Depression Among Low Income Latinos

A new, small study of low-income, depressed Latinos finds that those who stigmatize mental illness are less likely than others are to take medication, keep scheduled appointments and control their condition.

The findings could help physicians develop a series of question to identity patients who might especially be resistant to care and then help them understand how treatment works, said lead study author William Vega.

“Unfortunately, mental-health stigma turns out to be one of the most serious barriers for people receiving care or staying in care,” said Vega, professor of medicine and social work at the University of Southern California.

Many cultures have stereotypes about depression and mental illness, he said, with some viewing it as something that will brand a family for generations. Latinos, in particular, value resilience and think, “it’s a cultural value to be able to handle your own affairs,” he said. “If you can’t, it implies that you’re weak.”

While it might not be surprising that Latinos stigmatize mental illness, “like many things, it’s all anecdotes and innuendo until you do something more solid, like a research study, and start finding out what the issues are,” said Vega, who worked on the study with fellow researchers while at the University of California at Los Angeles.

In the new study, published in the March/April issue of the journal General Hospital Psychiatry, researchers surveyed 200 poor, Spanish-speaking Latinos in Los Angeles. They all had visited local primary care centers; 83 percent were women. All had shown signs of depression in an initial screening.

Another screening found that all but 54 of the 200 individuals were mildly to severely depressed. Researchers deemed 51 percent as those who stigmatize mental illness, based on responses to questions about things like the trustworthiness of a depressed person.

The researchers found that those who stigmatized mental illness were 22 percent less apt to be taking depression medication, 21 percent less likely to be able to control their depression and about 44 percent more likely to have missed scheduled mental-health appointments.

The findings “shows evidence that stigma does exist, and it’s related to things that are important to provide as part of proper treatment,” Vega said.

Jamie Walkup, a Rutgers University associate professor of psychology who studies mental health and stigma, said the key is to find ways to “push back against these negative ideas, hoping that a person with depression will no longer let an aversion to being a person with depression stop them from doing what they may need to do to get help.”

It might be worth asking, he said, “whether it may sometimes make more sense to switch gears with a patient who, for whatever reason, finds it intolerable to think of themselves as having depression.”

In such cases, doctors could find other ways to work with these patients without insisting that they acknowledge their diagnosis.

Source: Vega W, Rodriguez MA, Ang A. Addressing stigma of depression in Latino primary care patients. General Hospital Psychiatry 32(2), 2010.


Spanish-Language TV Commercials Contributing to Latino Youth Obesity, Says Study

The rising obesity epidemic among Latino youth may be traceable to the sheer volume of Spanish-language fast-food television commercials, according to a study in the Journal of Pediatrics. The research was conducted by pediatricians from the Johns Hopkins Children’s Center.

"While we cannot blame overweight and obesity solely on TV commercials, there is solid evidence that children exposed to such messages tend to have unhealthy diets and to be overweight," says study lead investigator Darcy Thompson, M.D., M.P.H., a pediatrician at Hopkins Children’s. Past research among English-speaking children has shown that TV ads influence food preferences, particularly among the more impressionable young viewers.

Programming during the heaviest childrens’ viewing hours on Univision and Telemundo, the two leading Spanish-language channels in the US, was monitored. (These channels reach 99% and 93% of US Latino households). The two or three food commercials aired each hour specifically targeted children, with nearly 50% of commercials advertising fast food, soda and other high sugar content drinks.

The researchers recommend limiting young children’s TV viewing to two hours a day or less, with parental guidance on healthy diet and food choices. Children under 2 should not be allowed to watch any TV at all, advise pediatricians.

Other recommendations include advising Latino childrens’ pediatricians of their parents’ heavy exposure to food advertising; and following the lead of many European countries in urging public health authorities to appeal to policy makers to limit food advertising to children.

The Journal of Pediatrics, DOI: 10.1016/j.jpeds.2007.09.011.