Friday, July 18, 2008

David Hayes-Bautista: the end of California as we know it - Q&A

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Latino Leaders: The National Magazine of the Successful American Latino
April-May, 2003

David Hayes-Bautista: the end of California as we know it - Q&A

Jorge Ferraez

Q. Tell us about your family background.

A. I am one of the few native Angelenos that you will ever find. My parents were born in the United States. My grandparents were from Mexico, from a town called Atlautla in the state of Mexico. My grandfather was a historian, and he came here almost a century ago. He liked it and went back and brought the family over. I went through second mad third grades in Los Angeles, where I was categorized as having learning deficiencies. I didn't know this until I graduated from high school. My parents were very happy that I graduated, and then they shared the terrible secret that they had been carrying around all these years. They had been assured by my teachers and counselors that I would never graduate because I just couldn't learn.

Q. Were your studies always focused on Latino healthcare?

A. I started off my college studies in engineering. My father was an engineer, so he wanted me to be an engineer. It made sense to him. It didn't make sense to me, but I studied it for three years. It was good preparation, but ultimately I decided that I didn't want to be an engineer. I started at UC Davis studying civil engineering and then transferred to the College of Letters and Science at UC Berkeley--this was in the mid-sixties. At this point, I had heard that there were 25 Chicano students at Berkeley, as opposed to one at UC Davis. Interestingly enough, two or three of us still work together. We formed relations in the mid-sixties, and we are still working in the healthcare field together.

Q. How did you feel as a student at this time?

A. It was the early days of the Chicano movement--it was very exciting. I began to get involved with community groups in East Oakland that wanted to set up a clinic, and I was graduating from UC Berkeley and going to UC Medical Center to do my graduate work. This community group asked me if I would head up this clinic, and I said, "I am just starting school. What do I know about this?" They insisted that I was the closest thing to anybody who knew anything about healthcare. I took up the challenge, and I became the founding director of La Clinica de La Raza in Oakland between 1970 and 1974. La Clinica just celebrated its 35th anniversary last fall. It is still a major healthcare provider, but it basically started as a student-community effort. I guess that really got me interested in Latino health. Meanwhile, I was going to school at UC Medical Center in San Francisco. I did my master's and Ph.D. while I was working at La Clinica, and when I was finished with both, I asked to do some teaching at UC Berkeley and joined the faculty in 1974. In those days, there wasn't a lot of information on Latino health. In tack there was very little. And I am a quantitative person. I need to have information, data. We need to have science behind things. I began working the few data sets that were there: the census, birth files, etc. Late in 1978, people thought that because the Anglo baby boom was over that soon there would be fewer children entering high schools and, later, the University. We were being told to be prepared to downsize the University of California--that we might need to close a campus. I was a member of the Systemwide Health Sciences Committee. We have five medical schools in the UC system, and this Committee had taken this message to heart and spent a whole year talking about which medical school it would close. At that point, I said, "Don't close anything. You are assuming that everybody has the same demographic behavior as non-Hispanic whites, which is low fertility and low immigration. Look at Latinos: high fertility and high immigration. There is going to be population growth, only it will be Latino and not non-Hispanic white." Everybody said, "You're crazy. It's never going to happen." So, I got the 1980 census out and started doing my own computations. It was clear to me that there was going to be huge Latino population growth. At that point, I had the heretical notion that California would one day be half Latino. Of course, that frightened people.

Q. How did the demographic data pan out?

A. On February 5, 2003, we released a report that analyzed a master birth file, which lists every birth in California--about half a million every year. As it turns out, beginning in the third quarter of 2001 over 50 percent of all babies born in California are Latino. The Latino majority has emerged. That Latino majority is now 18 months old. What this means is that in the fall of 2006, the majority of all children entering the state's kindergartens will be Latino. In the fall of 2013, the majority of children entering the state's high schools will be Latino. In the fall of 2016, the majority of new workers entering the labor force will he Latino. By 2019, the majority of young people who have turned 18 and are eligible to register and vote will be Latino. The Latino majority is here. I saw this happening in 1975.

Q. What has caused this phenomenon?

A. It has to do with population movement within a country. In the mid-fifties as many as half a million braceros were in California each year. The total Latino population of the state was not even a million and there were almost as many braceros as there were resident Latinos. In the mid-sixties, the bracero program ended just as immigration laws changed. They changed the status of the bracero to immigrant. Changing their status from bracero to immigrant meant that they could stay here and get married, have children. As braceros they had already been here for 22 years, but couldn't stay. They began to stay all year round instead of going back to Mexico. They got married and started to have children. During the seventies most of the population growth was due to braceros changing their status to immigrants. But ever since the mid-eighties, births have been the primary factor of Latino population growth. In fact, in the last 10 years about 85 percent of Latino population growth in California has been due to births, and only 15 percent is due to immigration. Immigration to California has really fallen off tremendously.

Q. What other observations halve you, made from your data?

A. What we have seen in our data is that Latinos do have lower incomes and less education. We seem to be the urban underclass, which means high levels of labor force desertion, high levels of welfare dependency, disintegrated families, health-harming behavior, shorter life expectancy, drug use, smoking, drinking--you name it. However, as we got better data, it became clear to me that there was a paradox, the Latino epidemiological paradox.

Q. What about obesity and its effects on Latino health?

A. It is clear that a higher percentage of Latinos will be obese or overweight compared to non-Hispanic whites. Obesity can be due to either diet or lack of physical exercise, usually some combination of the two. Although, what is interesting is that for Latinos obesity does not yet translate into elevated levels of heart attack, cancer, or stroke. But yes, obesity is a problem, and I don't think we should turn our back and say, "because it doesn't translate into elevated heart disease right now, we don't have to worry about it." Yes we do have to worry about it. We have a little grace period before something will probably start to go terribly wrong.

Q. Which Latino healthcare problems need to be addressed?

A. The No. 1 problem is to resolve the Latino physician shortage. For better patient care, and secondly to get more physicians into academic medicine researching this whole Latino epidemiological paradox. Usually, Latinos are interested in finding out why, but if there are few Latino researchers, there are few people who are doing the research, which is why I cannot tell you the mechanism by which Latino culture produces this paradox. All I can tell you is that it produces it. But also better patient care: if we can be this healthy with poor access to medical care, just suppose we had decent access to medical care. We would make the United States, in terms of health, start to compete with Japan and Sweden, countries usually considered the paragons of a healthy population.
he Latino Epidemiological Paradox

A minority's health profile should be weaker than its non-Hispanic white counterpart; however, this is not the case for Latinos.

* Latinos

have about 35 percent fewer heart attacks.

have 42 percent lower cancer rate.

have 25 percent fewer strokes.

have lower infant mortality.

have lower rates of drinking, smoking, and drug use.

in California live five years longer than non-Hispanic Whites.

* Despite

low income

low education

low access to care

Dr. David Hayes-Bautista
Director, UCLA Center for the Study of Latino Health and Culture
924 Westwood Blvd., Suite 730 Los Angeles, CA 90024
Tel: (310) 794 0663
COPYRIGHT 2003 Ferraez Publications of America Corp.
COPYRIGHT 2004 Gale Group

Jorge Ferraez "David Hayes-Bautista: the end of California as we know it - Q&A". Latino Leaders: The National Magazine of the Successful American Latino. April-May 2003. 18 Jul. 2008.

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