Beans for Life

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SEPTEMBER 8, 2003

Beans for Life

If a pregnant woman wears red underwear with a safety pin tucked
into it, will it make her newborn child healthier? No
self-respecting physician would say so. But the possibility may be
worth considering, thanks to a phenomenon scientists call the
"Latino health paradox."As you might suspect, people who don't have regular access to
medical care tend to end up sicker than people who do, since it's
through regular checkups that you're most likely to catch things
like cancer or heart disease before they kill you. And, naturally
enough, people who don't have health insurance tend to be sickest
of all. So, because Hispanics in the United States are far more
likely to be uninsured than the average American, it ought to follow
that they're also much less healthy than the average American. But
that's the paradox: They aren't. Quite the contrary: Hispanics in
the United States are healthier than the rest of the country. Far
healthier, in fact. According to surveys by David Hayes-Bautista, a
professor at ucla who has conducted some of the most authoritative
work on the matter, the rate of heart disease among California
Latinos is actually lower than for the population as a whole--this,
despite the fact that Latinos are more likely to be overweight and
smoke (both major risk factors for heart disease). Latinos are also
less likely to have strokes or suffer from cancer. By better
avoiding heart attacks, strokes, and cancer--the three leading
causes of death in the United States--Latinos enjoy unusually long
life expectancies. A Latina woman living in the United States, for
example, will probably live longer than the average American
female.

What does this have to do with wearing red underwear when you're
pregnant? Well, during lunar or solar eclipses, expectant mothers
from Mexico (and some other parts of Latin America) frequently wear
bright red panties with a safety pin tucked through them, the
result of a tradition dating back to Aztec days. Seems the Aztecs
(or maybe the Mayans, depending on whose research you believe)
thought the eclipse released energy that could cause birth defects.
To ward off its power, pregnant women wouldn't go outside without
tying a red string around their waists with an arrowhead attached
to it. Eventually, as superstition gave way to comfort, the string
and arrowhead evolved into a pair of panties with a safety pin
attached. And wouldn't you know it? Hispanic women are less likely
to have low-birthweight babies than the average American, even
though the average American gets much more sustained--and much
better quality--medical care during pregnancy.

Of course, nobody seriously thinks this has anything to do with
underwear, safety pins, or, for that matter, the alignment of the
solar system. But something about being Latino obviously makes you
relatively healthy, at least when it comes to heart disease and
certain types of cancer. Genetics could play a role, given the
well-known links between ethnicity and disease. (Think African
Americans and sickle-cell anemia or Jews and Tay-Sachs disease.)
But the Latino health "advantage" seems to dissipate over time; the
longer a Latino has been in the United States, the more likely he
or she is to suffer from the same health problems as other
Americans. As a result, most researchers believe some cultural
factor must be at work, too--i.e., something that has to do with
growing up in a Latino family or community and engaging in its
customs, rather than having a specific genetic trait. The most
likely candidate seems to be diet, perhaps something as simple as
eating a lot of beans, which are high in fiber and other nutrients
linked to better coronary health.

Unfortunately, not everybody is so eager to unravel this mystery.
Hayes- Bautista, for one, says that liberal activists frequently
try to downplay findings about Latinos' good health, which they
fear could undercut arguments for expanding health coverage to the
uninsured (who, in Southern California, are predominantly
Hispanic). It's not an implausible assessment, I suppose, given the
difficulty of rallying support for government-subsidized health
insurance; but there have to be better ways of helping the uninsured
than covering up information that might make all of us healthier,
particularly since healthier people means less spent on health
care, which means more financial resources for everybody.

Alas, a much more serious political challenge to studies of ethnic
health has emerged this year, in the form of Proposition 54. The
measure, which will appear on the same October ballot with the
proposed recall of Governor Gray Davis, would forbid the state--or
any institution that relies upon state funding--from collecting
information sorted by race. Although the initiative does contain an
exception for the collection of certain medical information, it's
so narrowly defined that it would apply mainly to clinical trials of
drugs, not the sort of generalized population data upon which
public health studies rely. The result, according to the physicians
rallying against it, would be sheer havoc. "It would stop my
research dead in its tracks," says Esteban Burchard, a
physician-researcher at the University of California, San
Francisco, who specializes in the effects of asthma on the Hispanic
population.

The mastermind behind the initiative is Ward Connerly, the same man
who six years ago organized the successful California initiative
banning affirmative action in state-funded institutions. Connerly
sees this latest ballot measure, which he calls the "racial
privacy" initiative, as merely the next step to move California
"beyond race--to stop living on the hyphen." Its approval, Connerly
told Time magazine, could eventually lead to a nationwide backlash
against "shuffling people into little boxes and tables." Maybe. Or,
maybe because it will eliminate data collection about (among other
things) cancer clusters that affect particular ethnic groups, more
people will wind up in a different sort of box--the oblong kind.
When it comes to letting politics get in the way of good science,
sometimes the right and left have more in common than meets the
eye.

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