmmakers on Jan 26

A subgroup of the LHAL program met with representatives of the Pittsburgh Filmmakers organization to discuss the possibility of collaborating on the production of the LHAL "PhotoVoice" project. Susan Myers, Rosa Thomson, Susan and Fernando Cardoza met with Gary Kaboly (Director of Exhibition) and Amy Robeson (Artist Svcs Coordinator). The meeting started with...

a description of LHAL, I-LEAD and the concept for collaborating on our "PhotoVoice" production by Sue Myers. Gary and Amy described the mission and goals of Pgh Filmmakers, its membership and educational programs. They stressed the need for careful planning of the project and for the development of clear "themes" prior to starting the venture. We discussed available resources and funding avenues for the project. With appropriate funding secured by us, Pgh Filmmakers would be able to help us by offering workshops on photography and by assisting us with artistic direction and with aspects of the exhibition of the final work. Specifics and details would need to be worked out after we more clearly define the project and investigate the funding sources. The visit concluded with an excellent tour of the facility, photo labs, auditorioums, gallery space, and classrooms at their site on 477 Melwood Avenue in Oakland.


"Give Kids a Smile Day" - FREE Dental Care for Kids!

During EARLY FEBRUARY, FREE dental care will be offered for kids 18 years of age or younger. Please contact Lin Delgado for more information and to register at 412-958-4284. Free treatments will include cleanings and fluoride applications.


LHAL Course Textbooks

We are fortunate to have access to excellent FIELD REFERENCE MATERIAL as textbooks for the LHAL program. But don't take my word for it. Click on the 'Read more....' link below to find out what the readers at say about these textbooks.




Wednesday, January 26, 2005

2005 PA Latino Health Summit

As an initiative of the Governor’s Advisory Commission on Latino Affairs, in association with the Pennsylvania Department of Health, we are in the process of organizing the first Pennsylvania Statewide Latino Health Summit. The summit is tentatively scheduled for May 18-19, 2005.

We are extending you an invitation to be a part of the kick-off planning committee meeting. The meeting is scheduled for Monday, January 31, 2005 from 1:00 p.m. – 3:00 p.m. at the Department of Health, Conference Room 812, Health and Welfare Building, Harrisburg, PA. During this meeting we will be discussing the purpose of the summit, goals and objectives and develop an agenda for the summit Attached please find directions to the site of the meeting.

We thank you in advance for your support and interest. I am looking forward to working together with you to address the health needs and concerns in Latino communities all across the Commonwealth. Please RSVP your attendance to the meeting by calling Gladys Gonzalez at 717-783-3877 or 1-800-233-1407. You may also contact Gladys via email at

See you on January 31st!


Norman Bristol Colón

Executive Director
Governor's Advisory Commission on Latino Affairs
Commonwealth of Pennsylvania
Office of the Governor
506 Finance Building
Harrisburg, PA 17120
Phone: (717) 783-3877
(800) 233-1407
Fax: (717) 705-0791
Web Site:


Tuesday, January 18, 2005

Chapter 9 Use of Cancer Screening Practices by Hispanic Women

Written by Cati Bazan-Arias
Chapter 9: Use of Cancer Screening Practices by Hispanic Women,Analyses by Subgroup

Authors: Ruth E. Zambrana, Nancy Breen, Sarah A. Fox, Mary Lou Gutierrez-Mohamed, from “Latina Health in the United States” by Marilyn Aguirre-Molina & Carlos W. Molina, Jossey-Bass, a Wiley Imprint, 2003.

Synopsis: Using National Health Interview Survey data (1990-1992), the authors provide data on cancer screening (Pap smear, mammogram, and clinical breast examination [CBE]) among five Latina subgroups to determine the factors that influence the utilization of these screening services.

• In 1987, 13% of Hispanic women reported having mammogram vs. 18% non-Hispanic white women; in 1992 both rates doubled.
• Low income women, women over 65, and Hispanic women remain at the greatest risk of not being screened.
• Hispanic women represent 9% of the total female population in the U.S., expected to increase to over 15% by 2020.
• “Hispanics do not comprise a single coherent community. Rather, they are a disparate collection of national origin groups with heterogeneous experiences of settlement, immigration, political participation, and economic incorporation into the U.S.”.

Research shows that Hispanic women:

1. tend to be younger when diagnosed with breast or cervical cancer;
2. less likely to have visited a physician in the last year or to know cancer warning signs;

The underlying factors that place Hispanic women at risk are low-income status, lack of access to health care, and institutional barriers.

Screening is most strongly associated with knowledge of screening, prior screening, and physician recommendation for a screening.

For Hispanic women, acculturation, income, and education are three interrelated factors associated with health behaviors. English language is a principal marker of acculturation, and it is associated with country of birth, completed years of education, and number of years in the U.S.

The study by the authors found, among other results, that:

1. Screening rates are higher than might be expected among the Hispanic sample; it is inferred that recent intervention strategies, including increased public education and community outreach have been effective.
2. Not having a usual source of care lessens the likelihood of obtaining a screening recommendation from a physician; some physicians may not make recommendations due to cost concerns.
3. If physicians were to recommend preventive screening practices and refer patients to appropriate facilities and increase in use is expected.
4. Community-based health promotion activities have shown to increase cancer-screening practices among Hispanic women.
5. Successful interventions involve the Hispanic community members, use Spanish-language media (in particular public radio announcements), and existing community networks.
6. Social factors such as poverty rather than ethnicity alone should serve as the indicator of who needs health services. Ethnicity, defined as shared dynamic cultural identity, should be used to inform providers what and how services should be delivered.


Sunday, January 16, 2005

SALUD PARA NIÑOS Enero y Febrero!

SALUD PARA NIÑOS - Clínica Pediátrica Gratuíta - Sábados Enero 15 y Febrero 26 from 10 AM to 12:30 PM*

Children’s Hospital of Pittsburgh Care Mobile / Clínica Gratuita Birmingham (Birmingham Free Clinic)
No se necesita cita o seguro de salud. Para ser atendido, por favor llegar antes del medio dia (12 PM)

Salvation Army, (Centro de Donaciones)
54 S. 9th Street (South Side), Pittsburgh, PA

412-692-4706 / 412-481-7900 Ext. 281


Friday, January 14, 2005

Health & Social Justice Ch.24: "Addressing Structural Influences on the Health of Urban Populations" By Arline Geronimus

LHAL Pittsburgh - Latino Health Advocacy & Leadership
Health & Social Justice - Ch.24: "Addressing Structural Influences on the Health of Urban Populations" By Arline Geronimus.

The author discusses the importance of research in understanding not just socioeconomic and demographic risk factors on the quality of health in urban populations, but also historical and structural factors contributing to today's urban ghettos.

Failure to do so when mounting a public health campaign will risk distorting the expected returns or overlooking important targets, approaches or resources.

There is an association between health and poverty. The poor may engage in unhealthy behaviors, depression and "persistent high effort coping" (stress).
There is a cumulative health impact of persistent disadvantage in access to health information, services, technologies by the poor.
The shift from manufacturing to service economy has been a factor in lowering wages, eliminating health benefits, increasing stress.
Lack of adequate housing is another factor.
Author claims that inadequate levels of support urban public park areas is another factor to urban decay, affecting the poor.

Needed programs:
(1) jobs
(2) quantity/quality/affordable housing
(3) municipal services
(4) clean environment
(5) health insurance and more physicians

RACE ETHNICITY (wrt poverty & health)
Concept #1: set of institutionalized social relationships between majority & minority populations
Concept #2: set of autonomous institutions within minority groups to respond/resist/mitigate/undo effects of concept #1

Rise of cultural frameworks to counter the dominant cultural framework in which they are marginalized. "As a minority group's economic strength diminishes, its ability to supply the protection conferred by social support and identity-affirming symbols may be especially critical to preserving the health of its members" (p.546). These frameworks tend to become overburdened and hard to sustain.

-- First do no (more) harm: paramount importance of protecting the formal organizations, the informal networks, the ideologies/ethos, the cultural frameworks, and the immense value of building coalitions with organizations that pursue goals shared by the majority (e.g., environmentalists, entrepreneurship).
-- Work to alter public perspective on race: recognize existing negative stereotypical judgments in the community. "In a structural framework, understanding what shapes public sentiment on race and how it might de influenced, becomes a critical public health objective" (p.548). In LHAL terms, if the majority can be made to understand the historical factors of illegal immigration and present Latino life and health, it may alter the way they think about Latinos. Discussion: the John Henry dilemma.
-- Distinguish between "ameliorative" and "fundamental" approaches: "ameliorative approaches target the risks factors that link socioeconomic position to health in a particular context,but do not fundamentally alter the context (or underlying inequalities)" (p.549). Note that a given risk factor may be virtually inevitable in a given social context... or it may be one of many factors present... or it may be followed by new a larger risks after being eradicated (!!!). "The only way to eliminate differentials in health is to address the underlying social inequalities that so reliably produce them". (p.550). Author urges for "working in partnerships with communities, engaging in bottom-up approaches, and recognizing that historical important and effective social movements derive their moral, political, and practical force from the autonomous networks and institutions developed and kindles within minority communities" (p.550).
CAVEATS/CAUTIONS: too much reliance on community-centered approaches... unrealistic expectations...
-- Increase attention to the needs of adults: adults as economic and moral foundations of families and communities... maternal health leads to infant health... etc. Downward spiral otherwise...

Quality of health has important interactions with factors of race, poverty, locality which are not fully understood yet. Need more research on personal experiences with racism ("racialized stress")... the broader role of culture on health... understanding the functioning (not form) of autonomous social institutions within communities (e.g., ask who performs the mother role not whether the mother married or not)... the role of the dominant cultural system...


Wednesday, January 12, 2005

LHAL Pittsburgh - Module 1 Session 4

Pittsburgh Latino Health Advocacy and Leadership Program
Module 1, Session 4

Announcements – Sue M.
• Celebramos
• Photovoice
• Distribution of New Books
American Cancer Society – Patti Patterson (10:00 am – 10:30 am)
Public Health Law (11:00 am – 12:30 pm)

Readings Review
• Measuring Health Inequities – Jaime Muñoz
• Structural Influences – Fernando Cardoza
• Use of Cancer Screening Practices – Cati Bazan Arias
• Risk Factors for Invasive Cervical Cancer – Rosa Thomson (?)
• Mass Media and Social Capital – Sue Myers
• Pregnant/Post-Partum Women – Renata Taveira
• Mental Health - Vijai Vaitley
• Demographics and Lifestyle Factors to Symptoms – Susan Cardoza
• Local, State and Federal Health Agencies – Sue M.

Revision of Curriculum to Reflect - Group
• Participant Interest
• MAPP process
Health Festival Planning - Group

Session 4 Objectives
At the end of this session, participants should be able to:
• Describe origins of public health law
• Become exposed to some of the current literature on disease prevention and progression
• Understand the structure of health agencies in Pennsylvania

Latina Health in the United States
Chapter 7 Subverting Culture: Promoting HIV/AIDS Prevention*
• 18 Protective Role of Social Capital*

Public Health: What it is and How it Works
Chapter 5 Core Functions (review)
• 7 Interventions (new)*

Fifth Discipline Fieldbook
Page(s) 253-263 Balancing Advocacy and Inquiry (review)*
297-328 Building a Shared Vision (new)*

Getting Ready to Negotiate
Chapter 1 Introduction
• 2 Preparation
• 3 Interests: What do People Really Want?*

The Path of Least Resistance
Chapter 1 The Path of Least Resistance*
• 2 The Reactive-Responsive Orientation*
• 3 Creating is No Problem*

Journaling: No suggestions this cycle